Migraine: Symptoms, Causes & Risk Factors, Complications, Diagnosis, Treatment & Prevention

Migraine is a kind of strong throbbing or pulsating headache on one side of the head. It is usually accompanied by nausea, vomiting and an increase in light and sound sensitivity. Migraine attacks can last anywhere from hours to days, and the pain may be severe enough to prevent you from going about your usual activities. A migraine can be associated with a symptom known as an aura that might appear before or with a headache in some people. Visual problems, such as flashes of light or blind spots, or other problems, such as tingling on one side of the face, arm, or leg, and difficulty speaking, can all occur during a migraine. Migraine is a special kind of headache. Severe cases can have a negative impact on a person’s day-to-day life, hindering their ability to work or study. 

It affects different people differently, with variable triggers, severity, symptoms, and frequency. Some people have many episodes per week, while others have them occasionally. Medications can help prevent and alleviate the pain of some migraines. The best treatment is usually a combination of medications with lifestyle adjustments.

Symptoms

Migraines can advance through four stages: prodrome, aura, attack, and post-drome, and can affect teenagers as well as adults. A day or two before a migraine, you may notice subtle changes that indicate an impending migraine, such as:

1. Constipation
2. Changes in mood, ranging from sadness to exhilaration
3. Hunger pangs
4. Stiffness in the neck
5. Increased urination
6. Fluid retention
7. Excessive yawning
8. Visual phenomena such diverse shapes, bright spots, or flashes of light
9. Stitches and pins and needles in the arms or legs
10. Weakness or numbness on one side of the body or in the face
11. Difficulty speaking
12. Pain on one side of the head is common, but it can also occur on both sides.
13. Throbbing or pulsing pain
14. Light, sound, and sometimes smell and touch sensitivity
15. Vomiting and nausea

Triggers

1. Many women develop headaches when their estrogen levels change, such as before or during menstrual cycles, pregnancy, or menopause.
2. Hormonal drugs, such as oral contraceptives, might aggravate migraines as well. However, some women report that using these drugs decreases their migraines.
3. Drinks: Alcohol, particularly wine, and too much caffeine can also trigger migraine.
4. Stress: Migraines can be brought on by stress.
5. Stimuli to the senses: Migraines can be induced by bright or flashing lights, as well as loud noises. Migraines can be caused by perfume, paint thinner, secondhand smoke, and other strong odors.
6. Sleep patterns shift. Sleep deprivation or more sleep can cause migraines in certain people.

Causes

While the exact etiology of migraines is unknown, genetic and environmental factors appear to play a role.

1. The trigeminal nerve which carries sensory messages from the face and helps in the functioning of the jaw has been implicated in migraine.
2. Imbalances in brain chemicals, such as serotonin, which helps regulate pain in the nervous system, could also have a role. The function of serotonin in migraines is being discovered by scientists. 
3. Other neurotransmitters, such as calcitonin gene-related peptide also play a role in migraines (CGRP).

Risk Factors

1. Family history of migraines: If you have a family member who suffers from migraines, you are more likely to develop them.
2. Age: Migraines can start at any age, although they most commonly begin at puberty. Migraines tend to peak in the 30s, and then steadily lessen in severity and frequency over the next decades.
3. Sex: Migraines are three times as common in women as in men.
4. Hormonal shifts: Migraine headaches can occur just before or shortly after women start menstruating. They can also occur during pregnancy and menopause. Migraines usually get better after menopause.

Complications

Complications of migraine occur rarely. They are:

1. Stroke: Patients with migraine have a small chance of developing a stroke
2. Epilepsy: An episode of migraine may rarely result in a seizure
3. Some episodes or migraine do not respond to treatment and can persist without relief for very long durations.

Diagnosis

Migraine is a clinical diagnosis that a doctor will make based on your symptoms. However, imaging may be performed in those who do not respond to treatment to look for other causes of headache.

1. Magnetic resonance imaging (MRI): MRI scan creates comprehensive images of the brain and its arteries using a high magnetic field and radio waves.
2. CT scan (computerized tomography): CT scan induces comprehensive cross-sectional images of the brain using a succession of X-rays. 

Treatment

The goal of migraine treatment is to alleviate symptoms and avoid future attacks. There are two kinds of migraine medications:

1. Analgesics (pain relievers): These medications, often a part of acute or abortive treatment, are administered during migraine attacks and are intended to relieve symptoms.
2. Medication for prevention: To minimize the severity or frequency of migraines, these medications are used on a regular basis, often daily.

The frequency and severity of headaches, coupled with whether or not they are accompanied with nausea and vomiting, the degree of disability they cause and any other medical issues experienced are all factors that influence treatment options.

Prevention

1. Sleep: Every day, including weekends and holidays, go to bed and wake up at the same hour. A headache might be triggered when you fall asleep at unusual times or when you receive too much or too little sleep.
2. Exercise on a regular basis: You may be tempted to avoid physical activity for fear of triggering a migraine. For some people, overdoing a workout might cause a headache, but evidence shows that regular, moderate aerobic activity can help migraine episodes be shorter, less painful, and less frequent. It also aids in the management of stress, which can be a trigger.
3. Eat at regular intervals: A migraine might be triggered by a dip in blood sugar, so do not miss meals. Drink plenty of water to avoid dehydration, which can also set off an episode.
4. Keep stress to a minimum. Stress is a typical cause of anxiety. Allowing some time each day to unwind may help alleviate stress and also manage anxiety.
   1. Relax by listening to soothing music.
   2. Practice yoga and meditation
   3. Acupuncture
   4. Massages
   5. Talk therapy 

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