Migraine is a chronic neurological disorder characterized by recurrent moderate to severe headaches often in association with a number of autonomic nervous system symptoms.
The word derives from the Greek ἡμικρανία (hemikrania), "pain on one side of the head", from ἡμι- (hemi-), "half", and κρανίον (kranion), "skull".
Typically the headache is unilateral (affecting one half of the head) and pulsating in nature, lasting from 2 to 72 hours.
Associated symptoms may include nausea, vomiting, photophobia (increased sensitivity to light), phonophobia (increased sensitivity to sound) and the pain is generally aggravated by physical activity.
Up to one-third of people with migraine headaches perceive an aura: a transient visual, sensory, language, or motor disturbance which signals that the headache will soon occur. Occasionally an aura can occur with little or no headache following it.
Migraines are believed to be due to a mixture of environmental and genetic factors. About two-thirds of cases run in families.
Fluctuating hormone levels may also play a role: migraine affects slightly more boys than girls before puberty, but about two to three times more women than men.
Propensity for migraines usually decreases during pregnancy. The exact mechanisms of migraine are not known. It is, however, believed to be a neurovascular disorder.
The primary theory is related to increased excitability of the cerebral cortex and abnormal control of pain neurons in the trigeminal nucleus of the brainstem.
Initial recommended management is with simple analgesics such as ibuprofen and paracetamol (also known as acetaminophen) for the headache, an antiemetic for the nausea, and the avoidance of triggers.
Specific agents such as triptans or ergotamines may be used by those for whom simple analgesics are not effective. Globally, approximately 15% of the population is affected by migraines at some point in life.
About 15-30% of people with migraines experience migraines with an aura and those who have migraines with aura also frequently have migraines without aura.
The severity of the pain, duration of the headache, and frequency of attacks is variable. A migraine lasting longer than 72 hours is termed status migrainosus.
There are four possible phases to a migraine, although not all the phases are necessarily experienced:
The word derives from the Greek ἡμικρανία (hemikrania), "pain on one side of the head", from ἡμι- (hemi-), "half", and κρανίον (kranion), "skull".
Typically the headache is unilateral (affecting one half of the head) and pulsating in nature, lasting from 2 to 72 hours.
Associated symptoms may include nausea, vomiting, photophobia (increased sensitivity to light), phonophobia (increased sensitivity to sound) and the pain is generally aggravated by physical activity.
Up to one-third of people with migraine headaches perceive an aura: a transient visual, sensory, language, or motor disturbance which signals that the headache will soon occur. Occasionally an aura can occur with little or no headache following it.
Migraines are believed to be due to a mixture of environmental and genetic factors. About two-thirds of cases run in families.
Fluctuating hormone levels may also play a role: migraine affects slightly more boys than girls before puberty, but about two to three times more women than men.
Propensity for migraines usually decreases during pregnancy. The exact mechanisms of migraine are not known. It is, however, believed to be a neurovascular disorder.
The primary theory is related to increased excitability of the cerebral cortex and abnormal control of pain neurons in the trigeminal nucleus of the brainstem.
Initial recommended management is with simple analgesics such as ibuprofen and paracetamol (also known as acetaminophen) for the headache, an antiemetic for the nausea, and the avoidance of triggers.
Specific agents such as triptans or ergotamines may be used by those for whom simple analgesics are not effective. Globally, approximately 15% of the population is affected by migraines at some point in life.
Signs and symptoms
Migraines typically present with self-limited, recurrent severe headache associated with autonomic symptoms.About 15-30% of people with migraines experience migraines with an aura and those who have migraines with aura also frequently have migraines without aura.
The severity of the pain, duration of the headache, and frequency of attacks is variable. A migraine lasting longer than 72 hours is termed status migrainosus.
There are four possible phases to a migraine, although not all the phases are necessarily experienced:
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