MIGRAINE(THE ONE-SIDED HEADACHE): CAUSES, AURAS, TRIGGERS, TREATMENT AND MANAGEMENT

OVERVIEW

 Migraine is a severe and painful headache that causes an intense throbbing sensation on one side of the head. Auras such as flashes of light, blind spot, tunnel vision and extreme sensitivity to light and sound usually precede migraine headaches in most people. Migraine is caused by changes in the interaction between the brain and a pain nerve or imbalances in the release of brain chemicals. Migraine headaches can also be triggered. These triggers include: bright light, physical or emotional stress, allergies, certain odours or perfumes, certain foods and medications etc. Treatment and management of migraine focuses on avoiding the triggers, controlling the symptoms and taking medications to alleviate the pain.

Migraine headache

CAUSES

Migraine is a neurological disorder believed to be caused by changes in the brain and its interaction with a major pain nerve (known as the trigeminal nerve). It is also caused by imbalances in the release of brain chemicals. A typical example of such brain chemical is Serotonin. Serotonin helps regulate pain in the nervous system and its level drops during the course of a migraine headache. This may cause the pain nervous system to release substances called neuropeptides which then travels to the meninges (the three outer coverings of the brain) resulting in the headache and pain.

Some people with migraine usually perceive an aura before the onset of the headache. These auras are sensory warning signs such as flashes of light, confusing thoughts, blind spots, tunnel vision, temporary loss of vision, needle-like tingling in the arms and legs and extreme sensitivity to light and sound

Migraine headaches can last from hours to even days and can be so severe that all the person thinks of is being alone. It affects more women that men and is most times accompanied by nausea and vomiting 

TRIGGERS

Most times, a bout of migraine headache is usually triggered. Some common triggers are:

• Bright lights, certain odours or perfumes and loud noise

• Hormonal changes

• Physical or emotional stress

• Allergies or allergic reactions

• Changes in sleep pattern or irregular sleep

• Skipping meals or fasting

• Smoking or exposure to smoke

• Alcohol

• Certain foods which contain known triggers like: Tyramine (e.g. red wine, cheese, beans, smoked fish), Monosodium glutamate(MSG), Nitrates (e.g. hot dogs, bacons etc)

• Physical activity

• Certain medications

• Changes in the environment

TREATMENT AND MANAGEMENT

As we speak, there is no clear-cut cure for migraine. It can only be managed. Its treatment measures centres on avoiding the triggers, controlling the symptoms and taking medicines to temporarily alleviate the pain. Medications are more effective if used earlier in an attack.

Knowing the strategy to use in the management of your migraine depends on the frequency and severity of your headache and your other medical conditions.

Medications used in migraine are divided into two main groups:

1. Pain-relieving medications: Also referred to as abortive medication, it involves taking drugs during migraine attacks so as to minimize or possibly stop it. For maximum results, it is best taken as soon as you begin to notice the onset of a bout of migraine attack. These medications include: 

• Analgesics

• Triptans

• Ergots

• Opioid medications

• Anti-nausea medications

• Glucocortisoids

2. Preventive medications: This involves measures that reduce the occurrences of migraine attacks 

• Analgesics
• Cardiovascular drugs
•  Anti-seizure drugs
•  Antidepressants
•  Onabotulinumtoxin A (Botox)

Other simple measures that can help you manage migraine headaches are:

• Avoiding loud sounds and bright lights

• Isolation in a dark room

• Trying to get some sleep

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