HOW TO TREAT MIGRAINE?

SAIMA IBRAHIM (feedback@pgeconomist.com)
Feb
1 - 7, 2010

Migraine is a neurological syndrome characterized by altered bodily perceptions, severe headaches, and nausea. This condition is more common to women than to men. The typical migraine headache is unilateral (affecting one half of the head) and pulsating, lasting from 4 to 72 hours.

Initial treatment is with analgesics for the headache, an antiemetic for the nausea, and the avoidance of triggering conditions. The cause of migraine headache is unknown; the most common theory is a disorder of the serotonergic control system.

There are migraine headache variants, some originate in the brainstem (featuring intercellular transport dysfunction of calcium and potassium ions), and some are genetically disposed.

THERE ARE TWO DIFFERENT KINDS OF MIGRAINE HEADACHES.

THE MOST COMMON ARE CLASSIC MIGRAINE AND COMMON MIGRAINE.

Classic migraines start with a warning sign, called an aura. The aura often involves changes in the way you see. You may see flashing lights and colors. You may temporarily lose some of your vision, such as your side vision. You may also feel a strange prickly or burning sensation, or have muscle weakness on one side of your body. You may have trouble communicating. You may also feel depressed, irritable, and restless. Auras last about 15 to 30 minutes.

Auras may occur before or after your head pain, and sometimes the pain and aura overlap, or the pain never occurs. The head pain of classic migraines may occur on one side of your head or on both sides.

Common migraines may start more slowly than classic migraines, last longer and interfere more with daily activities. The pain of common migraines may be on only one side of your head.

WHAT CAUSES MIGRAINE HEADACHES?

Migraine headaches seem to be caused in part by changes in the level of a chemical made in the brain called serotonin. Serotonin plays many roles in the body, and it can have an effect on blood vessels. When serotonin levels are high, blood vessels constrict (shrink). When serotonin levels fall, the blood vessels dilate (swell). This swelling can cause pain or other problems.

Many things can affect the level of serotonin in your body, including your level of blood sugar, certain foods, and changes in your estrogen level if you are a woman.

Triggers: 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.

Migraine attacks may be triggered by allergic reactions, bright lights, loud noises, and certain odors or perfumes, physical or emotional stress, changes in sleep patterns, smoking or exposure to smoke, skipping meals, alcohol, menstrual cycle fluctuations, birth control pills, hormone fluctuations during the menopause transition, tension headaches, foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs, and salami), and other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products, and fermented or pickled foods.

FOODS THAT MAY TRIGGER MIGRAINES

Aged, canned, cured or processed meat, including bologna, game, ham, herring, hot dogs, pepperoni and sausage, aged cheese, beans, including pole, broad, lima, Italian, navy, pinto and garbanzo, brewer's yeast including fresh yeast coffee cake, donuts and sourdough bread, caffeine (in excess), canned soup or bouillon cubes, cultured dairy products such as buttermilk and sour cream, lentils, meat tenderizer, monosodium glutamate (MSG), nuts and peanut butter, onions except small amounts for flavoring, papaya, passion fruit, pea pods, pickled preserved or marinated foods such as olives and pickles, and some snack foods, raisins, red plums, seasoned salt, and soya sauce.

POSSIBLE SYMPTOMS OF MIGRAINES

* Intense throbbing or dull aching pain on one side of your head or both sides

* Pain that worsens with physical activity

* Nausea or vomiting

* Changes in how you see, including blurred vision or blind spots

* Being bothered by light, noise or odors

* Feeling tired and/or confused

* Stopped-up nose

* Feeling cold or sweaty

* Stiff or tender neck

* Light-headedness

* Tender scalp

PREVENTION

The goals of preventive therapy are to reduce the frequency, painfulness, and/or duration of migraines, and to increase the effectiveness of abortive therapy. Another reason to pursue these goals is to avoid medication overuse headache (MOH), otherwise known as rebound headache, which is a common problem among migraineurs due to overuse of pain medications, and can result in chronic daily headache.

MANAGEMENT

Conventional treatment focuses on three areas: trigger avoidance, symptomatic control, and prophylactic (preventive) pharmacological drugs. Researchers find that the recommended migraine treatments are not 100% effective at preventing migraines, and sometimes may not be effective at all. Pharmacological treatments are considered effective if they reduce the frequency or severity of migraine attacks by 50%.

PARACETAMOL OR NON-STEROIDAL ANTI-INFLAMMATORY DRUG (NSAIDS)

The first line of treatment is over-the-counter abortive medication.

* Paracetamol (known as acetaminophen in North America) benefited over half of patients with mild or moderate migraines in a randomized controlled trial.

* Simple analgesics combined with caffeine may help. During a migraine attack, emptying of the stomach is slowed, resulting in nausea and a delay in absorbing medication. Caffeine has been shown to partially reverse this effect. Excedrin is an example of an aspirin with caffeine product. Caffeine is recognized by the U.S. Food and Drug Administration as an Over the counter drug (OTC) treatment for migraine when compounded with aspirin and paracetamol. Even by itself, caffeine can be helpful during an attack.

* Patients themselves often start off with paracetamol, aspirin, ibuprofen, or other simple analgesics that are useful for tension headaches.

AYURVEDIC REMEDY

As per the Indian Medicine System of Ayurveda, most of the migraines are caused by eating disorders. This is the reason for nausea and vomiting. The remedy provided is warm milk taken with a pinch of turmeric and 1/4 teaspoon of pepper powder. This has an effect within 30 minutes of intake and alleviates the pain.

TIPS ON REDUCING THE PAIN

* Lie down in a dark, quiet room.

* Put a cold compress or cloth over your forehead.

* Massage your scalp using a lot of pressure.

* Put pressure on your temples.