What is Migraine? Migraine Symptoms, Causes and Treatment

Migraine is a type of headache that occurs with severe throbbing pain on one side of the head as a result of abnormal brain activity and narrowing of blood vessels that temporarily affect nerve signals. Common triggers of migraine are decreased estrogen levels, alcohol use, stress, cold weather conditions, and lack of sleep. Symptoms of a migraine attack include increased sensitivity to light, sound, and odors, nausea, vomiting, loss of vision in one eye, difficulty speaking, and intense pain on one side of the head. It is known that approximately 20% of women and 8% of men suffer from migraine.

WHAT IS MIGRAINE?

Migraine is a type of headache accompanied by recurrent throbbing attacks on one side of the head caused by changes in chemicals in the blood vessels of the brain. The triggers of migraine, which occurs with symptoms such as nausea, vomiting, sensitivity to light and sound, are usually the use of certain medications, alcohol consumption, especially red wine, excessive caffeine intake, stress, bright light, sound, and sleep problems.

Migraine attacks may occur 1-2 times a year or several times a month. It can be said that most migraine pain is very severe. Migraine sufferers have difficulty in completing their daily work due to the factors accompanying the headache. Nevertheless, a long process and specialist doctor control are very important for a complete diagnosis of migraine.

Migraine attacks can develop in four stages: prodrome, aura, attack, and postdrome.

Migraine symptoms during the aura period often start gradually, increase within a few minutes, and may last up to one hour. Seeing bright spots or light beams, decreased vision, difficulty in speaking, pinpricks in the limbs such as arms and legs, and numbness in the body are symptoms of migraine during the aura period.

During the pain period, although the frequency varies, the pain can last up to 3 days during the pain period, which can be experienced at least once a month. Symptoms of migraine during the pain period are throbbing pain on one side of the head, sensitivity to light, sound, smell and contact, nausea and vomiting.

In the postdrome period, there is a feeling of exhaustion after migraine attacks.

WHAT CAUSES MIGRAINE?

Genetic factors are the leading cause of migraine. If there is a family history of migraine, the probability of having migraine is 40%. A person whose mother and father both have migraine can experience migraine complaints at a rate of 75%. One of the causes of migraine pain is hormonal changes. For this reason, migraine is most common in women. Migraine attacks, which are 3 times more common in women than in men, can increase their severity due to hormonal changes, especially during menstrual periods. The increase in severe headaches during menstruation can also be attributed to migraine. Nausea, vomiting, sensitivity to light and sound may occur. It is usually unilateral, intense, and throbbing.

WHAT ARE THE SYMPTOMS OF MIGRAINE?

Symptoms of migraine include headache, increased sensitivity to light, sound, smell, movement and heat, fatigue, nausea and vomiting, blurred vision such as seeing light beams and geometric shapes, abnormal positive and negative increase in appetite, mood changes and thirst.

Symptoms of migraine include:

• Throbbing headache
• Nausea and vomiting
• Sensitivity to sounds such as light and noise
• Dizziness, fainting, and changes in level of consciousness
• Ringing in the ears
• Slurred speech
• Blurred vision and difficulty seeing
• Mood swings such as depression
• Fatigue and low energy
• Numbness in hands and feet
• Desire to eat
• Difficulty speaking

Since there is increased sensitivity to light and sound during a migraine attack, exposure to these may increase the intensity of the pain. People with migraine also have increased sensitivity to odours, so odours such as perfume may cause nausea and vomiting.

The migraine period immediately before a severe headache is called “aura.” Migraine aura occurs before the onset of pain or during the first development of pain. It is short-lived; it usually lasts 20 minutes between 10 and 30 minutes.

Visual aura: Patients describe flickering twinkling lights.

Sensory aura: The sensory aura of migraine is numbness and tingling in the hands and tongue or mouth and jaw.

Severe, throbbing headache radiating from the nape of the neck

Migraine is characterized by a throbbing or shooting pain, usually worse on one side of the head. This is the most typical symptom of migraine.

Nausea and vomiting

 In migraine disease, which can usually last from 6 hours to 2 days, the person may also experience nausea and vomiting.

Sensitivity to sounds such as light and noise

 In certain types of migraine, there is sensitivity to light and noise. This is also a common symptom of migraine.

Dizziness, fainting, and altered level of consciousness

Migraine with headache can also cause dizziness, fainting and altered level of consciousness.

Tinnitus

Migraine also negatively affects the sensory organs. In this context, tinnitus symptom is experienced in migraine patients.

Slurred speech

Speech disorders can also be observed in migraine patients. The clearest indicator of this is the person’s slurred speech.

WHAT TRIGGERS MIGRAINE?

Although it varies according to the person, some foods such as cheese and chocolate, skipping meals, delaying meals, and not drinking enough water trigger migraine. Sleep pattern is also an important factor for migraine. Sleeping too little or too much, intense exercise, and long journeys can also trigger migraine and cause pain.

