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A migraine is a throbbing pain in one or both sides of the head. It happens when the nerves in the brain become over-stimulated and cause an excessive amount of certain chemicals (prostaglandins, serotonin and other substances) to be released. Migraines can be acute, chronic, with aura or without aura. An aura happens when the nerve changes trigger a wave that spreads over the cortex. The exact cause of this process is yet to be elucidated, but it is speculated that there is an error in the ion channels on nerve membranes that causes the nerve to malfunction. This error may be a result of genetic or environmental triggers. An acute migraine has four stages (1) Prodrome – occurs hours or days before the headache, involving changes in mood such as irritability or anxiety, yawning, increased sensitivity to light, smells and noise, or craving cheese or chocolate, (2) Aura – happens just before the headache, involves seeing zigzag lines, shimmering/flashing light, numbness, dizziness, paralysis, speech difficulty, memory loss, (3) Headache – painful pulsing in the head, face or neck that can last from hours to days, (4) Recovery. Aside from aura, other symptoms of migraine headaches include nausea and vomiting, abdominal pain; loss of appetite; feeling very warm (sweating) or cold; pale colored skin; tender scalp, diarrhea, and fever. Migraines can be triggered by emotional stress, food sensitivities, caffeine, hormonal changes in women, changes in normal sleep pattern, loud noises, exposure to smoke, perfumes or other odors. The diagnosis is usually a physical examination, discussion of medical history with the doctor and questions about symptoms experienced. The diagnosis criteria is: a headache that is moderately or severely painful, gets worse with physical activity, throbbing and is often worse on one side, interferes with daily activities e.g. school or work, increased sensitivity to light, sound or smells during the headache, long-lasting headache (4-72 hours). The treatment options are drugs that prevent or relieve symptoms e.g. Imitrex, Elavil, and Relpax. Analgesics such as ibuprofen and aspirin can also help to ease a migraine attack. Behavioral changes such as exercise, relaxation techniques, getting good quality sleep, and stress reducing therapies may reduce the number and severity of migraine attacks. It is also important to eat nutritionally balanced & scheduled meals with adequate water intake. Hormonal therapy may be used for women with menstrual cycle related migraines.
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