Migraine Treatment, Causes And Symptoms of Migraines, Auras Migraine And Headache Treatment

Every head has its own headache! Put together, the headaches of an entire population can hurt the economy of industrialized nations in terms of lost production.
Migraine’s prevalence ranges from 8 to 20 % of the population worldwide. For reasons unknown, migraine is twice as common in women as in men.

Migraine Headache

It’s a pulsating tornado that usually rages through one side of the head, lasting anywhere from 4 to 48 hours. Collateral damage such as nausea, vomiting, sensitivity to light or sound and vertigo (dizziness) often occur with a typical attack.

Migraine Auras

Migraine headache can be foreshadowed by auras or warnings such as these:-
Visual chaos (dots, blurs, spectra, lines), heightened perception of sound, Dysphasia (inability to choose words), Dysarthria (difficulty in articulating speech), Ataxia (inability to perform simple coordinated tasks like walking) and Hemiparesis (weakness in one half of the body).
Depending upon the occurrence of auras, migraine is classified as Classical Migraine (aura present) or Common Migraine (aura absent).

Migraine Auras Origin

This is still a mystery. However, theory postulates a spreading wave of depressed cortical activity that initiates ‘aura’. The ‘aura’ in turn cause an increased pulsatile cerebral and extracranial blood flow leading to throbbing headaches. In addition to these phenomena, the Plasma level of a versatile Neuro- hormone namely ‘Serotonin’ is altered.

Trigger For Migraine

In almost half the cases of migraine no contributing factor or trigger can be found, but do try and remember the mnemonic ‘CHOCOLATE’. Chocolate represents CHeese, Oral Contraceptives, Alcohol, Anxiety, Travel and Exercise. Usually, avoiding “CHOCOLATE” preempts some attacks in most patients. Rarely, almost all attacks may be attenuated in a lucky few!

Migraine Headaches vs Headaches Due To Other Causes

The Differentials Be warned, the following causes of headache may mimic migraine.
Cervical Spondylosis
Indeed, the neck collar arthritis, as it is commonly called, can cause vertigo with blackouts besides the headaches.
Hypertension
Elevated blood pressure bangs the head and busts the heart.
Refractive Error
Check your eyes, you might be headed for glasses. Those already wearing spectacles may have a worsened number.
Sinusitis
The human skull has air cells to keep our heavy brains buoyant in cerebrospinal fluid. Unfortunately though, these can sometimes get infected via a preceding common cold.
Tension or Cluster Headache
Needs evaluation of the patients’ stress factors. Anecdotally, migraine has even been attributed to common ailments such as toothache and constipation.

Drug Therapy For Migraine Headache Treatment

Both symptom-based and specialized treatment can be employed to curtail migraine headaches. Simple treatments include the following:-

NSAIDS

This group of pain killers includes effective drugs like Ibuprofen (ADVIL) or Acetaminophen (TYLENOL) which alleviate headache. Anti Emetic – Prochloperazine (COMPZINE) controls the nausea and vertigo.
Specific treatment aims at constricting the culprit cerebral blood vessels that are dilated during an attack. These are called vasoconstrictor agents.

Ergotamine

This drug was the pioneer. It can be used via the traditional Oral or sublingual routes. However, per rectal suppositories are also available for use in patients who vomit.
An interesting discovery found that Caffeine increases the absorption of Ergotamine and potentiates its vasoconstrictor action. Therefore in some countries combination preparations of ergotamine, caffeine and anti-emetics are widely marketed (VASOGRAIN).

Sumatriptan Succinate (Imitrex)

This novel drug has forever changed the face of both migraine and its patient! It provides significant and high quality relief with minimal dosing. Notably, Sumatriptan Succinate has the ability to suppress nausea and vomiting, unlike ergotamine which accentuates these symptoms. It works in a highly specialized manner on the brain’s Neuro- hormone ‘Serotonin’ ensuring constriction of dilated cerebral blood vessels by working selectively at the molecular or receptor level. A Single dose is effective in controlling migraine for up to a day, in some cases though, a repeat second dose may be needed.
It should never be used in combination with ergotamines. Patients with hypertension or Ischemic Heart Disease must not use it. Sumatriptan Succinate (Imitrex) can give rise to adverse reactions such as tightness in the chest, feeling of heat, altered sensation of the skin (limb paresthesias) and dizziness. These events are dose dependent and usually mild in nature. Detailed literature on Imitrex side effects and interactions are readily available online at your favorite drugstore as is Imitrex itself.

Prophylaxis

There is no universal panacea for migraine. One must try and avoid the earlier listed triggers where possible. Some patients do claim benefit with application of either warm or cold packs to the head. Others tell of how breathing into a paper bag successfully aborts an attack when no drugs are handy.
Certain medicines have a special role in attempting to prevent migraine on a long term basis. But none is effective in all cases. Despite this, they do help in reducing the frequency and severity of attacks, making them rapidly amenable to Imitrex therapy. These long term medications include Propranolol (INDERAL), Flunarizine (SIBELIUM) and Pizotifen (SANOMIGRAN).

Concluding Remarks – Migraine Treatment

Lead by Imitrex, the armamentarium against migraine is increasing. With research into newer molecules progressing rapidly, it appears as though mighty migraine’s days are now numbered.