July 26, 2024

MIGRAINE

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MIGRAINE

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  • SYMPTOMS

There are 4 stages to a migraine headache:

PRODROMAL STAGE: about 24-48 hours before the attack, the symptoms commonly reported were yawning (34%), mood change, lethargy, neck symptoms, restlessness, difficulties in focusing vision, feeling cold, sweating, excess energy, thirst, edema and sensitivity to light and sound. The patients usually realise an oncoming attack, when these symptoms appear.

AURA: this stage can occur a few hours before or during the headache. There can be motor (paralysis, rhythmic movements), sensory (tingling, numbness of limbs) and visual (scintillating scotoma- spots of black vision surrounded by zigzag edge, bright lines, decreased or loss of vision).

HEADACHE: often unilateral headache of throbbing nature associated with sensitivity to light, sound, touch, nausea, vomiting, watery eyes, running nose. Patients usually asks for a dark, silent room to sleep in. This stage may last from hours to days.

POSTDROME: the after effects of the migraine can be seen as dizziness, difficulty in concentration and weakness.

It a complex type of headache characterised by

  • Unilateral headache (may change sides or bilateral)
  • Nausea
  • Aura before headache
  • Pain is of throbbing in nature
  • Sensitivity to light, sound and touch
  • Tightness of muscles in neck
  • CAUSES

There is a strong genetic component, but it is uncertain as to which loci or genes are involved in the pathogenesis.

The migraine episodes may be triggered by something, or sometimes with no known cause. Some of the triggers that patients have reported include:

  • Stress
  • Hormonal
  • Hunger/ food habits/ certain food
  • Weather changes
  • Sleep distubrances
  • Neck pain
  • Odours
  • Exercise
  • Smoking
  • Alcohol intake
  • COMPLICATIONS

Prevention

  • Lifestyle changes like regular exercising and yoga can bring calm to the mind and cause good improvement in the patients.
  • Avoid skipping meals and hydrate well with lots of fruits or juice if not water.
  • Sleep in a dark room and avoid screens for one hour before sleep.
  • Try to find out your triggers.
  • DIAGNOSIS

  • According to the International Classification Of Headache Disorders, migraine is of 2 types in relation with aura i.e. migraine with aura and migrqane without aura.

The criteria to be filled to be diagnosed as suffering from migraine includes,

Headache lasting for 4-72 hours for more than 6 months, is of throbbing or pulsating nature, unilaterally, asoociated with the symptoms of nausea, vomiting, photophobia, phonophoia, weakness

  • Patients may need neuroimaging(CT,MRI,MRA,MRV), if they present with Systemic signs/symptoms, neurological signs/symptoms, position related changes in the intensity of migraine.

The types of migraines are:

  • Migrane with aura
  • Migraine without aura
  • Abdominal migraine (seen in children)
  • Chronic migraine
  • Hemiplegic migraine
  • Menstrual migraine (triggered by drop in estrogen)
  • Retinal migraine (with eye involvement)
  • Status migrainosus (lasts more the 72 hours)
  • HOMOEOPATHIC MEDICINES

Spigelia- left sided headache, worse from stooping, headache from morning to evening, facial pain along with headache

Gelsemium- dull, drowsy, blindness before headache; photophobia, phonophobia, better by urination

Sarsaparilla-right sided headache, sick headache from morning to night

Iris versicolor-sick headache  of gastric and hepatic origin, begins with a blur before eye, followed by intense vomiting

Lachesis- lfet sided, thribing headache, pains better after periods, worse after sleep

Phosphorus-left sided headache , from emotions and mental exertion

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