Migraine Management Migraine Also Known as Hemi Term Paper

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Migraine Management

Migraine, also known as hemi crania and megrim, is a severe and recurring headache. Commonly known as sick headache, it often affects only one side of the head, and is usually accompanied by nausea, vomiting, visual disturbances, and sensitivity to motion, light sound and odors.

'The, International Headache Society (HIS) has created a checklist by which migraine can be diagnosed. This is a simplified, standardized and globally accepted diagnostic test for migraine. The following criteria define common migraine, which is the migraine without aura:

A patient should have had at least five of these headaches.

The headache lasts from 4 to 72 hours.

The headache must have at least two of the following:

a. One sided location.

Pulsing or throbbing quality.

c. Moderate or severe intensity, making daily activities difficult or impossible to perform

d. Headache is worsened by routine physical activity. Such a bending over or climbing stairs.

The Headache is accompanied by at least one of the following:

a. Nausea and/or vomiting.

b. Dislike of light (photophobia) or dislike of sound (phonophobia).

5. Secondary causes of headache are excluded with a normal exam and/or normal CAT or MRI scans." (Tepper, 2004, pg: 3, 4)

In some cases of Migraine, post-migraine hangover is also experienced in which sufferers often feel drained of energy after the headache (Heins, 2003). Migraineurs, or the migraine sufferers can be grouped into two categories; those who have warning signs before the painful part of the attack begins, and those who don't. However the people who experience these warning signs or auras are a minority. An aura experience includes seeing imaginary lights, other vision disturbances or numbness on one side of the body. (Harder, 2005). Heins describes auras as:

"Typically lasting 5 to 30 minutes, an aura can come in the form of a flickering or zigzag light in the field of vision" (Heins, 2003).

Man has been searching for preventive methods to severe headaches for all of recorded times. As a cure to severe headache, the Ancient Egyptian scriptures suggest strapping a crocodile to the head which might have surprised and disturbed the sufferer considerably beyond his headache (Tepper, 2004, i). Thus, providing root to the Shock Theory. However ironic this may sound, time and research has devised and brought forth such advances in migraine treatment as would have been undreamed of, even 25 years ago. Research on migraine management shows despite the intensity of Migraine pain, clinical treatment may not be the soundest approach to combat it and hence several alternative treatments are being recommended.


Statistics reveal that, "Eighteen percent of women, six percent of men, and four percent of children have migraine. All races are affected, although for reasons that are unknown, whites are affected more than African-Americans, and Asian-Americans are least often afflicted." (Tepper, 2004, vii). Among all the complex disorders, migraines are more common than asthma, diabetes or congestive heart failure. According to American Medical Association migraine causes severe and often unbearable pain to about 26 million Americans. (Karen Goldberg Goff, 1999). This disease has considerable social and economic damages, to both the sufferers and the society as a whole. Since the U.S. society alone is at as much as of 13 billion dollars of lost-work owing to migraine (Tepper, 2004). Most sufferers miss out around of two days of work a month as a result of migraine-related problems (Heins, 2003). Therefore this problem is very critical and requires constant research for more effective treatment procedures.

However, surprisingly so, National Headache Foundation study estimates that less than half of migraine sufferers seek any kind of medical help (Heins, 2003). Even if they did seek help, it's likely that sufferers might not get the right treatment and support. Migraines are often wrongly linked to psychological problems, in cases of female patients particularly, who are 75 per cent of migraineurs (Heins, 2003). Richard B. Lipton, MD, professor of neurology at Albert Einstein College of Medicine of Yeshiva University in the Bronx, New York, is of the same view. While talking about how migraine is unjustly linked to psychological problems he says "Women are more likely to have their pain dismissed as being more imagined than real" (Lipton, 2002).

There are a range of effective medications available for migraine treatment from a benign to acute degree. These reduce a periodic count of attacks to about 40 per cent. (Harder, 2005). But all these are loaded with side effects ranging from forgetfulness to fatigue, nausea, and skin sensations that have no obvious cause. Some experts list drug dependency, and even cause severe headache that continues despite the use of medication, as commonly reported side effects. Therefore, most migraine experts suggest changing lifestyles to help prevent migraine and minimize pain if migraine occurs.


