Migraine is a common type of headache that causes intense throbbing or pulsing sensation on one area of the head. The pain may last for hours or even days and is usually accompanied by symptoms such as vomiting, nausea or sensitivity to light. Some migraines are preceded by sensory warning symptoms (aura), such as blind spots, flashes of light or tingling in the leg or arm.
Much about the cause of migraines is yet to be fully understood. But most medical experts agree that migraines may be caused by changes in the brain and its interactions with the trigeminal nerve, a major pain pathway within the brain. Imbalances in brain chemicals such as serotonin, which helps regulate pain in the nervous system, could be involved.
Researchers continue to study the role of serotonin in migraines. It has been observed that the levels of serotonin drop during migraine attacks. The drop in serotonin levels may cause the trigeminal system to release substances called neuropeptides which travel to the brain’s outer covering (meninges). The result is a sharp headache pain.
Vision disturbances, or aura, are considered a “warning sign” as an initial symptom of an impending migraine. The aura affects both eyes and may involve having eye pain, blurred vision, seeing stars, zigzag lines or tunnel vision. Other warning signs include yawning, lack of concentration, nausea and even trouble finding the right words.
Migraine headaches can be dull or severe. The pain is usually felt behind the eye or in the back of the head and neck. The headaches usually feel throbbing, pounding, or pulsating. What starts as a dull headache may worsen within minutes or hours and could last anything between 6 to 48 hours. Other symptoms that may accompany the headache include chills, increased frequency of urination, fatigue, sweating and loss of appetite.
The doctor can diagnose this type of headache by asking questions about the symptoms and family history of migraines. A complete physical exam may be necessary to determine if the headaches are due to muscle tension, sinus problems or a serious brain disorder. The doctor will then order a brain MRI or CT scan if it is thought to be serious or if the migraine is accompanied by unusual symptoms as weakness, memory problems or loss of alertness.
There is no specific cure for migraines. Treatment usually involves managing the symptoms or preventing the symptoms by changing or avoiding the triggers. Another key step involves learning how to manage the migraines at home. Doctors may ask the affected person to keep a headache diary to help them identify the headache triggers. This helps in planning on how to avoid these triggers.
- Antidepressants such as amitriptyline or venlafaxine
- Blood pressure medicines such as beta blockers (propanolol, metroprolol) or calcium channel blockers (verapamil)
- Seizure medicines such as valproic acid, gabapentin and topiramate.