Definition of Migraine Headaches

A Migraine headache may be described as a type of vertebrobasilar migranes, headache that causes a throbbing and pulsating pain around the head. The pain may be on one side of the head and its degree also varies from time to time and can last up to several hours or more. The Migraine headache is type of vascular headache that involves abnormal sensitivity of arteries within the brain resulting in triggers that often lead to rapid changes in the artery, resulting from spasm. As a result of this other arteries in the brain and scalp dilate resulting in terrible pain in the head.

Often as a result of Migraine headache a patient might be affected with sleep disruptions; fits of depression, nausea, vomiting and one might also become sensitive to light, sound, and smell. People with Migraine headaches get these attacks again and again though the intensity becomes lesser with time.

Migraine attacks commonly activate the sympathetic nervous system in the body. The sympathetic nervous system is often thought of as the part of the nervous system that controls primitive responses to stress and pain, the so-called "fight or flight" response. The increased sympathetic nervous activity in the intestine causes nausea, vomiting, and diarrhea. Sympathetic activity also delays emptying of the stomach into the small intestine and thereby prevents oral medications from entering the intestine and being absorbed. The impaired absorption of oral medications is a common reason for the ineffectiveness of medications taken to treat migraine headaches. The increased sympathetic activity also decreases the circulation of blood, and this leads to pallor of the skin as well as cold hands and feet.

At least 28 million people in the United States alone are affected by the Migraine headache, which also results in poor work performance and leads to lifestyle problems. Stress, menstruation problems and the onset of menopause can often trigger Migraine headaches.

Symptoms of Migraine Headaches

The Migraine is a chronic condition of recurrent attacks. Most, but not all, migraine attacks are associated with headaches. Migraine headaches usually are described as an intense, throbbing or pounding pain involving one temple.  The pain can also be located in the forehead, around the eye, or the back of the head. The pain usually is usually on one side of the head, (unilateral); although about a third of the time the pain can be on both sides of the head, (bilateral). The unilateral headaches typically change sides from one attack to the next. If a unilateral headache always occurs on the same side the patient should alert the doctor because it may be an indication of a brain tumor.  A migraine headache usually is aggravated by daily activities such as walking upstairs.

Complicated migraines are migraines that are accompanied by neurological dysfunction. The part of the body that is affected by the dysfunction is determined by the part of the brain that is responsible for the headache. Vertebrobasilar migraines are characterized by dysfunction of the brainstem, (the lower part of the brain that is responsible for automatic activities like consciousness and balance). The symptoms of vertebrobasilar migraines include fainting as an aura, vertigo (dizziness in which the environment seems to be spinning) and double vision. Hemiplegic migraines are characterized by paralysis or weakness of one side of the body, mimicking a stroke. The paralysis or weakness is usually temporary, but sometimes it can last for days.

You can determine whether you have a Migraine headache from the following symptoms:

  • A typical Migraine headache is seen to affect any one side of the head.
  • The intensity of the headache lasts for an hour or two and recedes after that.
  • In some cases a Migraine headache can last up to 24 hours or several days.
  • Accompanying symptoms may be vomiting, sensitivity to light, nausea, hands and feet becoming cold and sensitivity to sound also.
  • Those experiencing migraine with aura, experience a neurological phenomenon characterized by visuals in the forms of zigzag lines, bright shimmering lights around objects or wavy images, hallucination or even temporary loss of vision.
  • Those experiencing migraine with non-visual auras have language abnormalities in speech, motor weakness, tingling or numbness on the face, dizziness and vertigo symptoms.
  • Those experiencing migraine without aura may experience Nausea, vomiting, tiredness, mood changes and sensitivity to light.
  • Abdominal migraine has symptoms like abdominal pain arousing from gastrointestinal causes with flushing or paleness, vomiting and nausea.

Types of Migraine Headaches

There are several types of migraine, all share basic features, and each person will suffer this headache in a unique way. Generally, however, migraine often begins as a dull ache and then develops into a constant, throbbing and pulsating pain that you may feel at the temples, as well as the front or back of one side of the head. The pain is usually accompanied by nausea and vomiting, and sensitivity to light and noise.

