This Article is About
migraine headaches
visual disturbances
female population
medical disorder
nausea and vomiting
Migraine Headaches: Symptoms, Signs And Management
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Migraine headache in its classical or typical form is characterised by episodes of headache which are paroxsymal (of sudden onset), unilateral and accompanied by visual disturbances. It is often associated with dizziness, nausea and vomiting.

It is of utmost importance to indicate that although migraine is often referred to as hemicranial headaches, because it typically affects one side of the head, this is not always the case as there are many patients who experience a form of migraine with headaches which are bitemporal. In such cases of bitempooral migraine headaches, the characteristic features are the episodic, paroxsymal and pulsating (or throbbing) nature of the headaches. The visual disturbances may also not be present.

It is a fairly common medical disorder, can be quite debilitating in its severe forms and is more prevalent in the female population.

The mechanisms of the disease are not yet fully understood. However, it has been clearly demonstrated that during migraine attacks, at the onset there is an initial decrease in cerebral flow due blood vessel constriction or spasm followed by vasodilatation. Headaches are chiefly due to the dilation of blood vessels by the trigeminal nerve.

There are different forms of migraine headaces and are classified chiefly by the symptoms and signs or clinical manifestations. These forms include:

1. Classical migraine: these headaches are paroxsymal, unilateral and of a throbbing nature with visual disturbances and sensory symptoms which may precede or accompany the headaches.

2.Common migraine: these are also episodic and unilateral with chief symptoms being frontal headcahes, photophobia, nausea and vomiting. Vomiting usually provides some temporary relief or reduction in the intensity of the headaches. For this reason, the patients often induce vomiting.

3.Hemiplegic migraine: this type is type is the most debilitating and is characterised by headaches which are severe, lasts for days (sometimes days) but the distinctive feature, as the name suggests, is the hemiplegia which accompany or may develop after the headaches, but recovers slowly over hours. Hemiplegia ( hemiparesis) is paralysis or loss of motor function of one side of the body.

4.Basilar migraine: this is characterisd by occipital headaches (at the back of the head) and are preceded by dizziness, diplopia (double vision), mild speech or other sensory disturbances.

Because of the severity of migriane headaches and their debilitating nature, an important aspect in the management of patients is the identification and avoidance of the precipitating or trigger factors. These vary with individual patients. However, there are a wide range of common precipitating or trigger factors for migraine headcahes.

The common trigger factors include:

1.Dietary: dairy products, especially cheese, citrus products especially oranges, chocolates and products containing caffeine, like coffee, tea and some sodas. Hunger or long intervals between meals also precipitate attacks of migraine. Sweets can provide relief for some patients during an attack, but for others they act as a main trigger factor.

2. Environmental: bright lights, noise and vibrations, strong or pungent chemicals, sudden changes in weather patterns or extremes of heat or cold, areas of reducued oxygen concentration like crowded rooms and high altituteds.

3. Stress: worry, tension in relationhips, (family,friends, spousal or at the workplace), fatigue, lack of proper sleep, overworked, have been well documented factors.

4. Menstrual cycles: women are more affected by the disease than men and the monthly cycle for many is the main trigger. The menopausal changes that women undergo in midle age for many sometimes is the main factor which precipitated the onset of the disease.

5. Medications: these vary widely with individual patients and include those to which they have an allergy or intolerance. For example, a number of drugs used to treat high blood pressure, have been known to precipitate migraine attacks.

The treatment of migraine headcahes involve first and foremost a precise diagnosis of the disease, which form, identification of the trigger factors in each specific case, their avoidance, the appropriate lifestyle changes or modifications and the use of a number of medications. Other medical disorders like depression or uncontrolled hypertension whic can also act as a trigger also need also to be treated.

Commoly used medications are analgesic for pain relief, anti-emetic drugs for nausea and vomiting. Drugs which act on the blood vessels, hypotensive drugs such as the beta-blockers and calcium channel blockers and those which act on the nerve endings, for example the trycyclic antidepressants are generally used with good effect.

It is of utmost importance to emphasise that in any situation of persistent headaches there should be a thorough investigation of patients which may have to involve the different medical specialities. Even in cases of a correct and precise diagnosis of migraine based on the typical clinical symptoms and signs, the differential diagnosis of more serious medical disorders like aneurysms of blood vessels, brain tumors or an impending stroke must always be considered.

Street Talk

Thank you for the great medical information....well written and easy to understand for those who need laymen's terms and also very medical for those of us who do understand...Please do you have any information for those of us who get just the aura of bright lights in geometrical shapes flashing in our eyesight? This is followed by no headache. Magnesium supplementation seems to make it go away...

  about 1 decade ago
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