Migraine Headache

Excerpt

Migraine is a genetically influenced complex neurological disorder characterized by episodes of moderate-to-severe headaches, typically unilateral and frequently accompanied by nausea and heightened sensitivity to light and sound. The word "migraine" is derived from the Greek word hemikrania, which was later converted into Latin as hemigranea. The French translation of the term is migraine.

Migraine is a common cause of disability and loss of work. Migraine attacks are complex and recurrent neurological events that can unfold for hours to days and significantly impact daily activities and the quality of life of individuals. The most prevalent type of migraine, accounting for 75% of cases, is migraine without aura.

Subtypes of Migraine

Migraines can be classified into the following subtypes according to the Headache Classification Committee of the International Headache Society.

1. A migraine without aura: This subtype involves recurrent headache attacks lasting 4 to 72 hours. The pain is typically unilateral, pulsating in quality, moderate-to-severe in intensity, aggravated by physical activity, and associated with nausea, light (photophobia), and sound sensitivity (phonophobia).

1. Migraine with aura: This subtype features recurrent, fully reversible attacks lasting minutes, typically presenting with 1 or more unilateral symptoms such as visual, sensory, speech and language, motor, brainstem, or retinal disturbances, usually followed by headache and other migraine symptoms.

1. Chronic migraine: This is defined as a headache that occurs on 15 or more days in a month for more than 3 months, with migraine features present on at least 8 or more days in a month.

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

1. Episodic syndromes that may be associated with migraine are mentioned below.

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

   2. Benign paroxysmal vertigo involves brief, recurrent attacks of vertigo.

   3. Benign paroxysmal torticollis is characterized by recurrent episodes of head tilt to 1 side.

Complications of Migraine

Migraines can lead to various complications, including the following:

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

2. Persistent aura without infarction: This refers to an aura that persists for more than 1 week without evidence of infarction on neuroimaging.

3. Migrainous infarction: This refers to 1 or more aura symptoms associated with brain ischemia on neuroimaging during a typical migraine attack.

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