Other factors that trigger migraine can be listed as follows:

• Environmental factors such as noise and air pollution
• Very bright and flashing lights
• Pungent odours
• Climate changes
• Hormonal changes in women

You should be careful about foods and beverages that may trigger migraine such as chocolate, cocoa, broad beans, dried beans, lentils and soya products, various seafood, offal, alcoholic beverages, instant meat and chicken broth tablets, canned food, aged coffee and acidic drinks, figs, raisins, papaya, avocado, banana and red plum, peanut butter.

Although the symptoms of migraine may appear differently from person to person, in general, symptoms such as intense throbbing headache, nausea, and vomiting, and sensitivity to light and sound that affect daily activities are common.

HOW IS MIGRAINE DIAGNOSED?

The first process in migraine treatment is to make a clinical diagnosis after the complaints of the migraine patient are evaluated by the doctor. The past history of people with migraine complaints should be examined, and after the head and neck region examination, a personalized treatment plan is drawn up for the cause. Muscle structures should be examined during the examination. A trigger point in the neck and back region, for example, muscle contraction and earache, may also cause unilateral eye and facial pain starting from the neck.

The patient’s water consumption, how they are fed, sleep patterns, stress level, environmental conditions, and gastrointestinal system health should be determined. Because physiological disorders can also trigger pain as well as provide excessive perception of pain. Today, many people experience neck and back pain, and headaches that develop in addition to these are often confused with the diagnosis of migraine. In migraine disease, a multidisciplinary approach with neurosurgery, neurology, psychiatry, and physiotherapy departments is required. Studies show that 53 percent of patients actually suffer from pain due to psychogenic factors or psychological disorders that develop after the disease. For this reason, it is not the correct approach to use the same method for every patient.

Migraine types are very important for correct treatment. In order to evaluate migraine correctly, a specialist doctor should be consulted. The most common type of migraine is “migraine without aura.” Most people with migraine pain have migraine without aura. Those with migraine with aura, another type of migraine, may sometimes have attacks without aura.

When some diseases of the brain are suspected, examinations are performed to exclude them. A brain MRI should be performed in patients with recurrent headache and diseases that may mimic migraine should be investigated.

HOW IS MIGRAINE TREATMENT PERFORMED?

Patients can get rid of migraine attacks with correct diagnosis and appropriate treatment planning. In migraine treatment, if the pain is infrequent after the diagnosis of migraine, crisis treatment is planned to relieve pain attacks. When attacks occur 1-2 times a week or more, preventive treatment should be performed. In migraine treatment, sometimes pain attacks may disappear, or their frequency and severity may be reduced only by eliminating the factors that trigger migraine (such as hunger, insomnia, and hormone use). Likewise, medications used under expert control are also very important in migraine treatment. A pain-free life can be achieved for years with medications taken only once a day under the control of a doctor.

For an effective headache treatment, medications and changing the daily life routine are very important. If you do not plan your daily life according to migraine, using only migraine medications will not be beneficial.

• Keeping a headache calendar or headache diary
• Sleeping less or more
• Regular exercise
• Learning ways to cope with stress
• Achieving an appropriate weight
• Avoiding alcohol

Migraine treatment with medication

 Although using medication in migraine treatment is one of the first preventive methods that come to mind, it must be taken with the advice of a specialist doctor. The right migraine medication can end migraine attacks. If you have nausea accompanying your migraine pain, it may be useful to use drugs that prevent nausea and migraine pain together. However, migraine medication should not be used with the recommendation of your mate or friend.

 A migraine medicine that is good for your friend may not be good for you. If you use migraine medication, one of the most important things you should pay attention to is that you should always keep the medication with you. It is useful to use migraine medication as soon as you understand the symptoms of an attack. The earlier it is taken, the more effective it is.

Likewise, using migraine medication 2 to 3 days a week will develop tolerance in the body after a while, and it will start to become the cause of your migraine pain. This can make migraine treatment more difficult. If migraine medications do not work and the attacks are too frequent and severe, you should try “preventive treatment.” The medications taken during preventive treatment are different from painkillers and are more aimed at increasing the migraine threshold.

Migraine treatment with Botox

Another approach in migraine treatment is Botox, which is used to eliminate wrinkles on the face. The realization that the headaches of migraine patients with Botox decreased paved the way for the use of Botox in migraine treatment. Studies have shown that botox application is effective in the treatment of chronic migraine, which is defined as migraine-like headaches for 15 or more days a month for more than 3 months. This effect is thought to be due to the fact that Botox prevents inflammatory pain by inhibiting the release of certain neurotransmitters in nerve termination sites. In migraine treatment, Botox is applied to the forehead, temples, nape, and neck.

Botox, which is applied only in the face area for cosmetic purposes, is applied by subcutaneous injection of botulinum toxin to certain points in the forehead, temples, nape and neck areas in migraine treatment. In most cases, since the effect of the applications will last for about 3-4 months, it should be repeated for the continuation of the treatment. Botox treatment for migraine should be applied by a neurologist to be reliable.

Migraine treatment with migraine vaccine

Migraine vaccine, also known as migraine injection, is one of the prominent methods in migraine treatment in recent years. It has been determined that the molecule called CGRP in the body is effective in the occurrence of migraine pain and attacks. It is aimed to prevent attacks with migraine vaccine, which is based on the principle of administering antibodies developed against the substance that causes pain called CGRP in chronic migraine and migraine with aura.

