Migraine | Symptoms Causes Treatment & Diagnosis

What is Migraine?

The term migraine refers to a throbbing headache that may cause extreme throbbing pain, or a feeling of pulsing, typically in one head side. The most common symptoms are nausea, vomiting, or intense sensitivity to light and sounds. Migraine attacks can last up to a week and the pain could be so intense that it affects your normal activities.

For some, an ailment known as an aura may occur in conjunction with or prior to headaches. Auras can be characterized by visual disturbances such as flashes of blind spots or lights or other disturbances like tingling on an area of your face, or in the leg or arm and trouble speaking.

The use of medicines can prevent migraines and can make the migraines more comfortable. Certain medications, when combined with self-help solutions and lifestyle modifications, could aid.

Migraine meaning in Urdu

Migraine is the word of English language And its meaning in Urdu is: “Dard shaqeeqa درد شقیق, And Adhy sar ka dard — آدھے سر کا درد. And the synonyms we use for the word are Hemicrania, Megrim.

Migraine symptoms

Migraines, which are common among teens and children as well as adults can develop into 4 stages: prodrome attack, aura, and post-drome. Some migraine sufferers do not experience all four stages.

Prodrome

Two or three days before an attack, you may be able to notice subtle changes that signal of the possibility of migraines such as:

Constipation
Changes in mood between depression and happiness
Food cravings
Neck stiffness
Uterine frequency has increased
Fluid retention
Frequent yawning

Aura

In some individuals, An aura may occur prior to and during migraines. Auras are reversible manifestations that affect the nerve system. They’re typically visual, but may also be associated with other disorders. Each symptom typically begins slowly increasing over several minutes and may last for between 60 and 90 minutes.

The most common migraine symptoms are:

Visual phenomena, like seeing different forms, bright spots, or flashes of light
Vision loss
The sensation of needles and pins can be felt in the leg or arm
Numbness or weakness in the face or on the opposite or both sides of your body
Trouble speaking

Attack

A migraine can last from four to 72 hours if not treated. The frequency at which migraines occur differs depending on the individual. They can occur infrequently or may occur multiple times a month.

In the case of a migraine it is possible to experience:

The pain is usually located on the head on one side However, sometimes it is across both sides
The pain that pulses or throbs
Sensitivity to sound, light and occasionally smell and even touch
Nausea and vomiting

Post-drome

An individual may feel exhausted, confused, and depressed for almost a day following a migraine attack. Some report feeling joyful. The sudden movement of the head could trigger the pain in a brief period.

When should you see a doctor?

Migraines are usually not diagnosed and often left untreated. If you frequently experience symptoms and signs of migraine, make the details of your migraines and the way you dealt with them. Make an appointment to see your physician to discuss the headaches you are experiencing.

Even if there is frequent headaches, consult your physician in case the pattern is changing or the headaches suddenly become more severe.

Contact your doctor right away or visit an emergency room in case you experience one of these signs or symptoms that may indicate the presence of a serious medical condition:

A sudden, intense headache, similar to the sound of thunder
Headache and stiff neck, fever seizures, confusion, and double vision. Feeling weakness in any area of the body. These could be an indication of a stroke
Headache following a head injury
A headache that’s chronic and is more severe after exertion, coughing, straining, or sudden motion.
New headache pains following the age of 50.

migraine causes

Although migraine causes aren’t entirely identified, both genetics and environmental elements are believed to play a part.

The brainstem is undergoing changes and the way it interacts with the trigeminal neuron, an important pain pathway could be at play. It is also possible that brain chemicals, including serotonin which is a hormone that regulates the pain of your nervous system.

Researchers are studying the role played by serotonin in migraine. Other neurotransmitters can play a part in migraine pain such as calcitonin gene-related protein (CGRP).

