migraine

A migraine is a type of headache that can cause debilitating pain, often characterized by a throbbing or pulsating feeling on one side of the head [1]. It may also be accompanied by symptoms such as nausea, vomiting, and sensitivity to light and sound [2].

Migraines are typically moderate to severe in intensity and can last for several hours or even days [3]. The pain is often described as throbbing, pulsating, or pounding, and it may worsen during physical activity or when moving slightly [4].

In addition to the headache itself, people with migraines may experience other symptoms such as:

• Sensitivity to light and sound
• Nausea and vomiting
• Dizziness or vertigo
• Blurred vision or blind spots
• Tingling or numbness in the face or extremities

Migraines are a neurological condition that can be caused by abnormal brain activity, and they tend to run in families [5]. They affect more than 39 million Americans, with women being more likely to experience migraines than men [10].

Overall, a migraine is a complex condition that can have a significant impact on a person's quality of life.

Understanding Migraine Symptoms

Migraines are complex conditions that can manifest differently in various individuals. While a headache with light or noise sensitivity and nausea or vomiting are the hallmark symptoms, this condition can cause an array of symptoms throughout the body.

Common Migraine Symptoms:

• Headache pain, often throbbing and unilateral (on one side)
• Nausea and vomiting
• Sensitivity to light and sound
• Dizziness and lightheadedness
• Visual disturbances, such as blind spots or flashing lights
• Tingling or numbness in the face or extremities
• Stiff neck
• Changes in mood, such as irritability or depression
• Food cravings or aversion
• Increased urination

Phases of a Migraine:

A migraine can progress through four stages:

1. Prodrome: A warning phase that occurs up to 24 hours before the headache, characterized by symptoms like fatigue, yawning, and mood changes.
2. Aura: A group of sensory, motor, or speech symptoms that serve as a warning sign of an impending headache. This phase can last from five minutes to an hour.
3. Attack: The actual migraine headache, which can be accompanied by nausea, vomiting, and sensitivity to light and sound.
4. Postdrome: A recovery phase that follows the headache, during which individuals may feel exhausted or experience mood changes.

Subtypes of Migraine:

There are several subtypes of migraines, including:

• Migraine with typical aura, characterized by visual disturbances, sensory changes, and/or difficulty speaking.
• Migraine with brainstem aura (MBA), featuring symptoms like vertigo, slurred speech, and tinnitus.

Recognizing Migraine Symptoms:

If you experience any of the following, it may be a sign of a migraine:

• Feeling very tired and yawning a lot
• Craving certain foods or feeling thirsty
• Changes in your mood
• A stiff neck
• Peeing more frequently

It's essential to note that not everyone experiences all of these symptoms, and their severity can vary from person to person.

Sources: [1] [2] [3] [4] [5] [6] [7] [8] [9] [10]

Diagnostic Tests for Migraine

Migraines are complex conditions that can be challenging to diagnose, but various tests and examinations can help healthcare providers determine if you have a migraine or another underlying condition.

• Imaging Studies: Imaging studies such as magnetic resonance imaging (MRI) or computed tomography (CT) scans may be ordered to rule out other potential causes of headaches. However, these tests are not typically used to diagnose migraines [1][2].
• Neurological Exam: A neurological exam can help healthcare providers assess your symptoms and medical history to determine if you have a migraine [3].
• Magnetic Resonance Angiogram (MRA): An MRA is an imaging test that uses magnetic fields and radio waves to create detailed images of the blood vessels in your brain. It may be used to diagnose migraines, but it's not typically required for diagnosis [4].
• Electroencephalogram (EEG): An EEG measures your brain waves and can help healthcare providers assess your neurological function. However, it's not a primary diagnostic tool for migraines [5].

Key Points

• There is no single test that can definitively diagnose migraine.
• Healthcare providers will typically use a combination of medical history, physical examination, and testing to determine if you have a migraine.
• Imaging studies are usually used to rule out other potential causes of headaches rather than to diagnose migraines.

References:

[1] Context 3 [2] Context 4 [3] Context 5 [4] Context 6 [5] Context 8

Treatment Options for Migraine

Migraines are a type of headache disorder that can be debilitating and affect daily life. Various treatment options are available to manage migraines, ranging from over-the-counter medications to prescription drugs.