Migraine treatment with Neural therapy

Neural therapy treatment, which was discovered in 1926 during the treatment of a patient with migraine, is a method applied in the world and in Turkey since 2008. Neural therapy is a needle treatment with short-acting local anesthetics. It is based on the reorganization of the autonomic nervous system. It has almost no complications and can be applied to all age groups, including pregnant women. Neural therapy and a holistic approach have increased the chance of success in migraine treatment. Neural therapy can be supported with combined treatments such as trigger point injections, manual therapy, ganglion blockages, medication, and selection, depending on the degree of migraine.

WHICH FOODS CAUSE MIGRAINE ATTACKS?

Foods that cause migraine can be summarised as cheeses and foods containing tyramine. Tyramine occurs as a result of the breakdown of proteins as the food is kept waiting. The amount of tyramine also increases in foods with high protein content that are aged. We can say that especially, cheeses and wines, alcoholic beverages, and processed meats cause migraines because they contain plenty of tyramine. As an answer to the question of which cheeses affect migraine more due to their high tyramine content, Roquefort and similar moldy cheeses (stilton, gorgonzola), cheddar, feta cheese, mozzarella, parmesan, Swiss cheese can be listed.

Alcohol: Red wine, beer, whisky and champagne are migraine-friendly. They can trigger migraine pain quickly.

Food preservatives: Food preservatives trigger migraine because the nitrates in them dilate the vessels.

Cold foods: Cold foods consumed during exercise, walking, or in hot weather, especially when the body temperature rises, can cause migraine pain in some people. The pain, especially in the forehead and temples, usually lasts for a few minutes. Staying too cold can also trigger migraines.

Apart from these, foods that are not good for migraine can be listed as follows:

• Nuts and nuts
• Smoked or dried fish
• Baked yeast products (cakes, homemade bread, sandwich bread)
• Bananas, citrus fruits (oranges, tangerines, citrus, etc.), kiwis, pineapples, raspberries, red plums. Some dried fruits (dates, figs, grapes)
• Soups made with meat bouillon (does not apply to real broth)
• Aspartame and other sweeteners

FREQUENTLY ASKED QUESTIONS ABOUT MIGRAINE

 How to recognize migraine?

Migraine is a type of headache characterized by throbbing and pulsating pain attacks on one side of the head that develop with symptoms such as nausea, vomiting, and sensory sensitivity. Experiencing such symptoms is a diagnostic physical and mental symptom for migraine.

How does a person know that they have migraine?

Migraine disease means much more than a nasty headache. In migraine cases, debilitating, throbbing, and unilateral headaches, nausea, vomiting, and sensitivity to light or sound also indicate migraine disease.

What stops a migraine attack?

Hot or cold compresses can be applied to the head and neck area. Cold compresses have a numbing effect and can relieve the pain. Hot compresses can relax tense muscles.

How long does migraine pain last?

When a migraine attack starts, the headache can last from 4 hours to 3 days. A complete migraine headache, including prodrome, aura, attack, and postdrome, can last from 1 day to 1 week.

Does stress cause migraine?

 A significant proportion of people who experience migraine attacks mention stress as a common trigger. The link between stress and headache may be more severe in women than in men. If you spend half of a month with migraine, you have a high-stress level.

How does migraine feel?

The main symptom of migraine is a severe headache that occurs on one side of the head. In some attacks, the pain may occur on both sides of the head and may even affect the face and neck. The pain usually includes a moderate or severe throbbing sensation.

What is migraine without the headache?

Migraine without headache, also known as acephalgic migraine and silent migraine, is a type of migraine in which the patient has other symptoms such as aura (visual disturbance), dizziness, nausea, and sensitivity to light and sound.

What is migraine aura?

Migraine aura refers to sensory problems, including spots and flashes in vision. There are problems such as tinnitus, dizziness, and difficulty speaking. It occurs before or during a migraine attack.

Which exercises should migraine sufferers do?

Research shows that doing light exercises is of great importance among the remedies for migraine. Light exercises can reduce the frequency and severity of migraine attacks and may be helpful in the preventive treatment of migraine. If you have migraine pain, you can follow a regular aerobic exercise program that will not tire you too much. In addition, if you have migraines in your life, jogging, swimming, dancing, cycling, and brisk walking are among the exercise options you can choose from.

Does migraine cause depression?

Depression and anxiety symptoms are more common in people with chronic migraine pain. The definition of chronic migraine is having headaches every other day or more frequently for 3 months. Even if your migraine pain is not chronic, if you have depression and anxiety, this will cause your migraine pain to increase. It is very important to treat depression and anxiety in migraine treatment.

Is caffeine good for migraine?

Caffeine is good for migraines. Adding caffeine to your migraine medication makes the medication almost 40% more effective against headaches. Although caffeine-containing medicines are useful, caffeine-containing foods are not recommended. Coffee, tea, soft drinks, or chocolate can make a person more susceptible to rebound headaches. All migraine medications should be used under the supervision of a doctor.