What is a migraine headache?
A migraine headache is a primary headache disorder
that effects approximately 12% of the population. It is a headache that tends to
recur in an individual and is moderate to severe if left untreated. It can be
one sided, throbbing and aggravated by routine physical activity. It can be
associated with light and sound and even smell sensitivity and many patients
will become nauseated with it.. In a minority of patients there can be visual or
sensory changes before, during or after the headache, known as auras.
Who is affected by migraines?
The National Headache Foundation estimates that
nearly 30 million Americans suffer from migraines. Migraines occur about three
times more frequently in women than in men. Each migraine can last from four
hours to three days. Occasionally, it will last longer.
What causes a migraine?
The exact causes of migraines are unknown,
although they are related to changes in the brain as well as to genetic causes.
People with migraines may inherit the tendency to be affected by certain
migraine triggers, such as fatigue, bright lights, weather changes and others.
For many years, scientists believed that migraines
were linked to the expanding (dilation) and constriction (narrowing) of blood
vessels on the brain’s surface. However, it is now believed that migraine is
caused by inherited abnormalities in certain areas of the brain.
There is a migraine "pain center" or generator in the
mid-brain area. A migraine begins when hyperactive nerve cells send out impulses
to the blood vessels leading to the dilation of these vessels and the release of
prostaglandins, serotonin and other inflammatory substances that cause the
pulsation to be painful.
Certain brain cells that use serotonin as a messenger
are involved in controlling mood, attention, sleep, and pain. Therefore, chronic
changes in serotonin can lead to anxiety, panic disorder, and depression.
What triggers a migraine?
Many migraines seem to be triggered by external
factors. Migraine sufferers can help the physician identify these triggers. Possible triggers include:
- Emotional stress is one of the most common triggers of migraine
headache. Migraine sufferers generally are highly affected by stressful
events. During stressful events, certain chemicals in the brain are released
to combat the situation (know as the "flight or fight" response). The
release of these chemicals can provoke migraine. Repressed emotions
surrounding stress, such as anxiety, worry, excitement and fatigue can
increase muscle tension and dilated blood vessels can intensify the severity of migraine.
- Sensitivity to specific chemicals and preservatives in foods.
Certain foods and beverages, such as aged cheese, alcoholic beverages, and
food additives such as nitrates (in pepperoni, hot dogs, luncheon meats) and
monosodium glutamate (MSG, commonly found in Chinese food) may be
responsible for triggering up to 30% of migraines.
- Caffeine. Excessive caffeine consumption or withdrawal from caffeine
can cause headaches when the caffeine level abruptly drops. The blood
vessels seem to become sensitized to caffeine, and when caffeine is not
ingested, a headache may occur. Caffeine itself is often helpful in treating acute migraine attacks.
- Changing weather conditions such as storm fronts, barometric
pressure changes, strong winds or changes in altitude
- Menstrual periods
- Tension
- Excessive fatigue
- Missing meals
- Changes in normal sleep pattern