MIGRAINE

Frequent attacks of headache, migraine or non-migraine variety, have proved to be a pain in neck not only for the patients who have it, but also for the physicians who treat them. In this small write-up, we shall limit discussion to the migraine headache.

Well, migraine headache has been described as an episodic, paroxysmal headache, usually but not necessarily affecting one side of the head; which may or may not be associated with giddiness, nausea, vomiting or visual impairment. The painful episode of migraine is usually intense and lasting for half an hour to over a couple of days.

The exact cause often remains unknown. It has been proved that migraine is a vascular disorder. Due to some triggering factors, varying from person to person, there is some kind of vasoconstriction and vasodilatation of the branches of the carotid artery ( the major neck blood vessel) which leads to typical throbbing and congestive attack of headache.

While the exact causation in unknown, it has been observed in practice that migraine is often psychosomatic in origin. There are migraine personality and we have observed in a study of a series of migraine patients at our center, that, there is also a common thread in the migraine personality type.

Many independent studies at various institutes have also shown that most migraine sufferers show one or many of the following behavioral patter : conscientiousness, fastidiousness, rigidity of views, constant conflict between the environment and self, high level of expectation.

Migraine sufferers are more females than males. However, we are observing a shift. Often observed to be running in the family, showing hereditary links.

Migraine headache is a subjective experience. The commonly described pain is typically throbbing, bursting, hammering, or shattering. The pain might start on one side or a spot on the head and spreading to any other place. Ocular areas often affected. The pain is usually severe, intense and tends to be associated with nausea, giddiness and generalized sense of malaise. Many patients feel relieved if there is vomiting.

The episodes of pain are periodic, may be weekly, daily , fortnightly, monthly or irregular.

Migraine headache should be differentiated from other similar painful conditions where the headache could be due to high blood pressure, sinusitis, Trigeminal neuralgia, temporal arteritis, tension headache, etc. A good clinician can help the patient arrive to a correct diagnosis.