What is Headache/Migraine?
Headache is one of the most common complaints of pain the world over. Although it can occur due to various reasons, migraine is the most common reason for a headache. It can be disabling and prompt you to look for an immediate rest. Migraine is experienced by 17% of men and 6% of women, at least once in their life.
In some cases, the pain may come with a warning, such as flashes of light, a tingling sensation in arms and legs or blind spots. Migraine can also accompany other signs, such as nausea, vomiting and extreme sensitivity to sound and light.
Pain management has been one of the most discussed terms in medicine and physical sciences for the last decade and several ways to reduce the migraine pain has also been discovered. However, no exact cure for migraine is yet known.
Symptoms of Headache/Migraine
The common symptoms of migraine include one, some or all of the following
• A pain that is moderate to severe. The pain may be limited to one side of the head or may affect both sides
• Pulsating or throbbing sensation accompanied with head pain.
• Severe pain that interferes with your day to day schedule
• Feelings of nausea with or without vomiting
• Hyper -sensitivity to light and sound
• Pain that is related with physical activity. With increasing stress pain increases.
An episode of migraine may last from four to seventy two hours if left untreated. However, the nature of pain may differ from one person to the other. Some people also feel an aura before the onset of the pain.
Diagnosis of Headache/Migraine
Diagnosis of migraine usually requires a close inspection of the medical history and symptoms of the patient. There are however various other tests available to detect migraine, including computerized tomography (CT) scan, Magnetic Resonance Imaging (MRI) and Spinal tap.
CT Scan: This procedure uses a series of computer directed X-rays to determine any underlying medical conditions, such as brain tumors, infections and other defects which may be responsible for the headache.
Magnetic Resonance Imaging (MRI): Radio waves are used in this process for getting a cross-sectional view of the brain. It may detect problems, including tumors, aneurysms, neurological diseases, strokes, and other brain abnormalities.
Spinal Tap: In this process, a thin needle is inserted between the two vertebrae in the lower back to collect a sample of cerebrospinal fluid (CSF). This fluid can be analyzed in the laboratory for various brain abnormalities. This process is especially useful if the underlying condition is believed to be meningitis or subarachnoid hemorrhage.
Causes of Headache/Migraine
Physically, the researchers have found that during a pain the serotonin level of brain drop leading to release of neuropeptides by the trigeminal nerves. These neuropeptides travel to the outer layers of the brain where they cause inflammation and dilation of the blood vessels. This causes the pain or headache.
However there are some triggers which lead to migraine attack. These are the following;
1. Hormonal changes, such as fluctuations in the estrogen may trigger headache in many women. Many women complain about headache immediately after their menstrual periods which correspond to drop in estrogen level. Contraceptives and other hormonal change medications may also worsen migraine conditions.
2. Foods: foods may play an important role in triggering migraine. Some foods, such as alcohol, (beer and red wine); aged cheeses; chocolate; fermented, pickled or marinated foods may contribute to the onset of migraine. Moreover aspartame; certain seasonings; and many canned and processed foods, caffeine overuse and monosodium glutamate may also start migraine. Skipping meals may also sometimes cause migraine.
3. Stress and sensory stimuli may also trigger migraine. Overwork leading to stress is a leading cause of occasional migraine. Bright lights, noise and unusual smells may also cause migraine and headache.
4. Change in the sleep pattern, physical factors, such as intense exertions and changes in weather or surrounding conditions may also lead to migraine.
5. Some medicines are also responsible for the onset of migraine.
Types of Headache/Migraine
1. Abdominal Migraine: This type of migraine is characterized by periodic episodes of moderate to severe midline abdominal pain lasting for 1 to 72 hours.
2. Basilar Migraine: This type of migraine accompanies aura. The aura may include dizziness, confusion, slurred speech, double vision, loss of balance, hearing changes and tingling on both sides of the body etc.
3. Complicated Migraine: This type of migraine is referred to prolonged aura symptoms that last for hours to days or opthalmoplegic migraine. In case of opthalmoplegic migraine patients develop a partial or complete paralysis of the nerves that are required for eye movement.
4. Cyclic migraine symptom: In this type, patient suffers ten or more attacks of migraine in a month. Moreover, typical migraine symptoms remain prevalent in this type of migraine.
5. Hemiplegic migraine: In this type of migraine, the patient suffers from temporary motor paralyses or disturbances in sensory nerve functioning.
6. Nocturnal Migraine: This type of migraine attacks usually occur at the night or early morning hours. Reasearch suggests that this kind of migraine is due to changes in neurotransmitters.
7. Opthalmoplegic migraine: This type of migraine is limited to the surroundings of the eyeball and nearby areas. The pain may sustain from few days to months.
Treatment of Headache/Migraine
The medications that are used to treat migraine can be divided into two types: pain relieving medications and preventive medications.
Pain relievers: The major medications that act as pain relievers includes Non steroidal anti inflammatory drugs (NSAID) such as ibuprofen (Advil, Motrin, others) or aspirin. Triptans, including Sumatriptan (Imitrex), rizatriptan (Maxalt), almotriptan (Axert), naratriptan (Amerge), zolmitriptan (Zomig), frovatriptan (Frova) and eletriptan (Relpax) may also act as pain relievers. Before triptans were discovered, Ergots were the main drugs for relief from pain. Some anti nausea medications, such as metoclopramide (oral) or prochlorperazine (oral or rectal suppository) may also act as pain relieving medications. Medications that include narcotics (codeine) are also used as pain relievers in many cases.
Preventive medications: These may include beta blockers, calcium 
channel blockers (Calan, Isoptin) and antihypertensive medications lisinopril (Prinivil, Zestril) are also used as preventive medications for migraine. Antidepressants, such as amitriptyline, nortriptyline (Pamelor) and protriptyline (Vivactil) can also be used a spreventive medication.Anti seizure drugs used for epilepsy, such as divalproex sodium (Depakote) and topiramate (Topamax) are also useful, sometimes, as preventive medicines for migraine.
Cyproheptadine and Botulinum toxin type A (Botox) also show considerable preventive actions against migraine.
Living with Headache/Migraine
Living with migraine is a bit tricky since it originates in the brain which can hardly be controlled. It is necessary to keep eye on the triggers which may cause migraine. Taking the medications as advised by the physicians is also necessary. This not only keeps the pain under tolerable limit but also acts as a protection from relapses or frequent attacks.
Prevention of Headache/Migraine
Prevention of migraine can be a burdensome task due to the vastness and differences in natures of the types of migraines. Regular exercises can do a lot as they keep the immune and metabolic processes intact, thereby providing preventive measures from migraine. The patients should also avoid the triggers which cause migraine. The triggers are often found to be behind the onset of the headache due to migraine. Reduces amount fo estrogen in the body also seem to show considerable relief from migraine.
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