Migraine

Migraine is a painful neurological condition, of which the most common symptom is an intense and disabling episodic headache. Migraine headaches are usually characterized by severe pain on one or both sides of the head. Absent serious head injuries, stroke, and tumors, the recurring severity of the pain indicates a vascular headache rather than a tension headache. Migraines are often accompanied by photophobia (hypersensitivity to light), phonophobia (hypersensitivity to sound) and nausea.

Signs and symptoms The signs and symptoms of migraine vary among patients. Therefore, what a patient experiences before, during and after an attack cannot be defined exactly. The four phases of a migraine attack listed below are common among patients but are not necessarily experienced by all migraine sufferers. Additionally, the phases experienced and the symptoms experienced during them can vary from one migraine attack to another in the same migraineur:

  • The prodrome, which occurs hours or days before the headache
  • The aura, which immediately precedes the headache
  • The pain phase, aka headache phase
  • The penultimatedrome phase
  • The postdrome

Triggers
A migraine trigger is any factor that on exposure or withdrawal leads to the development of an acute migraine headache. Triggers may be categorized as behavioral, environmental, infectious, dietary, chemical, or hormonal. The trigger theory supposes that exposure to various environmental factors precipitates, or triggers, individual migraine episodes. Many people report that one or more dietary, physical, hormonal, emotional, or environmental factors precipitate their migraines. The most-often reported triggers include stress, over-illumination or glare, alcohol, foods, too much or too little sleep, and weather. Some women experience migraines in conjunction with monthly menstrual cycles. Sometimes the migraine occurs with no apparent “cause.”

Migraine patients have long been advised to try to identify personal headache triggers by looking for associations between their headaches and various suspected trigger factors. Patients are urged to keep a “headache diary” in which to note what they eat and when they get a headache, to look for correlations, and to try to avoid headache by avoiding factors they identify as triggers. Typically this advice is accompanied by a list of trigger factors.

Migraine and stroke risk
Recent studies have suggested that migraine sufferers may be at increased risk of stroke in later life. A meta-analysis of several such studies published in the British Medical Journal in 2005 appeared to confirm this association, with young adult sufferers and women taking the oral contraceptive pill at particular risk. The mechanism of any association is unclear, but chronic abnormalities of cerebral blood vessel tone may be involved.