Migraine is a very painful type of headache that can last between 4 and 72 hours, is described usually unilateral (affecting one half of the head), pulsating, associated with sensitivity to light and sound, nausea, severe pain, vomiting.

The classical migraine has 4 stages:

- early debut: weakness, dizziness, irritability, who lasts 24 hours.

- “the aura” (neurological symptoms announcing the headache, usually 30 minutes before it): the visual acuity decreases, the patient sees flashes, zigzag lines or black spots in the field of vision, or feels painful sensations or tingling in face muscles and extremities.

- the debut of severe unilateral, pulsating headache increased by any noise, particular smell or strong light, associated with dizziness, nausea.

- exhaustion, tiredness after the headache.



Causes:

- stressful factors:

- depression

- shock

- modification in daily routine

- irritability, nervousness

- food: - chocolate, cheese, red vine, fried food, artificial sweeteners such as aspartame, meat food containing nitrates, monosodium glutamate.

- different stimulus: bright light, loud noises, strong smells.

- passive smoke.

- hormones (estrogen) in women migraine: menstruation, birth control treatment, hormone treatment.

- several drugs: anti-inflammatory, anti-hypertension drugs, bronchodilators.



Migraines have a genetic link. The National Headache Foundation (NHF) estimates that 70-80% of migraine sufferers have a family history of migraine.

75% of the persons affected are women and they have an increased risk (3 times from normal) for cerebral or cardiac strokes, infarct.



Migraine is due to serotonin release which produces vascular spasms, followed by the dilatation of brain vessels.



Migraine treatment is:

1. acute treatment (at the beginning of an attack to relieve the symptoms):

- drugs containing a combination of aspirin, acetaminophen, and caffeine, anti-inflammatory drugs (NSAIDs), triptans and ergot derivatives (although the last 2 of them with cautious because of their possible side effects)

- caffeine taken with a painkiller if the caffeine isn’t itself the cause of the migraine.

2. preventive treatment:

- establishing a daily routine: eating, exercising regularly, trying to get up and go to bed the same time every day.

- knowing your triggers and avoiding them (bright lights, loud noises, smells, specific food).

- daily medication to reduce the frequency and severity of attacks: beta-blockers like propranolol and timolol (only if the blood pressure isn’t low).