• Triptans: These are a class of medications specifically designed to treat migraines. They work by constricting blood vessels in the brain and blocking pain pathways. Examples include eletriptan, which has been shown to be highly effective with a success rate of 78% [3].
• Ergots: Another type of medication used to treat migraines is ergots. These drugs work by constricting blood vessels and preventing the release of pain-causing chemicals in the brain.
• Antiemetics: Some medications, such as prochlorperazine and metoclopramide, are used not only for their antiemetic properties but also for their ability to prevent migraines [4].
• Lasmiditan: This is a new class of medication specifically approved by the FDA in 2019 for the treatment of acute migraine with or without aura. It works differently from other medications and has shown promise in clinical trials.

Other Treatment Options

In addition to prescription medications, there are several over-the-counter options available for treating migraines. These include:

• Ibuprofen: This is a common pain reliever that can be used to treat migraines.
• Acetaminophen: Another over-the-counter medication that can be used to treat migraines.

Important Considerations

It's essential to consult with a healthcare professional before starting any new medications, especially if you have a history of medical conditions or are taking other medications. They can help determine the best course of treatment for your specific needs.

References:

[1] FDA approval of lasmiditan (2020) [2] Triptans and their effectiveness in treating migraines [3] [4] Use of antiemetics in migraine treatment [5]

Note: The above information is based on a summary of the provided context.

Differential Diagnosis of Migraine

Migraine diagnosis involves distinguishing it from other types of headaches and neurological disorders. The differential diagnoses for migraine include:

• Temporal arteritis: A condition characterized by inflammation of the blood vessels in the head, which can cause severe headaches, fever, and visual disturbances [4].
• Acute glaucoma: A medical emergency that occurs when there is a sudden increase in pressure within the eye, leading to severe pain, redness, and blurred vision [4].
• Meningitis: An infection of the membranes surrounding the brain and spinal cord, which can cause headaches, fever, stiff neck, and confusion [7].
• Transient ischemic attacks (TIAs): Temporary episodes of stroke-like symptoms, including weakness, numbness, or paralysis on one side of the body, speech difficulties, and vision changes [4].
• Medication-overuse headache (MOH): A secondary headache disorder caused by excessive use of pain medications, which can lead to chronic headaches and other symptoms [8].

Key Symptoms for Differential Diagnosis

To accurately diagnose migraine, it's essential to consider the following characteristic symptoms:

• Aura: A neurological symptom that precedes a migraine attack, characterized by visual disturbances, such as flashing lights or zigzag patterns, or sensory changes like numbness or tingling sensations [5].
• Headache characteristics: Migraines are typically unilateral (one-sided), pulsating, and worsened by physical activity. They can also be accompanied by nausea, vomiting, and sensitivity to light and sound [6].

Clinical Considerations

The diagnosis of migraine is primarily clinical, with no specific blood tests, imaging studies, or electrophysiologic tests available to confirm the diagnosis [3]. A thorough medical history, physical examination, and consideration of differential diagnoses are essential for accurate diagnosis.

References:

[1] MAP Ruschel. (2023). Differential Diagnosis. Accurately diagnosing migraine headaches involves distinguishing them from other types of headaches and neurological disorders.

[2] JA Bernstein. (2013). The differential diagnoses in patients presenting with possible migraine include temporal arteritis, acute glaucoma, meningitis, transient ischemic attacks, ...

[3] The diagnosis of migraine is made clinically; there are no blood tests, imaging studies, or electrophysiologic tests to confirm the diagnosis.

[4] JA Bernstein. (2013). The differential diagnoses in patients presenting with possible migraine include temporal arteritis, acute glaucoma, meningitis, transient ischemic attacks, ...

[5] FM Cutrer. Cited by 43 — ... DIFFERENTIAL DIAGNOSIS · SOCIETY GUIDELINE ... The pathophysiology, clinical manifestations, diagnosis, and complications of migraine will be reviewed here.

[6] Characteristic symptoms of migraine facilitate differential diagnosis from other primary headache disorders, including tension-type and cluster headache.

[7] Jul 29, 2020 — Differentiating Migraine From Other Diseases · Confusion · Drowsiness · Personality change · Seizures · Nausea and vomiting · Loss of ...

[8] AK Eigenbrodt. (2021). Medication-overuse headache (MOH) is a secondary headache disorder that is an important differential diagnosis for chronic migraine30 (Box 1).