{"id":2225,"date":"2020-03-31T13:25:09","date_gmt":"2020-03-31T13:25:09","guid":{"rendered":"https:\/\/imedicalsociety.org\/?p=2225"},"modified":"2020-03-31T13:25:09","modified_gmt":"2020-03-31T13:25:09","slug":"migraine","status":"publish","type":"post","link":"https:\/\/imedicalsociety.org\/migraine\/","title":{"rendered":"Migraine: Description, Forms, Symptoms, Causes"},"content":{"rendered":"
In migraines, those affected suffer from mostly unilateral (on one side of the head) (Source<\/a>), often very severe headache attacks (Source<\/a>). They are often accompanied by nausea, sensitivity to light, and other neurological symptoms (Source<\/a>). The causes of migraine or cephalalgia have not yet been clearly established (Source<\/a>). Among other things, a disturbance of the messenger substances in the brain is suspected (Source<\/a>), combined with reduced blood circulation (Source<\/a>). Read here which forms of migraine there are, how they manifest themselves and how they can be treated.<\/span><\/p>\n ICD codes for this condition are G43 and <\/span>R51<\/span><\/span><\/p>\n People who suffer from migraines experience repeated headaches at irregular intervals. They are often accompanied by various other symptoms such as nausea, vomiting, or visual disturbances. Usually, the pain only affects one side of the head. It is described by those affected as pulsating, hammering or drilling. With physical exertion, it becomes worse.<\/span><\/p>\n A severe migraine can severely restrict the daily life of those affected. The duration of a single attack is between 4 and 72 hours. The attacks occur at different intervals. The duration and intensity can vary from time to time.<\/span><\/p>\n The most severe manifestation of the disease is the so-called status migranosus. Doctors speak of it when a seizure lasts longer than 72 hours. This is enormously stressful for those affected and requires medical treatment<\/a>.<\/span><\/p>\n<\/div>\n<\/div>\n<\/section>\n Overall, experts differentiate between various forms of migraine. These include:<\/span><\/p>\n Migraine without aura is the most common form of migraine. Typical are attack-like, unilateral headaches of medium to severe intensity. The pulsating pain is intensified by physical activity and is accompanied by nausea but also sensitivity to light and noise. The headache attacks last up to 72 hours.<\/span><\/p>\n About 30 percent of migraine patients experience certain neurological symptoms before the headache phase. Physicians refer to these symptoms collectively as an aura. This form of migraine is also called migraine accompagn\u00e9e (from French accompagner = to accompany).<\/span><\/p>\n Typical aura symptoms are<\/span><\/p>\n In most cases, these symptoms last for about half an hour to an hour and then disappear completely. The cause is probably a temporarily reduced blood<\/a> supply to certain areas of the brain, which is caused by a vascular spasm.<\/span><\/p>\n For medical laypersons, the symptoms that occur during the aura phase are hardly distinguishable from those of a stroke<\/a>. However, an important feature of the aura is that the symptoms start rather insidiously and slowly increase in intensity. In contrast, a stroke usually occurs very suddenly.<\/span><\/p>\n In a hospital, however, computer tomography (CT) or magnetic resonance imaging (MRI) can be used to determine exactly whether a stroke or migraine symptoms are involved.<\/span><\/p>\n A complication of migraine with aura is the so-called migraine infarction. In this case the aura symptoms last for more than 60 minutes. This can lead to a very pronounced reduced blood flow in certain parts of the brain, which can cause permanent damage (ischemic infarction). The reduced blood flow can be made visible with imaging techniques such as CT or MRI.<\/span><\/p>\n Another complication of migraine with aura is the so-called migralepsis. This is an epileptic seizure that occurs during or within one hour of migraine aura.