
Now a days , headache is a common problem often chronic or recurring signifying either vascular( migraine) or tension ( muscular contraction) origin in most patients.Migraine is commonly stereotyped in presentation.
Actually, migraine is a painful headache which can be excruciating and may incapacitate in hours or even days.
Migraine is a neurological disease affecting more than 45 million people in the U.S. and around one billion worldwide.

More than 90ā of sufferers are unable to work or function normally during their migraine.So, migraine is also called a “bad headache “.
Migraine are pulsating or throbbing in one area of the body.
Classification
1) Classic– the onset is usually in childhood, adolescence or early adulthood. There is a often positive family history and migraine is more common in women. The classical triad is visual scotomata or scintillation , unilateral throbbing headache( occurring either left or right) accompanied by nausea and vomiting.An attract lasting 2-6 hours with relief after sleep.
2) Common– unilateral or bilateral headache with nausea .It is more common in women. The pain becomes generalised and may persists for hours or days.

3) Tension headache – pain runs from the neck to the top of the skull.
4) Cluster– It is characterised by recurrent, unilateral , nocturnal retro orbital scaring pain. It is typically a young male 90ā awareness 2to 4 hours after sleep.Onset with severe pain accompanied by unilateral, lacrimation , nasal and conjunctival congestion.Pain lasts 20-60 minutes and subsides quickly but tends to recur at the same time at night or several times each 24 hours over several weeks.

5) Anxiety headache – in this case , pain crosses the headache.
6) Headache Caused by the digestive system- as stomach, intestinal, kidney or gall bladder ailments.

Causes–
It may be caused by functional changes in the trigeminal nerve system, a major pain pathway in the nervous system and by imbalance in the brain chemical including serotonin which regulates pain message going through this pathway.
Common migraine triggers include: –
1) Hormonal
2) certain foods
3) stress
4) unusual smell
5) bright light
6) intense physical exertion
7) changes in sleeping time
8) certain medications
9) changes of weather, season etc
Symptoms –
1) Moderate to severe pain- mainly feel pain on one side of their head, while some experience of pain on both sides
2) headache win a throbbing or pulsating quality

3) pain that worsens with physical activity
4) nausea with or without vomiting
5) sensitivity to light or sounds
6) tingling sensation in one arm or leg
7) thirst
8) drowsiness
9) irritability or depression
Signs
1) Disability and recurring headache
2) pain worsens when one is around light, loud music, noise and/or smell
3) nausea and or vomiting
4) intense throbbing sensation often on one side of head
5) neck pain
6) sinus symptoms( stuffy nose and watery eyes)

Treatment
Principle of treatment of headache
1) Establish a clinical diagnosis
2) after diagnosis, initiate therapy based on the frequency, severity and incapacitation caused by headache.
3) pain-relieving medicine – Take pain-relieving medicine as soon as experience signs or symptoms of a migraine headache. It may help if we rest or sleep in a dark room after taking drugs.
4) Ergots
5) Non-steroid anti-inflammatory drugs(NSAID) – Ibuprofen or aspirin may help relieve mild migraine. Others are a combination of acetaminophen, aspirin and caffeine also may ease moderate migraine.
6) Triptans:- Sumatriptan was the first drug specifically developed to treat migraine. It works faster than any other migraine-specific medication- in as little as 15 minutes and it is effective in most cases.
7) Medication for nausea- Metaclopromide is useful for relieving nausea and vomiting associated with migraine, not the migraine pain itself.

Preventive medication
Preventive medication can reduce the frequency, severity and length of migraines and may increase the effectiveness of pain-relieving medicine used during migraine attacks. Generally, in most cases, preventive medication does not eliminate the headache completely.
1) cardiovascular drugs – Beta-blocker
Which are commonly used to treat high blood pressure and coronary artery disease – can reduce the frequency and severity of migraine. These drugs are considered among the first-line treatment agent.
2) Antidepressant-certain antidepressants are good at helping prevent all types of headaches including migraine. This medication is considered among the first-line treatment agent and may reduce migraine by affecting the level of serotonin and other brain chemicals.
3) Non-steroid anti-inflammatory drugs– Ibuprofen, aspirin etc
Prevention
Whether or not taking preventive medication, we might benefit from lifestyle changes that can help reduce the number and severity of migraine. One or more of these helpful for them.
1) avoid trigger
2) exercise regularly
3) reduce the effect of estrogen
4) quit smoking and drinking habits

So, with this type of prevention, we can surpass the headache and live life happily.

Dr S.k.jha
It’s really informative š
LikeLiked by 1 person
Thanks
LikeLiked by 1 person