Migraine: Symptoms, Causes, And Management

Neurology Hospital in Old Airport Road Bangalore

Introduction

Migraine is a neurological condition that causes severe, debilitating headaches. It significantly affects the quality of life of the patients. It usually occurs in phases and lasts for a few hours to days. Its most common symptoms include throbbing headache, light sensitivity, and vomiting. The symptoms vary in terms of severity, frequency, and period. Different patients have different migraine triggers. The condition most commonly develops in people between 18-44 years of age. However, it can develop in people of all ages, including children.

Approximately 1 billion people globally suffer from this condition. It is the 3rd most prevalent disease and 6th most disabling illness. Women are at three times more risk for developing this condition. 

Stages 

Symptoms occur according to the phases of the migraine. About 30% of the patients with migraine experience the following migraine phases:

  • Pro-drome: It is a premonitory or preheadache phase. This phase may last for a few hours or a few days. The symptoms of this phase include neck stiffness, fluid retention, constipation, depression, frequent yawning, and increased urination.

  • Aura: The aura may occur just before or during a migraine. Most aura symptoms are related to vision; however, patients may also have other symptoms including bright spots or flashes of light, reversible loss of vision, problem in speaking, pricking sensation, and weakness.

  • Headache: This phase of migraine usually lasts 4 hours to 72 hours in the absence of medical intervention. The patients during this stage may experience a pulsating or throbbing headache, nausea, and vomiting.

  • Post-drome: This is the phase after a migraine attack. The patients are confused, drained, and unable to work during most of the day.

Types 

There are several types of migraines. Some of them are:

  • Migraine with aura (complicated migraine): This type of migraine occurs with aura. Approximately 15-20% of the patients have a complicated migraine.

  • Migraine without aura (common migraine): In this migraine, the patients do not experience a warning aura before the beginning of the migraine headache. However, the symptoms are similar to that of migraines with aura.

  • Migraine without head pain: This migraine is also known as acephalgic migraine or silent migraine. 

  • Hemiplegic migraine: In hemiplegic migraine, the patients experience numbness, vision changes, or weakness at one side of their body. 

  • Retinal migraine (ocular migraine): The patient with retinal migraine has partial, temporary, or complete vision loss in one of the eyes. Patients with this migraine should undergo comprehensive evaluation to rule out any serious medical issue. 

  • Chronic migraine: Patients with chronic migraine experience headaches for at least 15 days a month. The frequency of migraines may change along with a change in severity. Such patients require headache pain medications for 10-15 days a month to manage the symptoms.

  • Migraine with brainstem aura: Such patients have other symptoms, such as vertigo, vomiting, ringing of the ears, slurred speech, loss of balance, and double vision, before the migraine headache.

Causes And Risk Factors

The exact cause of migraines remains unknown. Environmental and genetic factors may play a role in migraines. Serotonin, a brain neurotransmitter that regulates pain, may also involve in migraines. Brainstem alterations along with its trigeminal nerve interaction may also cause migraines. 

Some important risk factors include:

  • Family history of migraine

  • Gender, as women are more likely to have a migraine

  • Age, as symptoms are most severe during the 30s and severity gradually declines with age

  • Alternation in hormonal levels during menstruation

Triggers

The triggers may from person to person and may include:

  • Excessive alcohol or caffeine consumption

  • Rigorous physical exertion

  • Stress

  • Alteration in weather conditions

  • Medications, such as oral contraceptives

  • Altered sleep routine

  • Strong smell

  • Strong light

Diagnosis 

The neurologist in Bangalore at Manipal Hospitals may implement the following techniques to diagnose migraine:

  • Comprehensive symptomatic evaluation: The doctor evaluates the health history and the family history of the patient and also obtains detailed information about the severity, frequency, and period of symptoms.

  • Blood tests: The doctor may advise the patient to undergo a blood test to determine inflammation.

  • Imaging tests: The neurologist may also recommend the patient to undergo an MRI or CT scan to rule out the presence of other neurological conditions.

Management 

There are several options for managing the symptoms of migraines. These are:

  • Pain management medications: The doctor may prescribe pain management medicines to patients for relieving pain and drugs to manage nausea and vomiting.

  • Preventive medications: The doctor may also prescribe medicines to reduce migraine frequency in patients including anti-seizure drugs, blood pressure-lowering drugs, Botox injections, anti-depressants, and CGRP monoclonal antibodies.

  • Lifestyle and Home remedies: Several lifestyles and home remedies may help manage the symptoms including relaxation techniques, regular exercise, adequate hydration, sound sleep, and a schedule eating routine.

  • Alternative therapies: These may include meditation and yoga, biofeedback, acupuncture, cognitive behavioural therapy, and herbal supplementation. 

Visit the nearest neurology hospital in Bangalore for migraine treatment in Old Airport Road, Bangalore.

 

Dr. Veena Vedartham

Associate Consultant - Neurology

Manipal Hospital, Old Airport Raod, Bangalore

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