Migraine is sometimes developed due to stressful lifestyle but often it is passed down to generations. To be able to fight off migraine effectively it is important to understand what triggers it. As already known, migraines can strike men, women, children with wide range of variations, intensities and symptoms. Therefore there are a variety of triggers that bring about this pain. What all types of migraines have in common is a pain lasting 4-72 hours, often at one side of the head and accompanied by nausea, vomiting and sensitivity to light or sound.

Experts are of opinion that an attack is triggered from within the brain itself. Once one begins, pain and other symptoms of migraine arise from a process swelling resulting from some exchanges between the trigeminal nerve and blood vessels found in the coverings of the brain. Serotonin, a naturally occurring chemical in the brain is considered responsible in this inflammatory process. (USA Today, 2001)

"It is a severe, pounding headache and a misunderstood, mistreated and misdiagnosed condition," says Dr. Seymour Diamond, executive director of the National Headache Foundation and a headache specialist in Chicago. "About 30% of patients get a warning - an aura - before the headache, which can be seeing jagged lines or bright stars or having numbness in arms and legs. A migraine is caused when the brain sends an impulse to certain receptors that control the blood vessels," he says. "The blood vessels then constrict and dilate."(Macmillan, 1995). Here are some of the things that generally trigger migraine.

Interestingly, a good seventy per cent of the migraine sufferers are women. While in more than half of the female sufferers, the headache is linked to hormonal changes in the menstrual cycle, says Dr. Diamond, author of the book "The Hormone Headache" (Macmillan, 1995). As much as 90 per cent of the sufferers are genetically endowed with migraine attacks. Pinpointing what may individually offset this attack depends on person to person. Often it could be cheese, chocolate and red wine. While sometimes it could be low blood pressure and tyramine, which is found in raw onions and smoked foods. Relaxation Techniques which will be discussed in the course of this paper are also very effective in preventing the headache.

Migraine sufferers need to abstain from the following things which most commonly trigger migraine: Ripened cheeses such as Cheddar, brie, Camembert, Herring, pickled or dried, Chocolate, Sour cream, Peanut butter, Sourdough bread, Foods containing MSG, Figs, raisins, papayas, avocados, bananas, citrus fruits, Caffeine, Nitrates found in sausage, bologna, salami, hot dogs, pepperoni, Alcoholic beverages, specially red wine.

Chocolate, cheese and red wine are particularly thought to trigger migraine. However it is only recently been considered that sufferers may crave for these foods just before an attack, as Dr. Mark McClean, a GP at Shankill Health Centre, believes it. (Chapman, 1997). Another migraine expert, Professor Philip Lamey of Queen's University Belfast has contributed a new cause for the trigger. He as proved that teeth grinding is a factor that triggers migraine in those sufferers whose attacks occur in waking and during early mornings. He has designed a special splint that is worn in the night to avoid the teeth grinding and cure migraine. Since clenching and grinding teeth can cause chemical changes in the saliva which disturb the blood vessels in the brain thus triggering the headache.

Other factors that could trigger migraine include stress, or relaxation after a period of stress, physical fatigue, lack of sleep or too much sleep, tension, anger, missed meals, certain foods and hormonal factors (periods, menopause, use of the Pill). It is possible that all of these impose a chemical effect on the saliva of teeth grinding.

Doctor McClean believes that child sufferers can especially benefit from the modern preventive methods for migraine, while types of migraine suffered by women before and during period time can be treated by Vitamin B6 or hormone therapy such as progesterone.

A new phenomenal research carried out by a Neurologist Roman Sztajzel appears to fascinate the migraine experts worldwide (Stacey, 2005). It has linked the migraine preceded by auras to a seemingly harmless hole in the heart. This hole between the right and left chamber of the…

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