Although the cause of migraine remains medically unclear, do you know that the latest imaging technology has allowed scientists to observe the brains of people who have migraine while they experience it. Even though they still do not understand every aspect of it, the existing information allows us to have a clearer understanding about the process by which migraine occurs. Accordingly, the components of migraine are divided to be examined more easily as follows:
- Trigger Factors of Migraine
Anything that can start the migraine process can be its trigger. In most people, however, the triggers can be in a mixed form combining multiple factors and then gradually build up over time until they become individualized triggers. These factors can be caused internally like hormones, stress and lack of sleep or externally such as by weather changes and food allergies, etc.
- Brain Control Center
Migraine triggers gather together at the hypothalamus, which is the part of the brain responsible for regulating the secretion of various hormones, sleep and hunger. The co-symptoms of migraine include nausea and vomiting and can result from signals sent from the hypothalamus to the nervous system, which is where migraine originate.
- Origin of Migraine
The hypothalamus sends signals to the upper brain stem where the trigeminal nerve is located. This nerve is a major neural network with branches spread throughout the entire brain like a safety helmet. When this nerve is triggered, migraine begins.
- Headache
Headache occurs as a result of dilation of the blood vessels at the outer part of the brain tissues and the nerves in the same region, which receive pain signals. When the nerves are triggered, they secret a substance that causes pain receptors to function, thereby causing blood vessels to dilate even further.
- Flashing Light
In some patients, their optic nerves and other sensory nerves are affected, causing electrical signals to travel across the entire brain in waves. These waves can distort vision and cause many patients to see a flashing light before they start having pain symptoms.
What sort of pain symptoms make up a migraine headache?
The symptoms of a migraine headache according to the International Headache Society (1988) are having headache for 4-72 hours and, if left untreated or without the help of sleep, the patient will have nausea, vomiting and inability to withstand bright lights or loud noises. The pain symptoms include at least 2 of the following items:
- Throbbing pain.
- Pain on one side of the temples or at the base of the neck.
- Moderate pain to work-disrupting pain.
- Normal activities like walking and moving the head causes migraine pain symptoms to worsen.
Some patients experience an aura that occurs before or at the same time as a migraine. Although its cause is not known for sure, it is hypothesized to be caused by waves spreading from the brain stem to the cerebrum, which usually cause visual symptoms such as zig-zagging lights or firefly-like lights for about 10 minutes before headache symptoms occur.
What should you do if you experience frequent migraine headaches?
- You have to observe what triggers cause migraine such as sleep deprivation or excessive sleep (such as having migraine on Saturday or Sunday mornings); being out in the sun or looking at bright lights for a long time, especially on long drives or during hot weather; fatigue; fasting; and certain types of food such as sausages (that contain nitrates), wines and Chinese food, which contain a lot of MSG. In addition, women often experience it before or during the first 2-3 days of menstruation (explained by hormonal changes). Once you know your headache triggers, you can avoid them in order to significantly reduce the frequency of these headaches while resting and eating on time and avoiding excessively tiring activities.
- When migraine symptoms occur, you should rest in a cool, dark and quiet room. If symptoms do not improve within 10-20 minutes, you should take pain medication. Most patients avoid taking medications, because they are worried that they would be taking too much medication. Accordingly, when pain symptoms become more severe, ordinary pain medications will not be able to control migraine symptoms, and they might ultimately have to go to the hospital. Therefore, taking medications early on can prevent you from having to take a lot of medications later on. Medications you should take include anti-vomiting medication and paracetamol or other NSAIDs (ponstan, brufen) and direct migraine medications, although these can produce side effects like heart palpitations and numbness in the body like consuming coffee or significant muscle soreness in some patients.
- If pain symptoms occur more than 2 times per month or are so severe that work or school is disrupted due to migraine, you should take preventive medications that can help reduce blood vessel sensitivity. These include B-blockers and tryptanol. Keeping a migraine diary can also help patients and doctors understand more about pain symptoms, triggers and responses to drugs in order to make a better mutual treatment plan.