<\/span><\/p>\n Usually the aura symptoms precede the headaches and do not last longer than about 40 minutes. However, an aura can also occur on its own, without a headache phase following. This is often called “eye migraine” or simply “migraine without a headache”\u00a0<\/span><\/p>\n Of those who suffer from a “classic” migraine with aura, about ten percent occasionally develop aura without a subsequent headache. This form of migraine is difficult to treat. In principle, it should be clarified particularly thoroughly, as the same symptoms can also be harbingers of a stroke.<\/span><\/p>\n In vestibular migraine, the vestibular system is mainly affected by migraines. The patients suffer from dizziness and impaired balance. Headaches are usually also noticeable, but the attack-like disturbances of the vestibular system are in the foreground.<\/span><\/p>\n According to experts, vestibular migraine is widespread. It causes similar symptoms to the inner ear disease<\/a> Meniere’s disease, with which it is sometimes confused.<\/span><\/p>\n A hemiplegic migraine (also called “complicated migraine”) is a subtype of migraine with aura. It is very rare and most commonly occurs in families.<\/span><\/p>\n In addition to the symptoms of migraine accompagn\u00e9e, patients with hemiplegic migraine also have restricted mobility. For example, they can move certain limbs only with difficulty, not purposefully or not at all. However, these symptoms disappear again after about an hour. Hemiplegic migraine is mainly associated with genetic defects on the 1st, 2nd, and 19th chromosomes.<\/span><\/p>\n Basilar migraine (basilar migraine or migraine of the basilar type) is also considered a subtype of migraine with aura. It occurs mainly in young adults. The headache is typically located at the back of the head (occipital).<\/span><\/p>\n Basilar migraine is named after the basilar artery, which supplies blood to the brain stem and cerebellum. Doctors assume that this artery temporarily cramps in basilar migraine. Then not enough blood reaches the area of the brain that supplies it. Depending on the region affected, typical symptoms of failure<\/a> occur. These include, for example:<\/span><\/p>\n In very rare cases, basilar migraine may be accompanied by a temporary locked-in syndrome (LiS). Although the person is fully conscious, he or she is no longer able to move or communicate with the environment. Locked-in syndrome due to basilar migraine can last from two minutes to half an hour.<\/span><\/p>\n There are two forms of migraine of the eyes: retinal and ophthalmoplegic migraine.<\/span><\/p>\n Retinal migraine:<\/strong> Retinal migraine is a very rare special form of migraine that mainly affects children and adolescents. About one hour before the headache, retinal migraine begins with visual disturbances such as flickering before the eyes, loss of visual field (scotoma), or temporary blindness. All symptoms are exclusively unilateral and disappear when the headache phase begins.<\/span><\/p>\n Opthalmoplegic migraine:<\/strong> This is also an extremely rare form of the disease and affects both eyes. Vision problems are also the most important symptom of ophthalmological migraine.<\/span><\/p>\n For both forms, experts discuss whether they are actually forms of migraine. Some researchers believe that they are more a reflection of other diseases.<\/span><\/p>\n By a menstrual migraine, doctors understand a migraine that occurs exclusively in connection with menstruation: It occurs between about two days before and two days after menstruation.<\/span><\/p>\n A menstrual migraine shows the same symptoms as a “normal” migraine. However, the symptoms are often more intense and last longer. Menstrual migraines can also occur with or without aura or motor difficulties. About seven percent of all women who suffer from migraines have menstrual migraines. The cause is probably the sharp drop in estrogen levels just before menstruation.<\/span><\/p>\n In some women, migraine attacks often occur in connection with menstruation, but also in other phases of the cycle. This is called menstrual-associated migraine or hormone-related migraine.<\/span><\/p>\n Migraine usually only occurs for a few hours or days, with symptom-free intervals in between. In chronic migraine, patients suffer from migraine attacks for more than 15 days a month for more than three months. Patients also have symptoms between attacks.