Characteristics of migraine

  Migraine is one of the common types of headache in clinical practice. It is characterized by recurrent attacks of headache with normal intervals between attacks. According to the presence or absence of aura symptoms, migraine can be divided into two types: migraine with aura (typical migraine) and migraine without aura (common migraine or simple migraine), and there is a special type of migraine that is less common in clinical practice, also called complex migraine, which refers to migraine with signs of neurological deficits.  Migraine is a functional vascular headache, and some scholars have observed more than 70 cases of children with migraine over a 30-year follow-up period, and found that although the disease has a long course, it does not cause organic damage or serious sequelae. Therefore, patients with this disease do not need to worry too much about their prognosis.  Migraine headache characteristics: Migraine headache attacks usually occur during the daytime, but can also occur at night after waking up from sleep, with more than half of the headaches being confined to one side of the head and about 1/4 of the patients showing full headache, with either side of the head being involved. In nearly half of the patients, the headache site can change from time to time, but severe headache attacks always involve the same side; in the other half of the patients, the headache is fixed on one side. In a few patients, the headache is located in the occipital area and the top of the head, and even in the face and neck. Therefore, the diagnosis of migraine should not be made only on the basis of the location of the headache.  Migraine often develops in adolescence, and some patients have a family history of migraine, which is mostly triggered by exertion, emotional factors, and menstruation. In typical cases (ophthalmic migraine), the headache is preceded by ocular aura, such as flashing light, black haze, foggy vision, hemianopia, etc. There may also be numbness of the face, tongue and limbs, which is related to intracranial vasospasm. After about 10-20 minutes, followed by extracranial vasodilatation, there is severe throbbing pain or distension on one side or both sides, mostly accompanied by pale face, cold limbs, fear of sound, fear of light, aggravated by activity, etc., and there may be changes in mood and behavior; the headache reaches its peak followed by nausea, vomiting, and lasts for several hours to a day to recover. The frequency of attacks varies. Those without the above aura are called “common migraine”. It is more common, and the attacks can last for several days. A few cases of recurrent headache followed by transient motoneural palsy are called “oculomotor palsy migraine”, but the oculomotor palsy does not return after a long period of attack. The pathogenesis of this disease is complex, but in recent years, it is believed that the triggering factors act on the central nervous system and produce neurotransmitter changes via monoaminergic pathways, followed by the activation of platelets that cause the release and depletion of 5-HT and thromboxane A2 (TX A2), and then produce the constriction and dilation of the intracranial and extracranial blood vessels, and the vascular hypersensitivity due to the adsorption of 5-HT in the dilated walls, and the involvement of histamine and bradykinin, and the headache occurs. and its neurovascular response.