Migraine Headache

Excerpt

Migraine is a genetically influenced complex disorder characterized by episodes of moderate-to-severe headache, most often unilateral and generally associated with nausea and increased sensitivity to light and sound. The word migraine is derived from the Greek word "hemikrania," later converted into Latin as "hemigranea." The French translation of such a term is "migraine." Migraine is a common cause of disability and loss of work. Migraine attacks are complex brain events that unfold over hours to days in a recurrent matter. The most common type of migraine is without aura (75% of cases).

Migraines can be classified into subtypes according to the headache classification committee of the International Headache Society. These subtypes are:

1. Migraine without aura is a recurrent headache attack of 4 to 72 hours; typically unilateral in location, pulsating in quality, moderate to severe in intensity, aggravated by physical activity, and associated with nausea and light and sound sensitivity (photophobia and phonophobia).

2. Migraine with aura has recurrent fully reversible attacks, lasting minutes, typically one or more of these unilateral symptoms: visual, sensory, speech and language, motor, brainstem, and retinal, usually followed by headache and migraine symptoms.

3. Chronic migraine is a headache that occurs on 15 or more days in a month for more than three months and has migraine features on at least eight or more days in a month.

4. Complications of migraine

   1. Status migrainosus is a debilitating migraine attack that lasts more than 72 hours.

   2. Persistent aura without infarction is an aura that persists for more than one week without evidence of infarction on neuroimaging.

   3. Migrainous infarction is one or more aura symptoms associated with brain ischemia on neuroimaging during a typical migraine attack.

   4. Migraine aura-triggered seizure occurs during an attack of migraine with aura, and a seizure is triggered.

1. Probable migraine is a symptomatic migraine attack that lacks one of the features required to fulfill the criteria for one of the above and does not meet the criteria for another type of headache.

2. Episodic syndromes that may be associated with migraine

   1. Recurrent gastrointestinal disturbances are recurrent attacks of abdominal pain and discomfort, nausea, and vomiting that may be associated with migraines.

   2. Benign paroxysmal vertigo has brief recurrent attacks of vertigo.

   3. Benign paroxysmal torticollis is recurrent episodes of head tilt to one side.