Migraine affects the Central Nervous System, which consists of the brain, spinal cord and peripheral nerves. The brain itself is responsible for basic unconscious functions such as breathing and heart beat, as well as higher thought processes such as language and reasoning. Nerves, meanwhile, are responsible for taking sensory messages to the brain to process, and sending messages commanding motor neurons to react. This is either through conscious effort, or due to a reflex to pain or extreme heat.
Phases of Migraine
Migraine has a variety of complex symptoms which sets it apart from other types of headache. A typical migraine has four phases.
- Pro-dome – This affects 40-60% of sufferers. This is a phase prior to migraine in which altered mood and irritability may be experienced, along with excessive tiredness and fatigue and a stiff, sore neck. The pro-dome may last for hours, or even days leading up to the migraine attack, and in those who know what to look for, it can act as a useful warning of an impending attack.
- Aura – The aura is a neurological phenomenon which precedes or accompanies the migraine attack. It can last between five minutes and one hour. There are various different auras, which are basically a visual disturbance. They range from black and white zig-zagging patterns (scintillating scotoma); uniformed flashes of light (photopsia); blurred or tunnel vision and hemianopsia: a small blurred spot of vision on which you cannot focus. Sometimes sufferers will not just suffer from a visual aura but will also experience a somatosensory aura, which is an aura affecting a different sensory receptor. These include pins and needles in the hands/arms/face; temporary dysphasia and vertigo among others.
- Pain phase – The pain of a migraine is typically uni-lateral and is moderate to severe in strength, typically of a throbbing nature. The pain tends to have a gradual onset, followed by a peak and subsidence. 90% of sufferers also experience nausea or vomiting during the pain phase, as well as photophobia, phonphobia and osmophobia. Concentration is greatly impaired and many sufferers only find relief by lying in a darkened room.
- Post-dome – The post-dome is the after phase or “hangover” of a migraine attack. It can continue for hours or even days after a migraine attack has ended. Concentration remains difficult and cognitive difficulties are often reported following a migraine. A mild headache may remain, and the subject may feel tired and weak in the aftermath.
The exact cause of migraines is unknown. They are both vascular and neurological in origin, as they affect the arteries leading into the brain. Sometimes migraines are caused by certain nerves in the brain stem becoming irritated. Chemicals are released to deal with this irritation, but this causes inflammation of the blood vessels, causing more irritation and resulting in a vicious cycle. One of the chemicals released is known as Substance P, which is responsible for aiding and sending pain signals to the brain, which is why migraines are so painful.
Another time migraines can begin is when blood vessels in the brain contract and relax when they are not required to. When this constriction ends, the blood vessels dilate, causing their once solid sides to become permeable. Fluid leaks out into the brain and its presence is felt by pain receptors, which interpret the fluid as pain. This leads the body to produce inflammation in the area, causing further constriction. It is believed that this is the reason migraine pain is typically throbbing in nature; every pulse of the heart beat causes constriction and pain within the brain.
Treatments
The migraine headache is an example of an area of the body about which we still do not know everything. No one is exactly sure of the cause or reason behind migraine headaches. Different people have different “triggers” for migraines including factors such as stress or diet. Others have no triggers at all and suffer from migraines without a determinate pattern or cause. Migraine headaches do not just affect the nervous system in terms of pain, they are also disabling to higher thought processes and sometimes this can be worse to deal with than the pain itself.
There are a variety of treatments available for migraine sufferers at different levels of severity. There are over-the-counter medicines like Migraleve available for mild cases. Those who know that a certain trigger, such as chocolate or caffeine, is responsible can do very well by avoiding their own personal triggers. For some, Paracetemol and ASPIRIN® work as effective pain killers. Cooling eye pads also provide relief for some. Triptans and ergotamine have been used with much success in many more serious sufferers.
Research on migraines is still being carried out. In 2010, it was discovered that migraine is linked to a genetic defect. In the same year, approval was granted for ground-breaking Botox treatments for chronic migraine sufferers.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
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Victoria Williams - I am a 25 year old writer living in Scotland. Writing has been a major passion of mine for my entire life.