Migraine triggers

There are a variety of migraine triggers, such as:

Changes in hormones in women. Changes in estrogen levels like when the menstrual period is in progress or during menopausal periods can trigger headaches for a lot of women. Hormonal medication, like oral contraceptives, can aggravate migraines. Women who are on these medications discover that their migraines happen less frequently while taking these drugs.
Drinks. This includes alcohol, particularly wine, as well as excessive caffeine, for example, coffee.
Stress. Stress at home or at work can cause migraines.
Sensory stimuli. Lights that flash or are bright can cause migraines, as do the sound of a loud horn. A strong smell — like perfume paint thinners, secondhand smoke, and others – cause migraines for some people.
Sleep patterns change. Insufficient sleep or too many hours of sleep can cause migraines for some people.
Physical aspects. Excessive physical activity, like sexual activity, can trigger migraines.
Weather conditions change. A shift in the barometric pressure or weather can trigger migraines.
Medications. Vasodilators and oral contraceptives like nitroglycerin can trigger migraines.
Foods. Old cheeses, salty and processed foods can cause migraines. So might skipping meals.
Food additives. They include sweetener aspartame as well as the preservative monosodium glucamate (MSG) which is present in a wide variety of food items.

Risk factors

A variety of factors can make you more susceptible to suffering from migraines. These include:

Family background. If there is relative suffering from migraines, there is a high chance of getting them too.
Age. Migraines can start at any age, although the most common occurrence is during the adolescent stage. They tend to peak in the 30s and then slowly decrease in severity and are less frequent over the subsequent decades.
Sex. The risk for women is three times higher to experience migraines.
Hormonal changes in the hormones. Women who suffer from migraines headaches can begin prior to or soon after the onset of menstrual flow. They can also alter in menopausal and pregnancy. Menopausal migraines generally get better after menopausal.

Complications

Injecting painkillers frequently could cause severe headaches due to medication use. The risk is the highest for aspirin, acetaminophen, and caffeine combination. Headaches from overuse can also happen when you are taking aspirin or Ibuprofen (Advil, Motrin IB, other) for longer than 14 days per month, or triptans or sumatriptan (Imitrex Tosymra) as well as rizatriptan (Maxalt Maxalt, Maxalt-MLT) for longer than nine days per month.

Headaches caused by overuse of medications occur when they stop relieving pain and then begin creating headaches. It is then necessary to use additional pain medication, and this continues the cycle.

Diagnosis

If you suffer from migraines, or have a familial history of headaches an expert on treating migraines (neurologist) is likely to determine whether you have migraines based upon an examination of your medical records, the symptoms as well as a neurological and physical exam.

If your condition is uncommon or complex, or suddenly becomes extreme, testing to determine if there are possible causes of your pain could include:

Magnetic resonance imaging (MRI). A MRI scan makes use of a powerful magnet and radio waves that create clear images of the blood vessels and brain. MRI scans can help doctors identify tumors or strokes, bleeding inside the brain area, infection and various other neurological and brain system (neurological) disorders.
CT scans are computerized (CT) scan. CT scan makes use of a series of X-rays in order to produce precise cross-sectional pictures of the brain. It helps doctors identify tumors and brain injuries, infections as well as bleeding in the brain and other medical conditions that could cause headaches.

Migraine Treatment

The treatment for migraine is focused on stopping the symptoms and preventing future attacks.

A variety of medications have been developed to treat migraines. Treatments for migraines are classified into two general categories.

Pain-relieving medications. Also called acute or abortive treatment, these medications are prescribed when migraine attacks occur and are designed to reduce the symptoms.
Preventive medicines. These are the kinds of medicines that are typically taken every day, to decrease the intensity or frequency of migraines.

The treatment options you choose to pursue depend on the frequency and intensity of your headaches, including whether you are experiencing nausea and vomiting in conjunction with headaches, how difficult your headaches are, as well as other medical conditions you suffer from.

Relief medication

Treatments for migraine pain are best taken as soon as there is an indication of a migraine that is about to occur and as soon as symptoms and signs of migraine appear. The medications that are available to treat migraine include:

