Migraines

Posted June, 2008

Migraine is complex disease. The headache a Migraine sufferer experiences is only a symptom of the complex headache-triggering process. Migraine pain is caused by cranial vasodilation (which means expansion of the blood vessels) in the head. "Common headache" pain is typically caused by vasoconstriction (the exact reverse of a Migraine, this is a narrowing of the blood vessels).

During a classic Migraine, inflammation of the tissue surrounding the brain, called "neurogenic inflammation," aggravates the perceived pain. Because of this, medicine that's often prescribed to treat a normal headache, such as beta-blockers, can dilate the blood vessels and thus make a Migraine worse. Much worse.

Unlike a tension or cervically-induced headache, the Migraine has many symptoms. These usually include intense nausea followed by uncontrollable vomiting, auras (light spots in the field of vision), painful sensitivity to light, sound, (or both) numbness, difficulty in speech and comprehension, and severe semi-hemispherical head pain (which means pain in only one side of the head).

Experts debate whether a Migraine can spread to both halves of the head. Some agree that it can, others say by definition, a Migraine only on affects a single hemisphere. Suffers report Migraines that start on one side and then spread to both. This is a process that cascades across the head over a period that may last minutes, hours, or even days. In any case, no matter whether the pain involves one or both halves of the head, these symptoms can utterly disable the Migraine sufferer. Most can do nothing but lie in bed in a dark room when afflicted with a Migraine attack.

A single Migraine episode can last for eight hours, several days, or even weeks. Extreme attacks of cerebral blood vessel dilation can—in people predisposed to it by an undiagnosed weakness of the afflicted vascular walls—trigger a cerebral vascular accident. (Called a CVA, or more commonly "a stroke.")

If you suffer from this disease it's critical to discover, by keeping a careful dietary and behavioral diary, what your "triggers" are. They may be controllable (such as what you eat, or how much regular sleep you get) or uncontrollable (when migraines are provoked by the menstrual cycle or changes in barometric pressure such as then when a storm system comes into the area).

Once you've discovered your triggers then you can try to exercise some control over this condition (We'll list some common dietary and behavioral triggers, and should you wish, you could try removing them from your diet or schedule to see if they help. Of course it's important to discuss any treatment plan with your regular physician prior to altering your diet significantly.)

Certain drugs, such as Imitrex® can help many Migraine-afflicted patients, although the vasoconstrictors they contain can have dangerous side-effects (such as unexpected heart attacks, breathing problems, and similar issues). If you're in poor health, have heart problems due to arterial blockage, you probably won't be able to employ these vasoconstrictor remedies.

There are also other steps we can take, working together, to help you get control of this often-misunderstood syndrome. In addition to using drugs like Imitrex, there are several medications than can lessen your chance of even provoking a migraine episode. These drugs appear to alter the way your system handles triggering agents, and they dampen the aggravated Migraine response. Some patients taking these medications find that even their most "dangerous" dietary triggers won't cause a Migraine, or will cause a vastly smaller and less painful episode.

Finally, for the most severe Migraines we've found that specific nerve blocks may further decrease the odds of one occurring. We're eager to help chronic migraine suffers who have, of course, first spoken with their primary care physician, and have gotten a proper "work up" in order to rule out other previously undiagnosed issues that can cause severe headaches.

!!If you have headaches that do not feel like your usual migraine headaches, or they're accompanied by changes in your vision, hearing, balance, or any other sense, you should contact your general physician immediately. Migraine sufferers are known to have an increased instance of strokes and other vascular problems.