Causes of a Bad Migraine

Symptoms

The fluorescent lighting feels as though it is a spotlight in your eyes. The typing you hear in the cubicle next door feels like a jackhammer inside your brain. Your head feels as though it will crack open, and Athena, herself, will burst forth fully grown as she did from Zeus' head, but all of the pain is only on one side of your head. Congratulations, you have a migraine. How did this happen?

Origin

The predisposition to migraines starts in the womb because genetics play a factor. If your mother, uncle or great-grandfather had migraines, chances are, you or your siblings also will suffer from them. If you're female, you're also three times as likely as your brother to experience migraines. Science is not exactly sure why this ailment occurs more frequently in women, but researchers at UCLA believe it is because women may have a faster brain wave trigger mechanism in their brains than men.

When something in your environment changes--pulsing light; eating certain foods such as cheese, red wine, or monosodium glutamate (MSG); stress; or weather changes--it may cause changes in the trigeminal nerve, a major pain pathway in the brain. The UCLA team also believes imbalances in the brain chemical serotonin are involved in the process. When serotonin levels drop during a migraine, neuropeptide cells in the brain activate, causing the covering of the brain to become inflamed, which, in turn, causes pain.

Phases

A migraine headache occurs in four distinct phases: the prodrome, aura, migraine headache and postdrome. The prodrome phase occurs in 60 percent of sufferers in the hours or days leading up to an attack. Symptoms include a stiff neck, cold feeling, sluggishness, dizziness, increased thirst and urination, loss of appetite, sensitivity to light and/or sound depression and euphoria. The aura phase, experienced by only 20 percent of migraine patients, usually lasts between five and 20 minutes before an attack and can include both changes in the visual field and muscle strength. Actual migraine symptoms are different from other types of headaches. Pain will be centered behind the eye, usually on one side of the head, is moderate to severe and is worsened with physical activity. Other symptoms include nausea and vomiting; sensitivity to light, sound and odors; tenderness of the scalp; fatigue; depression; and blurry vision. This phase can last from four to 72 hours. After the pain subsides, the postdrome phase is marked by fatigue, irritability, impaired concentration, scalp tenderness and mood changes.

Risk Factors

In addition to family history, age, sex and hormonal changes in the body all put certain people at greater risk for experiencing migraines, according to doctors at the Mayo Clinic. Before turning 20, half of all migraine sufferers experience their first episode. The primary age range for migraine attacks is in people between the ages of 20, and 40 with migraines being most common in the third decade of life. By the time a female reaches puberty, her chances of experiencing a migraine have already outpaced males. Doctors at the Mayo Clinic believe this could be due to fluctuating hormones in a woman's body. Many women report experiencing these headaches more frequently just before or after menstruation and during the first trimester of pregnancy.

Triggers

Common triggers for migraines are largely environmental. The exception to this rule appears to be fluctuations in estrogen levels. Both before and after the monthly menstrual cycle, women experience a drop in estrogen. Pregnancy and menopause also can trigger migraines in certain women, as can oral birth control and hormone replacement therapy. Common food triggers include alcohol, especially beer and red wine; aged cheeses, salty, or processed foods; caffeine; chocolate; and aspartame and MSG. Skipping meals also can trigger an attack. Environmental factors triggering migraines include stress at work or home; bright lights; loud sounds; and unusual or irritating odors such as cigarette smoke, perfume and certain chemicals. Still other possible triggers include changes in the sleep pattern such as insomnia or jet lag, excessive physical exertion, certain medications and a drop in barometric pressure. While some of these triggers are unavoidable, controlling your exposure to others can help mitigate the damage a migraine wrecks on your schedule and relationships.

Prevention

Avoiding triggers when possible is the single greatest thing you can do to minimize the number of migraines experienced. Keeping a journal of what was happening prior to the onset of a migraine is one way you can determine individual triggers. Also, establishing regular sleep and meal patterns will help your body to reduce the incidence of attacks. The Mayo Clinic doctors further suggest regular exercise as a means of reducing stress. Medications can be a bit more tricky. Changes in birth control methods or hormone replacement therapy can help. A class of migraine prevention medicines includes beta blockers, calcium channel blockers, serotonin antagonists, tricyclic antidepressants, anticonvulsants, selective-serotonin reuptake inhibitors and other drugs. Consulting your doctor is the best course of action when learning to live with migraines.

References

• Migraine phases
• Women get migraines more often
• Triggers, process

Resources

• Migraine information from paincare.org
• All about migraines