Pain relief medications. These prescription or over-the-counter pain relievers are aspirin and Ibuprofen (Advil, Motrin IB, and many others). If taken for over a long period, they could result in headaches due to medication overuse as well as ulcers and bleeding from the stomach.
Migraine pain relief drugs that include caffeine aspirin, aspirin, and Acetaminophen (Excedrin Migraine) could be beneficial however, they are usually used to treat moderate migraine pain.
Triptans. Prescription medicines like sumatriptan (Imitrex Tosymra, Imitrex) and rizatriptan (Maxalt Maxalt, Maxalt-MLT) are prescribed to treat migraine as they stop pain-related pathways within the brain. They are available as pills, shots or sprays for the nasal, these are able to reduce migraine symptoms in a variety of ways. They may not be suitable for people who are at high risk of having a stroke, or heart attack.
Dihydroergotamine (D.H.E. 45, Migranal). It is available as a nasal spray, or an injection, this medication is most effective if taken within a few hours of the onset of migraine-related symptoms which last for more than 24 hours. The side effects could include a worsening of nausea and vomiting related to migraines.
People suffering from coronary arterial disease or high blood pressure or liver or kidney problems must avoid dihydroergotamine.
Lasmiditan (Reyvow). The latest oral tablet is approved to treat migraine that is not associated with aura. In clinical trials, lasmiditan significantly improved headache pain. Lasmiditan may have the effect of sedation and may result in dizziness. Therefore, those who are taking it should not drive or use machinery for more than eight hours.
Ubrogepant (Ubrelvy). This oral calcitonin gene-related protein receptor antagonist has been approved for treating acute migraine, with or without Aura in adult patients. It’s the first medication that’s of this kind to be that has been approved to treat migraine. In clinical trials, ubrogepant was found to be more effective than placebo at relieving migraine-related symptoms like nausea and the sensitivity to sound and light for two hours following the administration. Common adverse consequences include nausea, dry mouth or excessive sleeping. Ubrogepant shouldn’t be used along with other strong CYP3A4 inhibitors.
CGRP antagonists. Ubrogepant (Ubrelvy) as well as Rimegepant (Nurtec ODT) are both oral CGRP antagonists that were recently approved for treatment of acute migraine that is not accompanied by aura for adults. In clinical trials, medications of this class were more effective than placebo for alleviating pain and other migraine-related symptoms, such as nausea and sensitization to sound and light for two hours following the administration. Common adverse reactions include nausea, dry mouth as well as excessive tiredness. Rimegepant and ubrogepant shouldn’t be used in conjunction with powerful CYP3A4 inhibitors.
Opioid medication. For those who aren’t able to utilize other migraine treatments, Opioid narcotics may aid. Because they can be extremely addicting, they are typically utilized only when other treatment options are successful.
Anti-nausea drugs. They may help if you suffer from migraine is followed by nausea and vomiting. The most commonly used anti-nausea medication is chlorpromazine. metoclopramide (Reglan) or prochlorperazine (Compro). They are typically taken along together with pain medication.

migraine medicine in Pakistan

panadol migraine. In my opinion, Panadol Migraine is the best migraine medicine in Pakistan. Most of the patients affected with this pain, experience relief with just one dose.

it contains acetylsalicylic acid, paracetamol, and therapeutically active caffeine.

Also, synflex tablet uses for migrain pain relief in pakistan.

Certain of these medicines aren’t safe to use during pregnancy. If you’re pregnant or planning to become pregnant, do not take any of these medicines without consulting your physician.

Preventive medicines

The use of medications can reduce the frequency of migraines. Your physician might suggest preventive medicines if you experience persistent, severe or long-lasting migraines that do not respond to treatment.

Preventive medications are aimed at decreasing the frequency you experience migraines, the severity of the attacks are, and the time they last. The options include:

Blood pressure-lowering medication. These include beta-blockers, such that propranolol (Inderal, InnoPran XL, other) as well as metoprolol tartrate (Lopressor). Calcium channel blockers, such as verapamil (Verelan) are beneficial in preventing migraines that have an aura.
Antidepressants. Tricyclic antidepressants (amitriptyline) is able to prevent migraines. Due to the negative side effects of amitriptyline such as insomnia and sedation, other antidepressants may be prescribed instead.
Anti-seizure drugs. Valproate and Topiramate (Topamax, Qudexy XR, other) could be helpful if have less frequent migraines however, they can trigger side consequences such as dizziness nausea, weight loss, and many more. These medicines aren’t recommended for pregnant women or those who are trying to become pregnant.
Botox injections. The injections of onabotulinumtoxinA (Botox) approximately every 12 weeks can help stop migraines for some adults.
CGRP monoclonal antibody. Erenumab-aooe (Aimovig), fremanezumab vfrm (Ajovy) as well as galcanezumab gnlm (Emgality) and eptinezumab jjmr (Vyepti) are the newest drugs that were approved by the Food and Drug Administration to treat migraines. They are administered monthly or quarterly via injection. The most commonly reported adverse reaction is at the site of injection.

Discuss with your doctor whether these medicines are suitable for you. Certain of these medicines are not suitable for use during pregnancy. If you’re pregnant or planning to become pregnant, don’t apply any of these drugs without consulting your physician.

