Migraine

Migraine is a neurologic disease, of which the most common symptom is an intense and disabling headache. Migraine is the most common type of vascular headache. Migraine headaches are usually characterized by severe pain on one or both sides of the head, an upset stomach, and at times disturbed vision. The word "migraine" comes from the Greek construction "hemikranion" (ημικρανίον, pain affecting one side of the head) . more...

Signs & Symptoms

Migraine with aura is a neurological disease characterized by flare-ups generally referred to as "migraine attacks." "Aura" refers to the non-headache features of migraine that often happen before. It is possible to have a migraine attack marked by other symptoms and no headache at all, which is called acephalgic migraine. Many migraine sufferers have headache without aura. Migraine had been thought to be caused by vasodilation in the head and neck; however, newer research suggests that vascular dilation associated with migraine is a symptom of migraine, not the cause of migraine symptoms.

Blood vessel diameter is under neurochemical control; in other words, blood vessels dilate during a migraine episode because the nervous system tells them to. The cause of the pain itself is from activation of the trigeminal nerve. This theory is still being examined though. The trigger of the migraine may be overactivity of nerve cells in certain areas of the brain (for example, the raphe nucleus). Often a migraine episode is associated with strong emotional expression or psychic tension, but those may be migraine symptoms rather than migraine triggers.

The pain from a migraine is typically one-sided, though it may encompass the whole head, or move from side-to-side as the migraine progresses. Additionally, the pain from a migraine is usually described as throbbing and moderate to severe in intensity. Migraines are frequently accompanied by nausea/vomiting and either photophobia (excessive sensitivity to light) or phonophobia (excessive sensitivity to sound), causing the sufferer to seek a dark, quiet room for recovery.

In migraine with aura, formerly called classical migraine, the headache phase is preceded or accompanied by a group of specific symptoms called aura, most commonly experienced as a visual disturbance prior to the attack. Aura usually lasts less than 60 minutes, and in those who suffer migraine with aura there is generally little time between the onset of aura and the onset of the attack. Migraine without aura, formerly called common migraine, in contrast to migraine with aura, lacks any manifestations associated with headache. Some experience aura without migraine, a condition formerly called amigrainous migraine or optical migraine, now usually called acephalgic migraine. Although sometimes comparable in severity, the symptoms of migraine differ from those of cluster headache.

Visual aura can include castellated scotoma or fortification spectra, multicolored zig-zag patterns which can cover a large part of the visual field of one eye (sometimes both). Other types of visual aura involve distortions in perception of color, such as color bleeding or the appearance of halos, or as a white spot in the visual field, similar to when a camera flash temporarily "blinds" your vision. While the most common type of aura is visual, it can manifest as any specific neurological symptom complex. Some experience tingling sensations called paresthesias or disturbances of other regions of the brain (such as language ability or smell) instead of a visual aura, either as an occasional alternate or as their normal aura. Aura need not be related to the five senses: many migraineurs experience a prodrome, a vague feeling that things are just not right. While the types and severity of aura can be extremely diverse, a given sufferer will generally experience similar manifestations of aura with each migraine attack. Many people experience difficulty in speaking and/or forming cohesive syntax.

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