<\/span><\/p>\n A migraine without aura is more likely to become chronic than migraine with aura. It should not be confused with painkiller-induced headaches. In the latter case, pain medication taken too frequently causes<\/a> the headache.<\/span><\/p>\n A special form of migraine is an abdominal migraine. It mainly affects children. In abdominal migraine, a dull pain occurs around the navel area. Headaches, however, are usually absent. Loss of appetite, paleness, nausea, and vomiting can be added to this. An attack of abdominal migraine can last from one hour to several days.<\/span><\/p>\n The causes of abdominal migraines are not yet fully understood. However, it is possible that classic migraine with headache and abdominal migraine have similar causes. The most important thing for affected children is that they can rest and relax. Abdominal migraine is rarely treated with medication. Children with abdominal migraines have an increased risk of developing classic migraine headaches in adulthood.<\/span><\/p>\n<\/div>\n<\/div>\n<\/section>\n In children, migraine headaches often occur on both sides and mainly affect the forehead and temples. The disease is often overlooked for a long time. In many young patients, the symptoms are atypical because the headaches are less pronounced or completely absent. In addition, dizziness, impaired balance, and olfactory sensitivity are significantly more common in children than in adults as accompanying symptoms<\/a> of migraine.<\/span><\/p>\n Instead, children with migraines more often suffer from symptoms such as lethargy, fatigue, paleness, dizziness, abdominal pain, nausea, or vomiting. In addition, small children are not yet able to express their symptoms adequately.<\/span><\/p>\n The trigger of migraines in children is, very often, stress. This can be physical, e.g. due to overtiredness, exhaustion, too little drinking or eating, but also stimulus satiation. Mental stress such as stress at school, conflicts at home, or arguments with classmates also triggers migraine attacks in children.<\/span><\/p>\n The treatment of migraine in children also differs somewhat from that of adults. The focus here is on non-drug therapy. It often works very well in children. This includes a regular daily routine, learning a relaxation method, or biofeedback.<\/span><\/p>\n When supportive medication is needed, children are often prescribed different drugs than adult patients.<\/span><\/p>\n You can find detailed information on this topic in the article Migraine in children.<\/span><\/p>\n<\/div>\n<\/div>\n<\/section>\n <\/p>\n The most important migraine symptom is a severe, usually unilateral headache. In addition, there are other complaints such as photophobia or hypersensitivity to sounds. In addition, various neurological deficits (also known as aura) can herald a migraine.<\/span><\/p>\n A migraine can be divided into up to four different stages with different symptoms. They can manifest themselves to different degrees in each stage. Not everyone affected goes through all phases. The four stages are:<\/span><\/p>\n In about one-third of migraine patients, migraine signs are announced hours to days before the actual attack by various symptoms<\/a>. These include<\/span><\/p>\n<\/span><\/h2>\n
Migraine: a short overview<\/span><\/strong><\/h2>\n
\n
Description<\/span><\/strong><\/h2>\n
\n
Migraine without aura<\/span><\/h3>\n
Migraine with aura (Migraine accompagn\u00e9e)<\/span><\/h3>\n
\n
Aura or stroke?<\/span><\/h3>\n
Migraine infarction<\/span><\/h3>\n
Migralepsie<\/span><\/h3>\n
Aura without headache\u00a0<\/span><\/h3>\n
Vestibular migraine<\/span><\/h3>\n
Hemiplegic migraine<\/span><\/h3>\n
Basilar migraine<\/span><\/h3>\n
\n
Locked-in syndrome (LiS)<\/span><\/h3>\n
Migraine of the eyes<\/span><\/h3>\n
Menstrual migraine<\/span><\/h3>\n
Hormonally induced migraine<\/span><\/h3>\n
Chronic migraine<\/span><\/h3>\n
Abdominal migraine<\/span><\/h3>\n
Migraine in children<\/span><\/strong><\/h2>\n
Main Trigger Stress<\/span><\/h3>\n
Treatment Of Migraines In Children<\/span><\/h3>\n
Symptoms<\/span><\/strong><\/h2>\n
Migraine symptoms in four phases<\/span><\/h3>\n
\n
Symptoms in the migraine preliminary phase (prodromal phase)<\/span><\/h4>\n
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