Back in the old days, it was claimed that ordinary people only suffered from headaches, while the aristocracy was affected by migraine. However, they did not know how to distinguish between the two. Today it is known that a migraine headache is something different from a normal headache.
Migraine headaches are distinguished from headaches by so-called attacks (attacks) of pain, which last up to 72 hours and, importantly, occur with varying frequency (from several per month to single attacks throughout the year). Migraine pain is usually of a throbbing nature accompanied by nausea, vomiting, phonophobia, photophobia and, importantly, is exacerbated by any physical activity.
Migraine affects people of all races equally, is more frequent in women than in men, is familial (hereditary), and in most cases affects people before the age of 35, although there are cases of the disease in children and adolescents.
The most important forms of migraine
- Migraine without aura (most common). It starts with a throbbing, gradually increasing headache (right or left half), with time, the pain becomes very strong and covers the whole head. It is accompanied by nausea, vomiting, eye pain, irritability to light, sounds and smells. In most cases, the pain is exacerbated by physical activity. Migraine without aura may also be accompanied by symptoms such as sweats, chills, diarrhoea, dizziness, fainting or palpitations. Currently, a distinction is made between mild, moderate and severe attacks. In some cases, a pain attack is preceded by so-called precursory symptoms, or foreboding symptoms (e.g. drowsiness, appetite problems, change in mood and others).
- Migraine with aura (visual, aphatic, haemiplegic, paresthetic) accounts for up to 15% of cases. In this type of disease, there are short-term visual sensations, mainly in the form of a so-called flickering glare (a twitching, expanding, shining spot in the visual field). There are cases in which the patient complains of visual impairment. Another type of migraine with aura is unilateral paresthesias (occupying the corner of the mouth or hand). All symptoms of this aura are reversible, last up to several minutes and are followed by the pain attack described above in migraine without aura.
photo: panthermedia
Factors favouring an attack (seizure) of pain in migraine include:
- lack of sleep or sleep problems,
- mouldy cheeses,
- wine (red),
- irregular diet,
- changes in the weather,
- hormonal disorders and many others.
This is an individual issue for each patient, who, after many years of illness, is able to determine for himself what factors, foods, odours favour the onset of a pain attack.
The diagnosis of migraine follows a thorough medical history, in which all symptoms and pain attacks are revealed. A neurological examination and a fundus examination are necessary.
Currently, detailed diagnostic criteria for migraine are used for this purpose. Treatment includes patient education, avoidance of factors that may provoke an attack, seizure control and preventive treatment.