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Guide to Migraine headache

What is a Migraine headache?

Migraine is a complex, chronic neurological disorder that is characterized by recurrent moderate to severe headaches. Two types of migraines exist:

Migraine with aura

(Classic migraine) – This migraine is preceded by aura symptoms that include visual disturbances, extremity paresthesia, nausea, vomiting and sensitivity to light hours to days before the migraine itself.

Migraine without aura

(Common migraine) – headaches without the visual or auditory disturbances.

What causes a Migraine headache?

Sadly the exact causes of migraine are still unknown, but they are thought to be as the result of abnormal brain activity which temporarily affects the nerve signals, chemicals and blood vessels in the brain. It is not clear why these changes happen, but it is possible that your genes may make you more likely to experience migraines as a result of a specific trigger.

Migraines are more common in females and tend to run in families with a previous history of migraines.

How is a Migraine headache diagnosed?

Symptoms of migraine will depend on which type of migraine you get. Migraine with aura typically presents itself a few hours to days before the attack with prodromal symptoms such as lethargy, mood changes, sensitivity to light, sound and odours. These aura symptoms develop slowly and can last up to an hour. Symptoms are mostly visual but may also include a combination of sensory and physical components.

During the attack phase of migraine, patients will usually complain of one-sided, moderate to severe throbbing or pulsating headache. The pain can be felt anywhere in the head and neck but is most common in the front of the head, the sides and around the eyes. The headaches develop over hours and can last up to 4 to 72 hours.

The diagnosis of migraines is based on the patient’s history. A thorough physical and neurological assessment is needed to exclude a more sinister diagnosis.

How is a Migraine headache treated?

The treatment of migraine is divided into two categories. The first category is abortive therapies which look to stop or reverse the progression of an existing headache. These treatments are effective when given within the first minutes of an attack such as abortive medications and NSAIDs which your doctor would prescribe to you.

The second category of treatment is prophylactic treatments and is aimed at controlling the triggers of your migraine attacks, these can be things such as stress, diet and menstrual cycle. Several clinical trials and research studies are suggesting that spinal manipulation carried out by a chiropractor or an osteopath are appropriate means of treating migraine headaches. A study done in Harvard found that manipulation of the neck reduced migraine days duration and its intensity. There are other several treatment options available in which your practitioner will decide which would be the appropriate one for you.

References

Rist PM, Hernandez A, Bernstein C, Kowalski M, Osypiuk K, Vining R, Long CR, Goertz C, Song R, Wayne PM. The Impact of Spinal Manipulation on Migraine Pain and Disability: A Systematic Review and Meta-Analysis. Headache: The Journal of Head and Face Pain. 2019 Apr;59(4):532-42. https://headachejournal.onlinelibrary.wiley.com/doi/full/10.1111/head.13501

The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24 Suppl 1:9-160

Dodick DW, Gargus JJ. Why migraines strike. Scientific American. 2008 Aug 1;299(2):56-63. http://faculty.collin.edu/cdoumen/2401/Migraines.pdf

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