Mar 19, 2021

Understanding Migraine - Periodicity, Triggers, Stages, Symptoms, Diagnosis, Causes and Risks

- By Dr. Mary Alphonse



What is Migraine?

Migraine is a primary headache disorder characterized by recurrent headaches with varying intensity, often accompanied by nausea and sensitivity to light and sound.  Migraine headache is a complex condition of the nervous system which are sometimes preceded by warning symptoms, "an aura". Typically, the headaches affect one half of the head, are pulsating in nature.


What is the Periodicity of Migraine ?

Migraines typically last anywhere from four to 72 hours. The frequency of migraines differs for everyone, but usually, there would be two to four headaches per month. In some, the migraines may occur every few days, while others may get them once or twice a year.


What are the Triggers?

  • Triggers include hormonal changes, certain food and drinks, stress, exercise and strong stimuli like loud noises or strong smells
  • The pain in generally made worse by physical activity
  • Other triggers include: Sleep deprivation, schedule changes, weather changes, hunger, dehydration, menstruation, alcohol or wine, medications such as vasodilators, caffeine
  • A trigger may be encountered up to 24 hours prior to the onset of symptoms.


What is an Aura? 

  • About one-thirds of people experience sensory warning symptoms which is usually a short period of visual disturbance which signals that the headache will soon occur. 
  • These early-warning symptoms may include flashes of light, blind spots, zig-zag lines, temporary loss of vision, or tingling in the arm or leg.


What are the four Stages of Migraine?

The prodrome, which occurs hours or days before the headache. 

The aura, which immediately precedes the headache. Aura gradually builds up over several minutes and lasts for 20 to 60 minutes.

The pain phase, also known as headache phase lasts anywhere from four to 72 hours with a throbbing or pulsating pain.

The postdrome, the drained out experience following the end of a migraine attack.


What are the Symptoms of Migraine?

The symptoms for the two most common forms of migraine are as follows.

Migraine with aura: 

In Classic Migraine, you can observe the below symptoms with an aura 10 to 30 minutes before an attack:

  • Seeing flashing lights, zigzag lines, or blind spots
  • Numbness or tingling in the face or hands
  • Altered sense of smell, taste, or touch
  • Feeling lightheaded


Migraine without aura: 

In Common Migraine, you do not have an aura, but have all typical symptoms of an attack:

  • Throbbing or pulsating headache which gets worse after a physical activity
  • Sensitivity to light, noise, and smell
  • Nausea and vomiting
  • Loss of appetite
  • Feeling warm or cold
  • Fatigue
  • Dizziness
  • Pale skin


How to Diagnose a Migraine? 

The diagnosis of migraine is based on the signs and symptoms, according to the International Headache Society, can be made according to the "5, 4, 3, 2, 1 criteria":

Five or more attacks—for migraine with aura, two attacks are sufficient for diagnosis.

Four hours to three days in duration

Two or more of the following:
  • Unilateral (affecting half the head)
  • Pulsating
  • Moderate or severe pain intensity
  • Worsened by or causing avoidance of routine physical activity

One or more of the following:
  • Nausea and/or vomiting
  • Sensitivity to both light (photophobia) and sound (phonophobia)

  • If someone experiences two of the following: photophobia, nausea, or inability to work or study for a day, the diagnosis is more likely. 
  • In those with four out of five of the following: pulsating headache, duration of 4–72 hours, pain on one side of the head, nausea, or symptoms that interfere with the your life activities, then the diagnosis is 90% of times a migraine.


What are the Causes of Migraine?

Though migraine causes aren't understood, genetics and environmental factors appear to play a role.

Migraines may be caused by changes in the brainstem and its interactions with the  trigeminal nerve, a major pain pathway.

Imbalances in brain chemicals including serotonin, which helps regulate pain in your nervous system may also be involved.

Serotonin levels drop during migraine attacks. This may cause your trigeminal nerve to release substances called neuropeptides, which travel to your brain's outer covering (meninges). The result is migraine pain. 

  • Other neurotransmitters play a role in the pain of migraine, including calcitonin gene-related peptide (CGRP).


Who Risk having Migraine?

If you have a family member with migraines, then you have a good chance of developing them too.

Migraines can begin at any age, usually the first occurs during adolescence. Migraines tend to peak during your 30s, and gradually become less severe and less frequent in the following decades.

Women are three times more likely to have migraines. Headaches tend to affect boys more than girls during childhood, but by the time of puberty and beyond, more girls are affected.

Hormonal changes. If you are a woman who has migraines, you may find that your headaches begin just before or shortly after onset of menstruation.

They may also change during pregnancy or menopause. Migraines generally improve after menopause.

Migraines often return during the postpartum period.


What are the Complications?

Sometimes your efforts to control your migraine pain cause problems, such as:

Abdominal problems. Certain pain relievers, may cause gastric complications such as abdominal pain, bleeding, ulcers and other complications, for a long period of time.

Medication-overuse headaches. Rebound headaches are caused by over use of headache medication.

Serotonin syndrome. Serotonin syndrome is a rare condition that occurs when your body has too much of the nervous system chemical called serotonin. 


How Homeopathy helps in Migraine?

  • Homeopathy for migraine is based on individualized case study of your history as the symptoms are not the same in each and every one. 
  • Homeopathic medicines can be helpful for migraines with treatment towards cure. 
  • Recurrent migraines require the attention of a Homeopathic Physician who analyses the condition according to the individualized case study based on which is your constitutional remedy best suited to you is prescribed.


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