Migraine Migraine is a common and recurrent headache disorder characterized by pulsating, severe headaches on one or both sides of the head, often localized to one side. It may be accompanied by symptoms such as nausea, vomiting, and sensitivity to light and sound. In academic terms, it is defined as a chronic neurovascular disorder.

Migraine is a common and recurrent headache disorder characterized by pulsating, severe headaches on one or both sides of the head, often localized to one side. It may be accompanied by symptoms such as nausea, vomiting, and sensitivity to light and sound. In academic terms, it is defined as a chronic neurovascular disorder.

The academic community has very detailed classifications for migraine, primarily used for scholarly research. Based on the main clinical manifestations of headaches, it is classified into migraine without aura, migraine with aura, and chronic migraine, with the first two types detailed in the symptom section.

Chronic migraine refers to attacks that meet the characteristics of migraine occurring more than 15 days per month for three consecutive months or longer, with at least 8 days of attacks each month. The diagnosis of this type of headache should exclude headaches caused by other reasons, especially those caused by medication overuse.

There are also some clinically rare types of migraines:

Brainstem aura migraine

Also known as basilar-type migraine, the aura symptoms of this type of headache originate from the brainstem and can be very severe, such as sudden unclear speech (dysarthria), dizziness, tinnitus, hearing impairment or deafness, visual disturbances or partial visual field loss (visual field defects), unsteady gait, ataxia, and even sudden loss of consciousness. However, this type of migraine usually does not have symptoms of motor weakness.

Hemiplegic migraine

As the name suggests, it presents symptoms similar to "hemiplegia," with weakness in one side of the body, along with at least visual, sensory, and speech abnormal auras.

Retinal migraine

This type presents as recurrent, completely reversible visual disturbances in one eye, including flickering, dark spots, or even blindness, but with normal eye examination. The difference between this type of migraine and brainstem aura migraine is that the visual symptoms are limited to one eye.

Genetic factors

Migraine has a genetic predisposition, with about 60% of migraine patients having a family history. If a person has migraines, the risk of migraines in their relatives is 3 to 6 times that of the general population. Some researchers have identified a specific mutated gene in a group of migraine patients, and there is a certain autosomal dominant inheritance. Based on the comprehensive presentation during attacks, this type of migraine is called familial hemiplegic migraine (FHM).

Neuronal excitability disorders

Some researchers have found that a certain type of neuroexcitatory-related gene mutation is associated with common types of migraines, suggesting that migraines are related to neuronal excitability disorders in the brain.

Endocrine and metabolic factors

This factor is particularly evident in clinical practice, especially in relation to female hormone levels. The incidence of migraines in women is three times higher than in men, particularly during adolescence, and often follows a regular pattern during the menstrual period. Migraines may decrease or cease during pregnancy or after menopause.

Diet

Foods containing tyramine such as cheese, foods containing nitrites such as cured meats, pickled foods, foods containing phenylethylamine such as chocolate, foods containing monosodium glutamate, aspartame, wine, and high-caffeine beverages can trigger migraines. Additionally, skipping meals or fasting can also trigger migraines.

Stress or stress

Stress, tension, emotional instability, stress, and relaxation after stress can trigger migraines from work or life.

Sensory stimulation

Intense light, loud noise, strong odors (perfume, paint odors, secondhand smoke, etc.) can trigger migraines.

Sleep-wake cycle changes

Lack of sleep or excessive sleep can trigger migraines.

Physical activity

Intense physical activity can trigger migraines, including sexual activity.

Environmental changes

Research suggests that changes in weather or air pressure can also lead to migraines.

Medication

Oral contraceptives and vasodilators (such as nitroglycerin) can exacerbate migraines.

Common symptoms of migraine include: headache, which typically starts as a dull pain and gradually becomes throbbing, worsened by movement, and may shift from one side of the head to the other, involving the front or entire head; sensitivity to light, noise, and odors; accompanied by nausea, vomiting, stomach discomfort, abdominal pain; loss of appetite; feeling excessively warm or cold; pallor; fatigue; dizziness; blurred vision; diarrhea. Rare symptoms include fever and impaired normal limb movement.

The headache of most patients lasts for about 4 hours, but in severe cases, it can last for more than 3 days. The frequency of migraine attacks varies from person to person, with 2 to 4 attacks per month being common, but some patients experience migraines every few days, while others have migraines only once or twice a year.

Physical examination

Emphasis is placed on the examination of the nervous system. Based on the aura symptoms and the nature of the headache, it may include checking for clear consciousness, speech, eye movements, and neck stiffness. However, once a seasoned doctor diagnoses migraine, if the patient is still in the midst of an attack, they may quickly advise the patient to rest quietly to avoid triggering a more severe headache through excessive examination.

Blood tests

Blood tests are rarely performed for migraines, but when there is suspicion of concomitant vascular diseases, spinal or intracranial infections, or endocrine disorders, relevant tests may be arranged.

Magnetic Resonance Imaging (MRI)

MRI uses a powerful magnetic field and radio waves to produce detailed images of the brain and blood vessels, which can help doctors exclude brain tumors, strokes, cerebral hemorrhages, infections, and other diseases of the brain and nervous system.

Computed Tomography (CT)

CT scans use a series of X-rays to create detailed cross-sectional images of the brain, which can help doctors rule out tumors, infections, brain injuries, cerebral hemorrhages, and other diseases that may cause headaches.

Lumbar Puncture

If there is suspicion of intracranial infection, bleeding, or other potential diseases, the doctor may recommend a lumbar puncture.

Patients can alleviate the condition of migraines by changing their lifestyle and engaging in appropriate exercise, such as:

Practice muscle relaxation training: Relaxation methods include progressive muscle relaxation, meditation, or yoga.

Ensure adequate sleep: Maintain a regular daily schedule and ensure sufficient sleep without overdoing it.

Rest and relaxation: When experiencing a headache, try resting in a dark, quiet room. Additionally, a cloth-wrapped ice pack can be placed at the back of the neck and lightly pressed on the painful areas of the scalp.

Maintain a headache diary: Even if you have seen a doctor, it is important to maintain a headache diary. This will help identify migraine trigger factors and the most effective treatment methods.

In daily life, it is important to avoid migraine trigger factors, such as consuming foods like cheese, chocolate, and certain medications like oral contraceptives and nitroglycerin. Additionally, it is important to avoid overwork, stress, and emotional instability, and to follow medical advice regarding medication.

By changing lifestyle and adopting preventive strategies, the frequency and severity of migraine attacks can be reduced by:

Creating a daily living plan: Establish a regular sleep pattern and regular meal times in daily life. Additionally, try to control stress as much as possible.

Regular exercise: Regular aerobic exercise can relieve tension and help prevent migraines. With the doctor's permission, choose preferred aerobic exercises, including walking, swimming, and cycling. It is important to warm up slowly before exercise, as sudden intense exercise can trigger headaches. In addition, regular exercise also helps with weight loss or maintaining a healthy weight, as obesity is considered a predisposing factor for migraines.

Reducing the influence of estrogen: For female migraine patients, estrogen may trigger or worsen headaches, so it is important to avoid or reduce the use of medications containing estrogen.

While paying attention to avoiding migraine trigger factors, it is advisable to take preventive medications as prescribed by a doctor.