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Migraine; Overview.

The excruciating throb of a migraine, often accompanied by nausea or sensitivity to light and sound, can be brutally painful. As anyone who's suffered a migraine can tell you, these headaches, when left untreated or treated ineffectively, can disrupt every aspect of a person's life, from the ability to work to day-to-day activities and relationships. They can eventually lead to a loss of self-confidence, sense of control and self-esteem.

In the U.S. alone, an estimated 28 to 32 million women and men--about 12 percent of the population--suffer from migraine headaches, and 40 percent could benefit from preventative therapies, according to the American Migraine Prevalence and Prevention (AMPP) Study.

Women experience migraines three times more frequently than men. Researchers have found that migraines have a greater overall impact on the lives of female sufferers, affecting their self-esteem, professional development and family and social life.

What are Migraines?

Migraine is a biologically based disorder. Its symptoms are the result of changes in the brain, not a weakness in character or an inappropriate reaction to stress. For many years, scientists believed migraines were linked to the dilation and constriction of blood vessels in the head. They now believe migraine is caused by inherited abnormalities in certain cells in the brain. People with migraine have an enduring predisposition to attacks triggered by a range of factors. Specific, abnormal genes have been identified for some forms of migraine.

People who get migraine headaches appear to have special sensitivities to various triggers, such as bright lights, odors, stress, the menstrual cycle weather changes or certain foods and beverages.

If you get a migraine, you may experience an aura five to 30 minutes before the attack. An aura may lead to seeing flashing lights, visuals resembling TV static or zigzag lines, or you may temporarily lose vision. Other classic symptoms of a migraine aura include speech difficulty, weakness in an arm or leg, tingling of the face or hands, and confusion. An estimated 20 percent of migraine victims experience an aura prior to an attack. Even if you don't have an aura, you may experience a variety of vague symptoms before a migraine, including mental fuzziness, mood changes, fatigue and unusual retention of fluids.

The pain of a migraine is described as intense, throbbing or pounding and is felt in the forehead, temple, ear and/or jaw, around the eye or over the entire head. It may include nausea and vomiting and can last a few hours, a day or even up to three or four days.

People who suffer from migraines may also experience cutaneous allodynia, a condition in which you feel pain on your scalp from a source that should not cause pain, such as a single strand of hair.

Migraines can strike as often as several times a week, or as rarely as once every few years. Some women experience migraines at predictable times such as when menstruation begins or every Saturday morning after a stressful work week.

In addition to the classic migraine described above, migraine headaches can take several other forms:

Hemiplegic migraine: Patients with hemiplegic migraine have temporary paralysis on one side of the body, a condition known as hemiplegia. Some people with this form may experience vision problems and vertigo (a feeling that the world is spinning). These symptoms begin 10 to 90 minutes before the onset of headache pain.

Ophthalmoplegic migraine: In ophthalmoplegic migraine, the pain is around the eye and is associated with a droopy eyelid, double vision and other sight problems.

Basilar artery migraine: Basilar artery migraine involves a disturbance of a major brain artery. Preheadache symptoms include vertigo, double vision and poor muscular coordination. This type of migraine occurs primarily in adolescent and young adult women and is often associated with the menstrual cycle.

Status migrainosus: This is a rare and severe type of migraine that can last 72 hours or longer. The pain and nausea are so intense sufferers are often hospitalized. The use of certain drugs can trigger status migrainosus. Neurologists report that many of their status migrainosus patients were depressed and anxious before they experienced headache attacks.

Headache-free migraine: This type is characterized by such migraine symptoms as visual problems, nausea, vomiting, constipation or diarrhea. However, there is no head pain. Headache specialists have suggested that unexplained pain in a particular part of the body, fever and dizziness could also be possible types of headache-free migraine.

References

R.B. Lipton, D. Dodick, R. Sadovsky, et al. " A Self-Administered Screener for Migraine in Primary Care." Neurology 2003 Vol. 61. (pages 375-382) http://www.healthfinder.gov.

National Institute of Nuerological Disorders and Stroke, National Institutes of Health. NINDS Migraine Information Page. September 5, 2003. http://www.nih.gov.

American Council for Headache Education. http://www.achenet.org. Accessed June 4, 2004.

"Headache Consortium Guidelines" American Headache Society. http://ahsnet.org. Published April 2000. Accessed June 4, 2004.

W.F. Holmes, E.A. MacGregor, J.P.C. Sawyer, R.B. Lipton. "Information About Migraine Disability Influences Physicians' Perceptions of Illness Severity and Treatment Needs." Headache, The Journal of Head and Face Pain. Vol. 41, No. 4, April 2001. http://ahsnet.org

National Headache Foundation. Chicago, IL. http://www.headaches.org. Accessed June 4, 2004.

"Migraine Headaches." National Women's Health Information Center. Office of Women's Health. U.S. Department of Health and Human Services. 1998. http://www.4woman.gov. Accessed June 4, 2004.

"Women and Migraines: Take Charge of the Pain." National Women's Health Resource Center Health Report. Vol. 20, No. 1. February 1998.

"Migraine Medications" Jewish Hospital HealthCare Services. Updated March 2002. http://jhhs.org. Accessed June 4, 2004.

"Guidelines for Treatment of Migraine Headaches" No. A-650-600. Geisinger Health System. Revised: May 1999. http://www.geisinger.org. Accessed June 4, 2004.

American Migraine Prevalence and Prevention (AMPP) Study Fact Sheet." National Headache Foundation. http://headaches.org. Accessed July 7, 2006.

Keywords: Asymptomatic shedding,Benzodiazepines,Post-exertional malaise,Salpingo-oophorectomy,Systemic sclerosis,Healthcare proxy
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Date:Dec 11, 2006
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