21/02/2020
Posting my ever 1st writing on MIGRAINE,
is a common chronic multifactorial neurovascular disorder associated with repeated attacks of headache lasting up to minimum 4 and maximum 72 hours and it is widely varied in intensity, frequency and duration, the attack is mostly unilateral accompanied with nausea, vomits or sometimes with light or sound sensitivity.[1,2,3,4] It is categorized in two types; one is migraine without aura which involves autonomic nervous system dysfunction and the other is migraine with aura which involves neurological symptoms like visual and auditory symptoms which may vary person to person. [5] Auras are focal neurologic, usually visual, symptoms that are reported in approximately 20% of attacks. There are no objective markers or diagnostic tests that define migraine. Migraine without aura is characterized by attacks lasting for 4 to 72 hours. Typical headaches have at least two of the following characteristics: one-sided pain location, pulsating quality, moderate or severe intensity, and aggravation by routine physical activity. In addition, attacks are associated with nausea and with photo- and phono phobia. Migraine with aura is characterized by attacks of neurologic symptoms unambiguously localized to the cerebral cortex or brainstem, which usually develop gradually over 5 to 20 minutes and last less than 60 minutes. Headache, nausea, or photophobia usually follows neurologic aura symptoms directly or after a free interval of less than 1 hour. [6]
What Causes Migraine:
Migraine can be caused by various factors which act as triggers for it. The cause may vary with age, gender and race. There are also some exogenous factors like diet, psychosocial conditions and medications that may cause the onset of migraine attack. Demographic variations also play a key role in its onset. Migraine is consistently found to be more prevalent in females than in males, with a female: male ratio ranging from 2:1 to 3:1. In most recent epidemiologic studies, migraine prevalence has moreover been found to be age-dependent. [8] The higher prevalence of migraine in women may be explained in part by hormonal factors. Onset of menstruation has been identified as a risk factor for migraine without aura, possibly because of the sudden decrease in plasma estradiol that occurs at this time. Furthermore, many women find that their migraine improves or disappears during pregnancy. However, persistence of the gender difference in prevalence rates after menopause suggests that other factors are also involved. There is conflicting evidence regarding a possible relationship between migraine prevalence and income. There was no apparent correlation in a study in Kentucky, in two studies in Canada, and in studies in Denmark, Germany, and France.[7] By contrast, in the American Migraine Study, the prevalence of migraine increased as household income decreased. Medication overuse is also thought to cause worsening of migraine. Caffeine withdrawal, snoring/ sleep apnea they also emerge as risk factors for migraine headache. Depression, anxiety and other stressful life events play a key role in the onset of a migraine attack. Depression is strongly associated with migraine and it is thought to be a strong trigger factor of the onset of attack. [9] A recent study made in Japan suggests that obesity is also a cause or underlying risk factor for the onset of migraine. Obesity may lead to chronification of migraine. Individuals with BMI 30 or more than 30 are at greater risk of developing migraine.