The two most prevalent types of migraine are migraine with aura (formerly referred to as classic migraine) and migraine without aura (formerly referred to as common migraine).  Most of the Migraine headaches can be classified depending on the symptoms they generate.  Commonly a Migraine headache might be classified into –

Migraine with aura - Generally, the aura begins from five to thirty minutes before the actual onset of the headache. The patient may see wavy or jagged lines, dots or flashing lights; or, you experience tunnel vision or blind spots in one or both eyes. The aura can include vision or hearing hallucinations and disruptions in smell (such as strange odors), taste or touch. It can become even more disconcerting or frightening if it involves feelings of numbness, a "pins-and-needles" sensation or even difficulty in recalling or speaking.

Migraine without aura - During the pre-headache phase, blood vessels constrict; when vascular dilation occurs, the migraine begins. The blood vessels may become inflamed as well as swollen.  It is believed that migraine pain is caused by this inflammation, as well as by the pressure on the swollen walls of the blood vessels.  Most migraine headaches last at least four hours, although very severe migraines can last up to a week.  The headaches may begin at any time of the day or night; and while a patient may wake up with one, a migraine will rarely awaken a person from sleep.

The other types of Migraine headaches, which are less seen to affect people, some of these are:

Basilar artery migraine - This is a very rare form of migraine, which is accompanied by dizziness, confusion or imbalance.  It can come on suddenly and result in fleeting visual disturbances, the inability to speak properly, ringing in the ears, and vomiting. Throbbing occurs in the back of the head. The basilar artery migraine is strongly related to hormonal influences and primarily strikes young adult women and adolescent girls; as patients’ age, the migraine with aura may replace the basilar artery type.

Carotidynia - The pain of carotidynia is most often unilateral and localized to the neck, although radiation to the face, ear, or malar region is not uncommon. It is frequently described as dull and throbbing in character and continuously present, although day-to-day or hour-to-hour exacerbations and remissions are common. Severity varies from mild to agonizing, and the pain is frequently aggravated by swallowing, yawning, coughing, sneezing, or elevating the head while moving it toward the contralateral side. A history of migraine may be present or a history of previous pharyngitis, tonsiitis, upper respiratory tract infection, oral conditions, or recent dental procedures is reported.

Abdominal migraine – This migraine is difficult to diagnose because the pain is felt in the abdomen. Nausea, vomiting and diarrhea may occur, and the pain usually occurs in the middle of the abdomen. The attack typically lasts hours and occurs mostly in children as a forerunner of migraine headaches.

Ophthalmoplegic migraine or Ocular migraine – This is a rare and severe migraine, the ophthalmoplegic migraine’s pain usually surrounds the eyeball and lasts from a few days to a few months. There may be paralysis in the muscles surrounding the eye. If these symptoms occur, you should seek immediate medical attention because the symptoms can be caused by pressure on the nerves behind the eye.

Retinal Migraine – This is another rare type of migraine.  The retinal type starts with a temporary, partial, or complete loss of vision in one eye. It is followed by a dull ache behind that eye that may spread to the rest of the head.

Confusional migraine - This type of migraine is uncommon and usually occurs early in the second decade of life. Attacks are sometimes precipitated by minor head trauma and are characterized by the rapid development of confusion and agitation. Affected children are delirious, restless, combative, and appear in pain but do not complain of headache. Episodes typically last less than 6 hours and are followed by deep sleep. Upon awakening, the child is normal and is amnestic for the attack. These confusional attacks tend to recur but are eventually replaced by typical migraine.

Hemiplegic Migraine - This rare but severe type of migraine with aura,  probably results from the patient having a family history of it. The hemiplegic migraine often begins with temporary motor paralysis and/or sensory disturbances on one side of the body, followed by the headache -- within the hour -- which may be accompanied by numbness or the "pins and needles" sensation. When the headache appears, the initial neurological symptoms may disappear.

Status Migrainosus - Patients with severe and continuous migraine headaches (lasting 72 hours or more) often require admission to a hospital.  Exacerbating factors such as analgesic abuse, hormone treatment and depression may need to be addressed.  The use of certain drugs can trigger status migrainosus. Neurologists report that many of their status migrainosus patients were depressed and anxious before they experienced headache attacks.

Women experience Migraine headaches more than that of men, as such there are some types of migraine, which affect women prior to or even during menstruation. Such headaches, are aptly named menstrual migraines, these headaches are mostly related to hormonal imbalances in the body. There are yet other women who develop these migraines during their pregnancy or after their menopause.

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