Migraine

What is migraine?
A migraine is usually a severe headache felt as a throbbing pain on one, or sometimes, both sides of the head and is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and sound. They are more common in women. Migraine headaches often begin in childhood, adolescence or early adulthood. Some people who get migraines have warning symptoms, called an aura, before the actual headache begins. An aura is a group of symptoms, including vision changes. An aura is a warning sign that a bad headache is coming.

There are several types of migraine, including:
Migraine with aura (classic migraine): where there are warning signs before the migraine begins, such as seeing flashing lights.
Migraine without aura (common migraine): With this form of migraine, a person does not have an aura but has all the other features of an attack.

What are Migraine triggers?
Many possible migraine triggers have been suggested, including hormonal, emotional, physical, dietary, environmental and medicinal factors

• Emotional triggers: stress, anxiety, tension, shock, depression, excitement
• Physical triggers: tiredness,poor quality sleep, low blood sugar (hypoglycaemia), strenuous exercise, if you are not used to it
• Dietary triggers: missed, delayed or irregular meals, alcohol, the food additive tyramine, caffeine products, such as tea and coffee
•  Environmental triggers: bright lights, smoking (or smoky rooms), loud noises, changes in climate, such as changes in humidity or very cold temperatures, strong smells
• Medication: some types of sleeping tablets, the combined contraceptive pill, hormone replacement therapy (HRT), which is sometimes used to relieve symptoms associated with the menopause

A migraine attack can typically be divided into four phases:
1. prodrome (pre-headache) stage
2. Aura (if it occurs)
3. Headache stage
4. Postdrome

Prodrome (pre-headache) stage
The prodrome is the first potential phase of a Migraine attack, It occurs in about 60% of Migraine patients and One or two days before a migraine, you may notice unusual sensations that signify an oncoming migraine, including:
• Cravings for certain foods
• Mood changes — feeling depressed, irritable, etc.
• Constipation
• Diarrhoea
• Fatigue
• Frequent urination
• Neck stiffness
• Uncontrollable yawning
• Increased thirst

Aura
Aura may occur before headaches. Auras are nervous system symptoms that are usually visual disturbances, such as flashes of light. Sometimes auras can also be touching sensations (sensory), movement (motor) or speech (verbal) disturbances. Most people experience migraine headaches without aura. Aura symptoms typically develop over the course of about five minutes and last for up to an hour. Examples of aura include:
• Visual problems, such as seeing flashing lights, zig-zag patterns or blind spots
• Vision loss
• Numbness and pins and needles are the second most common type of aura. Numbness usually starts in the hand, travels up the arm, then involves the face, lips, and tongue.
• Feeling dizzy or off balance
• Speech or language problems (aphasia)

Headache stage
The general symptoms of migraines include:
• A headache that lasts anything from four up to 72 hours
• Pulsating or throbbing pain, often just on one side of your head.
• A headache that gets worse when you’re active or stops you from being active
• Photophobia (increased sensitivity to light), Phonophobia (increased sensitivity to sound)
• Nausea and vomiting
• The pain is moderate or severe. The pain may be so bad that you can't do any of your usual activities.
Other symptoms that sometimes occur include: blurred vision, poor concentration, hunger, diarrhoea, abdominal pain, sweating and sensations of heat or cold.

Postdrome
Migraines also have typical aftereffects, such as a feeling of exhaustion, depression, or feelings of well-being and euphoria that lasts a day or two after a severe migraine headache has faded. Not all people who get migraines have Postdrome.