I. Symptoms of migraine and its origin
In ancient Greece 2500 years ago, Hippokrates of Kos, a famous physician who was respected as the “father of medicine” in the West, found that many headache patients often showed one-sided headache when they had an attack, that is, only left The nature of the headache and the course of the attack were similar, and the headache was similar to the throbbing headache at the lateral temples of the forehead, accompanied by nausea and vomiting, sometimes with cold sweat on the head, and often accompanied by visual symptoms before and during the attack.
With the progress of science and the study of migraine, people began to find that migraine is not only limited to one side of the head, but sometimes it can be painful on both sides; in some patients, the headache is only located at the temples on the outside of the forehead, but it can also extend to the top of the head, the occipital area or the whole headache.
Migraine is currently defined as a recurrent, primary headache characterized by pulsating, moderate to severe headaches on one or both sides. The headache is mostly lateral, usually lasts 4 to 72 hours, and may be accompanied by nausea and vomiting, and may be aggravated by light, sound or activity. About 60% of the patients have unilateral headache, and 40% of the patients have bilateral headache.
II. Triggering factors of migraine
Endocrine factors: menstrual flow, ovulation, oral contraceptives, hormone replacement therapy
Dietary factors: alcohol, nitrite-rich meat, MSG, aspartic acid methyl ester, chocolate, cheese, irregular diet
Psychological factors: stress, stress release (weekends or holidays) anxiety, worry, depression
Natural/environmental factors: visual stimuli such as glare, flicker, odors, weather changes, high altitude
Sleep-related factors: lack of sleep, too much sleep
Drug effects: nitroglycerin, cilostazol, reserpine, hydrazinepyridazine, ranitidine, etc.
Other factors: head trauma, strong physical labor, fatigue, etc.
III. Stages of migraine attacks
Migraine attacks are divided into four periods, namely, the prodromal period, the aura period, the headache period and the recovery period, but not all patients or all attacks have the above four periods.
Prodromal phase: 1~24 hours before the headache attack, patients may have discomfort symptoms such as irritation, fatigue, less activity, change in appetite, repeated yawning and stiffness of the neck, but they are often ignored by patients and should be carefully asked.
Aura phase: Aura refers to the reversible focal abnormal brain function symptoms that appear before the headache attack, which can be visual, sensory or verbal. The visual aura is the most common and typically presents as a flashing dark spot, such as a zigzag-shaped flash near the point of gaze that gradually expands to the periphery, followed by a “jagged” dark spot. Some patients may only have dark spots without flashes. The next aura is a sensory aura, which is a pins-and-needles, numbness, or anthralgia, mainly in the face and upper extremities. The aura may also manifest as a speech disorder, but this is infrequent. The aura usually lasts 5 to 30 minutes and does not exceed 60 minutes.
Headache phase: About 60% of headache attacks are predominantly unilateral, alternating between right and left, and about 40% of headaches are bilateral. The headache is mostly located in the temporal region, but may also be located in the forehead, occipital region or lower occipital region, with throbbing as the main characteristic feature. Simple activities such as walking, climbing a building, coughing or sneezing can aggravate the headache, so patients tend to rest in bed. Migraine attacks are often accompanied by a loss of appetite, and about 2/3 of patients have nausea or, in severe cases, vomiting. Headache attacks may be accompanied by increased sensory perception, including sensitivity to light, sound and odor, and a preference for dark, quiet environments. Other less common manifestations include dizziness, upright hypotension, irritability, difficulty with speech, memory loss, and difficulty concentrating. Some patients experience pain from normal non-painful stimuli during the attack phase.
Recovery: The headache may resolve on its own after an attack lasting 4 to 72 hours, but the patient may also experience fatigue, exhaustion, irritability, restlessness, inattention, scalp tenderness, euphoria, depression, or other discomfort.
The migraine process can start at any stage, not all stages are present, and migraines can stop at any
Therefore, some headache sufferers only have aura and the headache never occurs.
Dangers of migraine
Migraine can cause damage in addition to the disease itself, and can lead to further damage. To date, there have been several studies of the relationship between migraine and stroke in large populations, and the results suggest that migraine is an independent risk factor for stroke. Ischemic stroke, unstable angina, and transient ischemic attack (TIA) occur more frequently in migrainees than in those without migraine. In particular, the risk of stroke is higher in those with migraine with aura,
It is also associated with a higher risk of coronary heart disease. In addition, migraine can lead to subclinical white matter lesions, an increased incidence of asymptomatic cerebral infarction in the posterior circulation, and an increased risk of white matter lesions on cranial MRI compared with those without migraine, even in young migraineurs without cerebrovascular risk factors. Recurrent migraine attacks can also lead to cognitive decline, primarily in speech. It can also be associated with a variety of disorders, such as epilepsy, depression, and affective psychosis. Depression and depression with anxiety are more prevalent in women with migraine with aura than in those without migraine with aura.
It is hoped that in the near future, with the development of medicine, everyone will be able to say goodbye to the suffering caused by painful diseases and live a healthy and happy life. Such a bright future has always inspired our medical colleagues to continue to move forward, to explore and innovate bravely!