A primary headache disorder – Migraine
A migraine is a common multifactorial illness characterized by recurrent unilateral headaches. In certain scenarios, it is linked with aura – optical or sensorial manifestations that emerge ahead of the pain, sometimes during the pain attack or later. Aura can be like light glints, blind spots, or prickling on one side of the face or in your arm or leg. A headache is often accompanied by sickness, vomiting, and extreme sensitivity to light and noise. It can be so intense sometimes, which can lead to partial disability for a few hours to days. Due to a significant genetic component, migraine is most usual in women.
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What induces a migraine?
The causes of a migraine aren’t implicit yet, but it is evident that genetics and ecological factors are important.
What are the triggers of a migraine?
As we mentioned in our medical animation video that numerous factors might trigger a migraine, for example:
- Hormonal changes in women: Estrogen changes seem to start headaches in many women. Women often reported about headaches, immediately before or throughout their periods, when they have a significant drop in estrogen. It also applies to hormonal drugs, such as oral contraceptives and hormone replacement therapy.
- Food: Some briny and smelly ones like aged cheeses, processed food may trigger migraines. It also acts with different food ingredients: the sweetener (aspartame) and the preservative (monosodium glutamate or MSG).
- Beverages: Alcoholic drinks especially wine, and highly caffeinated drinks may trigger migraines.
- Stress: Sleep and wake routine changes. Too much sleep or missing a night’ sleep could be the trigger.
- Physical activity: Intense exercising and training could be the triggers too.
- Ambiance and weather changes: A change in the atmospheric pressure, temperature fluctuation, can provoke a migraine.
- Drugs: Vasodilators, such as nitroglycerin, FDA-5 blockers can exasperate migraines.
The pathophysiology is not defined for now. However, a lot of theories exist. One of them is described in our animation.
Cortical spreading depression theory (CSD)
It was discovered in 1944, explaining the action of migraine aura. CSD is a phenomenon characterized by the appearance of depolarization waves of the neurons and neuroglia that spreads from its source point through the cortical gray matter at a speed of 2-6 mm/min. This wave of depolarization explains the primary cortical phenomenon or aura period; on the other hand, it activates fibers of the trigeminal nerve, leading to the headache phase. Potassium or the excitatory amino acid glutamate discharge is the neurochemical foundation of CSD.
Some endogenous inflammatory mediators are believed to be released during a migraine, that is capable of activating and sensitizing peripheral and central trigeminovascular neurons. Peripheral sensitization mediates the throbbing perception of the headache and central sensitization is believed to mediate cephalic cutaneous allodynia during migraine.