What is Migraine ?
Migraine is defined as an episodic headache, which is one sided, often associated with vomiting and visual disturbances. It occurs commonly in women. Migraine is recurring disorder in which headache - sometimes mild and relatively bearable but often severe and disabling - may be accompanied by a wide variety of symptoms which indicate temporary disturbance of brain function, particularly of those parts of the brain which are concerned with seeing, speech and feeling.
Types of Migraine
1. Classical Migraine : There may be an accompanying aura like visual sensory symptoms.
2. Common Migraine : There is no accompanying aura.
3. Paralytic Migraine : Prolonged headache lasting hours or days and is followed by a mild paralysis of limbs.
4. Basilar Migraine : Headache at the back of the head preceded by giddiness, double vision and speech defects.
5. Cluster headache : also known as migrainous neuralgia. Mostly affects males. There may be bouts of severe pain around one eye associated with tears and running nose.
- Dietary factors e.g., consumption of chocolates, cheese and alcohol.
- Oral contraceptives
- Pre menstrual tension
- Stress and anxiety
- Genetic predisposition
Clinical Features of Migraine
- Condition often starts at puberty and continues till late middle age.
- Attacks occur at intervals of a few days to several months.
- Attacks last for hours to days.
- Visual disturbances like zig zag lines, flashing coloured lights or defects in the field of vision may be present.
- On rare occasions, speech defects occur as also a mild paralysis of limbs.
- Headache is mostly present in the front of the head. It may be generalised too.
- Headache is severe, throbbing in nature and accompanied by vomiting, paleness, weakness.
Children with migraine
Children do not usually need any of the more powerful remedies such as ergotamine, pizotifen, or methysergide and should not be given these. Headache is usually mild and soluble asprin is enough. Nausea and sickness may need occasionally an anti-emetic (vomiting-reducing) drug such as promethazine or prochlorperazine and, if the migraine attacks start to be very frequent under stress, a mild sedative for a month or two may help.
Treatment Option for Migraine
- Patient to lie down in cool darkened room.
- Stop oral contraceptives
- Reassure anxious patients
- Light diets, avoid alcohol, chocolates and cheese