More than 29.5 million Americans suffer from migraine,
with women being affected three times more often than men. This vascular
headache is most commonly experienced between the ages of 15 and 55,
and 70% to 80% of sufferers have a family history of migraine. Migraine
is often misdiagnosed as sinus headache or tension-type headache.
The pain of a migraine headache is often described
as an intense pulsing or throbbing pain in one area of the head. It is
often accompanied by extreme sensitivity to light and sound, nausea,
and vomiting. Migraine is three times more common in women than in men.
Some individuals can predict the onset of a migraine because it is preceded
by an "aura," visual disturbances that appear as flashing lights,
zig-zag lines or a temporary loss of vision. People with migraine tend
to have recurring attacks triggered by a lack of food or sleep, exposure
to light or hormonal irregularities (only in women). Anxiety, stress,
or relaxation after stress can also be triggers. For many years, scientists
believed that migraines were linked to the dilation and constriction
of blood vessels in the head. Investigators now believe that migraine
is caused by inherited abnormalities in genes that control the activities
of certain cell populations in the brain.
The pain of migraine occurs when excited brain cells
trigger the trigeminal nerve to release chemicals that irritate and cause
swelling of blood vessels on the surface of the brain. These swollen
blood vessels send pain signals to the brainstem, an area of the brain
that processes pain information. The pain of migraine is a "referred" pain
that is typically felt around the eye or temple area. Pain can also occur
in the face, sinus, and jaw or neck area. Once the attack is full-blown,
many people will be sensitive to anything touching their head.
Migraine pain is often described as throbbing or pulsating
pain that is intensified by routine physical activity, coughing, straining,
or lowering the head. The headache is often so severe that it interferes
with daily activity and may awaken the person. The attack is debilitating,
and migraine sufferers are often left feeling tired and weak once the
headache has passed.
Tests such as the CT scan and MRI are useful to confirm
the lack of organic causes for the headaches. There is currently no test
to confirm the diagnosis of migraine.
A migraine typically begins in a specific area on one
side of the head, then spreads and builds in intensity over 1 to 2 hours
and then gradually subsides. It can last up to 24 hours, and in some
cases, several days.
There may be accompanying symptoms such as nausea, vomiting,
sensitivity to light (photophobia), or sensitivity to sound (phonophobia).
Hands and feet may feel cold and sweaty and unusual odors may be intolerable.
Migraine characteristics include:
- Pain typically on one side of the head
- Pain has a pulsating or throbbing quality
- Moderate to intense pain affecting daily activities
- Nausea or vomiting
- Sensitivity to light and sound
- Attacks last four to 72 hours, sometimes longer
- Visual disturbances or aura
- Exertion such as climbing stairs makes headache worse
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