Migraines are less common than tension-type headaches but represent a much larger health problem. In North America, about 1 in 5 females and 1 in 15 males suffer migraine attacks of varying frequency and severity. The condition is considered to be chronic if migraines are experienced for 15 days or more a month. Intense head pain is the hallmark of migraines but they are much more than this.
The migraine experience
There are five phases to a migraine attack. Victims of migraine may not experience every phase but will tend to experience the same phases each time.
The prodrome phase affects more than half of all migraine victims and precedes the headache phase by several hours or even days. Symptoms may include a dramatic change in mood, a heightened sensitivity to light, fatigue, loss of appetite, muscle pain, nausea, diarrhea or any other significant change from normal well being. Every migraine victim, or migraineur as they are called, will experience their own particular symptoms. Recognizing the prodrome symptoms provides an opportunity for early abortive treatment.
The aura phase affects about 20% of migraineurs. The symptoms are neurological and can be quite frightening. They develop gradually over 5 to 20 minutes and usually last less than an hour. The aura phase is named after the most common type of symptom which is a disturbance of vision. This may involve flashing lights, dazzling zigzag lines, blurred, cloudy or shimmering vision, tunnel vision or even a zone of visual loss. Other symptoms include a tingling sensation moving from one hand up the arm and into one side of the face, auditory or olfactory hallucinations, vertigo, difficulty in communicating and hypersensitivity to touch. Migraines with an aura are referred to as classic migraines and those without an aura are called common migraines.
The pain or headache phase usually begins within an hour or so after the aura phase has ended. Head pain with migraines is much more intense than with tension-type headaches and at its worse can be almost unbearable. It typically occurs on one side of the head and tends to be a throbbing kind of pain. Other typical symptoms include nausea and vomiting and an abnormal, distressing sensitivity to light, sounds, smells and touch. Some sufferers may experience abdominal pain, diarrhea, trembling, cold sweats or poor balance. The pain phase usually lasts between 4 hours and 3 days. Migraines are often made worse by physical activity and for many, a migraine attack is so debilitating that they are bed ridden during the pain phase.
The resolution phase occurs when the head pain gradually subsides over a period of several hours.
The postdrome phase has been called the migraine hangover phase. It can last as little as a few hours or as much as several days. During this time the migraine victim will feel tired and irritable, may have a queasy, sick stomach, have difficulty concentrating and may have sore muscles. Eventually even these symptoms subside as the body fully recovers.
What causes a migraine?
Although the exact cause of migraines has not been proven, the prevailing theory suggests that migraines are a genetically inherited neurological disorder involving the brain stem, the trigeminal nerve and the blood vessels on the surface of the brain.
Before the onset of pain there is a phenomenon call cortical spreading depression. CSD is a malfunction in the electrophysiology of the brain, in which a slowly expanding wave of depolarization depresses neurological activity over an area of the cortex. At the leading edge of the CSD there is a brief period of stimulated neuronal activity and this is thought to be the cause of the strange symptoms that occur during the aura.
At about the same time as the CSD occurs; parts of the brain stem become highly activated. This abnormal neuronal activity moves from the brain stem through the trigeminal nerve toward the blood vessels on the surface of the brain. Serotonin levels drop triggering the trigeminal nerve to release chemicals called neuropeptides. These cause the blood vessels to dilate and become inflamed which causes the intense pain.
This neurological disorder appears to be triggered by a multitude of environmental, dietary, and lifestyle conditions as well as hormonal changes and medications. Some triggers are fairly common but they can vary considerably between individuals. A change in estrogen level in the body is known to trigger a migraine which explains why more women suffer from migraines than men and why their migraines are often tied to their menstrual cycles.
Treatment and prevention of migraines
Migraines can not be cured and no medication exists at this time that is completely effective in relieving the symptoms. Living with migraines requires treatment to reduce symptoms during an attack and prevention to reduce the frequency of attacks. Some experimentation is needed to discover what works best for you. If you suffer from migraines you should seek professional medical help.
Your first priority should be prevention. It is easy to respond to a splitting headache but working to avoid the next headache takes a little dedication. Keep a diary and try to identify your headache triggers. Begin by researching and checking common triggers. Eliminating known triggers can be the most productive way to reduce the frequency and severity of attacks. Be more conscious of your health. Strive to maintain regular patterns for eating and sleeping and maintain a regimen of moderate exercise.
Medications called triptans are usually the first choice in treating migraines. They are designed to stop a migraine attack after the pain phase begins by stimulating serotonin to reduce inflammation and constrict blood vessels. Triptans are effective in reducing the symptoms of typical migraines in the majority of patients but they may not work for unusually severe migraines. Triptans carry the risk of serious side effects and it taken too frequently will cause medication overuse headaches. They should not be used during pregnancy or if you have high blood pressure or a heart condition. They are an expensive medication for anyone not covered by a drug plan.
Aromatherapy - a complementary therapy
Few migraine sufferers are happy with results delivered by migraine medication alone and try alternative therapies to ease their discomfort. Aromatherapy is a good choice for a safe complementary therapy. Although some migraineurs with acute sensitivity to odors and touch can not use Aromatherapy, many have discovered that it delivers significant improvement in pain and nausea relief.
Several essential oils are effective in reducing headache pain but peppermint oil (menthe piperita) is the first choice. Clinical studies have shown that its analgesic effect is comparable to acetaminophen. It will also help to alleviate the nausea and can be used in conjunction with prescribed medications. Dilute a few drops of peppermint oil with carrier oil such as Jojoba or Almond and rub the blend into your temples, onto your forehead, or on the back of your neck at the hairline. Alternately you may inhale the peppermint by using a diffuser or a personal inhaler or by simply placing a few drops on a tissue.
Other essential oils worthy of consideration are Lavender, Rosemary, Roman Chamomile and Marjoram.
Ginger essential oil has been found to be very effective in reducing nausea and many find it to be very helpful during a migraine attack.
Migraines are a serious illness that can significantly disrupt your life. Always consult your doctor and try to find the treatment that works best for you.
You may find that Aromatherapy is an effective and safe complement to prescription migraine medication.
Marilyn Flook manages the Forever Fragrant website which promotes aromatherapy and natural products Tension-type headaches are less severe than migraines but they are much more common. Read how aromatherapy can ease the discomfort of tension-type headaches
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