Lifestyle and home remedies for home

If you notice that migraine symptoms are beginning to manifest begin, you should seek an area that is dark and quiet. Relax your eyes, and then close them or lie down. Put a cool, soft cloth or an ice pack tied with a cloth fabric on the forehead. consume plenty of fluids.

These techniques could also help ease migraine pain

Try relaxation techniques. Biofeedback and other types of relaxation training can teach you methods to manage stress-inducing situations. This can decrease the number of migraines that you experience.
Create a sleep and eating routine for eating and sleeping. Do not sleep too much or sleep too little. Establish and adhere to a regular routine for your sleep and wake times daily. Eat your meals at the same time each day.
Drink lots of fluids. Drinking enough water, particularly water, can aid.
Keep a headache diary. Noting your headache symptoms in a journal will allow you to learn more about the triggers that cause migraines and what treatments are most effective. It can also aid your doctor in diagnosing the cause of your migraine and track your progress over time between visits.
Exercise regularly. Regular aerobic exercise can ease tension and may help to stop migraines. If your doctor is on board to do so, select an aerobic exercise you enjoy, like cycling, swimming, or walking. Start slowly, however, since extreme, sudden exercise can cause headaches.
Regular exercise can aid in losing weight or keeping a healthy weight. Obesity is believed to be the cause of migraines.

Alternative medicine

Other therapies may help relieve chronic migraines.

Acupuncture. Clinical trials have proven that acupuncture can be beneficial in relieving headaches. The treatment involves an acupuncturist inserting several tiny needles, which are disposable, in various areas of your skin at specific places.
Biofeedback. Biofeedback has been proven to be beneficial in helping to ease migraine pain. This method of relaxation utilizes special equipment that helps you learn to control and monitor certain physical reactions that are triggered by stress, like tension in muscles.
Cognitive therapy for behavioral issues. Cognitive-behavioral therapy can be beneficial to certain migraine sufferers. The psychotherapy will teach you how thoughts and behaviors can affect your perception of pain.
Yoga and meditation. Yoga can help relieve stress and anxiety, which is a well-known source of migraine. If practiced regularly yoga could decrease the frequency and duration of migraines.
Herbs as well as vitamins and minerals. There is evidence to suggest that the herb feverfew, as well as butterbur, may help to alleviate migraines or decrease their intensity, although the results are not conclusive. Butterbur is not recommended due to safety issues.

Riboflavin, a high-dose vitamin (vitamin B-2) can decrease the frequency and severity of headaches. Coenzyme Q10 supplements may reduce headache frequency but more studies are required.

Magnesium supplements are used to treat migraines, however with mixed results.

Discuss with your doctor whether these treatments are suitable for you. If pregnant, avoid one of the treatments before discussing it with your doctor.

Making preparations for your appointment

You’ll likely first consult an primary care doctor and they may recommend you to a physician skilled in diagnosing and treating migraines (neurologist).

Here’s some tips to help you prepare for your appointment.

What you can do

Note down your symptoms. Keep a journal of your headaches, recording a detailed description of every instance of visual or strange sensations, which includes the date they occurred, as well as the length of time they lasted, and the trigger. A headache diary can assist your doctor determine the cause of your headache.
Note important personal details such as major stressors or life events that have occurred recently.
Write down every vitamin, medication, or supplements you consume and the dosages. It’s crucial to note the medications you’ve taken to treat headaches.
Note down any questions you want you’d like to inquire with your doctor.

Consider bringing an adult friend or family member with you, if possible to aid you in remembering the information you’ve received.

For migraines, the questions you should ask your doctor may include:

What could be triggering my migraines?
Are there other factors that could be causing my migraine?
What kinds of tests will I require?
Do my headaches seem to be to be temporary or do they last for a long time?
What is the most effective method of action?
What alternatives do you have to the main approach you’re suggesting?
What modifications to my life or diet would you recommend I consider making?
I suffer from these health issues. How do I handle them all?
Are there any printed materials I can get? What websites do you recommend?

Don’t be afraid to ask additional questions.

What should you expect from your doctor?

Your doctor will likely be able to ask you many questions, such as:

How often do headaches happen?
How serious are your symptoms?
What is it that you have tried to help you feel better?
What do you think is likely to be causing your condition to get worse?
Do any other members of your family suffer from migraines?

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