Friday, March 15, 2013

Splitting Headache: Is It a Migraine?

I have a splitting headache, is it serious?
May be not a serious problem. Most of the chronic headaches are benign and not serious. Most of the serious headaches are tension type of headaches.

What are the different types of headaches?
There are three types of headaches:
1. Migraine Headache (MH)
2. Tension Headache (TH)
3. Cluster Headache (CH)

My headache is mostly unilateral, is it a MH?
Most of the unilateral headaches are migraine headache. MH is always unilateral but rarely MH can be bilateral. CH is rare but often unilateral. CH seldom can be bilateral. TH is mostly bilateral but at few circumstances tension headache may be unilateral.

Is migraine a common illness among female?
Thirty million Americans suffer with MH every year. MH is three times more common among female patients. Hormonal changes among female during menstruation, pregnancy, or menopause triggers MH.

What are the symptoms of migraine headaches (MH)?
MH symptoms include severe pain (headache) and aura. MH is preceded by an aura in 20 to 33% patients. Symptom of aura starts about 30 minutes before actual headache symptoms observed.

Characteristics of Migraine Headache (MH):
1. Mostly unilateral and occasionally bilateral.
2. Throbbing and pulsatile severe pain.
3. Mostly located on lateral side of the scalp above ear and also on forehead above the eyes.
4. Intensity of pain is moderate to severe.
5. Physical activities during headache initiate nausea, vomiting, or both.
6. Aura such as sensitivity to light, noise and smell precedes headache. Intensity of pain becomes worst if not treated.

Aura symptoms are as follows:
1. Visual Symptoms - See spots, flashing lights, seeing wavy lines and visual loss.
2. Numbness or a "pins-and-needles" feeling in hands, arms, or face.

Associated Symptoms:
1. Unable to speak or having difficulty to speak.
2. Tingling and numbness spread over face, arms, and shoulders.
3. Hemiparesis - Unilateral short term weakness on one side.
4. May feel like fainting and lightheadedness.

Can headache get better without treatment?
Yes, it may last 48 to 72 hours or longer.

How often are attack of migraines observed in one month?
You may have migraines several times a month.

Why do I feel on and often depressed and irritable?
You are going through premonitory warning symptoms. Premonitory symptoms are observed between migraine attacks in 40% to 60% of migraine attacks.
Premonitory symptoms are as follows:
1. Sleepiness.
2. Irritability.
3. Fatigue.
4. Depression or euphoria.
5. Excessive thirst, retention of fluid, and increased urine volume.
6. Diarrhea or constipation.
7. Lethargy or yawning.

Can Migraine Cause Stroke?
No, migraine does not cause stroke. Most of the scientific studies indicate there is no risk of migraine causing stroke. But one of the study involving 20925 patients performed in Taiwan and published in scientific journal suggest 0.54% of migraine group had stroke risk. Vascular anomalies of blood vessels in brain causes tension headache (TH). Stroke is caused by lack of blood supply to brain or bleeding within the brain from rupture aneurysm. Vascular anomalies like aneurysm causes continuous TH, which is not associated with aura. Vascular anomalies or cerebrovascular diseases are rare in patients suffering with MH.

What is a Cluster Headache (CH)?
It appear in cluster or groups. Premonitory warning symptoms are absent unlike MH. CH is most intense headache and a lot severe at times than migraine headache. It is caused by chemical changes in brain and often associated with aura. Typical symptom of CH is tearing or bright red blood shot eyes and running nose on same side as headache.

What treatment choices exist for MH?
Medications used for migraine headache are either to prevent migraine or treat active headache. Several medications are used for prevention and for abortive treatment of active migraine. Abortive medications are prescribed for headache after migraine headache has commenced with moderate to severe intensity.

Which are the Abortive Therapeutic Medications?
1. Non steroidal anti-inflammatory medication.
2. Ergots - Dehydroergotamine (DHE) is prescribed for migraine headache and most of the patient suffering with migraine headache responds within 5 minutes. Ergotamine can be prescribed as tablets, suppositories and nasal spray.
3. Tryptans - Triptan are prescribed as a nasal spray and intravenous therapy. Sumatriptan injection is very effective in treatment of migraine headache and works within 15 minutes. In most of the cases, the effect of nasal treatment last less than 45 minutes. Quality of pain relief is better with intravenous therapy than nasal spray treatment.

Which are preventive medications?
1. Beta Blockers - Inderal and Toprol, which relaxes blood vessels.
2. Calcium channel blockers - Cardizem and Procardia, vasodilator and relaxes blood vessels causing migraine headache.
3. Tricyclic antidepressants - Amitriptyline.
4. Anticonvulsants - Depakote and Topamax.

Is there any alternative therapy to treat migraine headache (MH)?
MH is at times difficult to treat. Alternative therapy is tried if pain relief is inadequate with traditional treatment or some patients are tired to taking medication. Therapeutic effects and side effects of alternative therapy for migraine are not documented in any scientific literature. Choices of alternative therapies are as follows:
1. Botox.
2. Oxygen Therapy.
3. Acupuncture.
4. Acupressure.
5. Yoga Therapy.
6. Herbal Treatment.
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About the Author

Roji Khangembam, Team PainAssist. - Know more about Pain, Disease and Conditions causing pain, Pain Management, Pain Relief options, Sports Injury, Personal Injury, Opioids, Watch Pain Videos and Find Pain Physicians.

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