Migraine Headache (cont.)
What are the symptoms of migraine headaches?
Migraine is a chronic condition
of recurrent attacks. Most (but not all) migraine attacks are associated with
headaches. Migraine headaches usually are described as an intense, throbbing or
pounding pain that involves one temple. (Sometimes the pain can be located in
the forehead, around the eye, or the back of the head). The pain usually is
unilateral (on one side of the head), although about a third of the time the
pain is bilateral. The unilateral headaches typically change sides from one
attack to the next. (In fact, unilateral headaches that always occur on the same
side should alert the doctor to consider a secondary headache, for example, one
caused by a brain tumor). A
migraine headache usually is aggravated by daily activities like walking
upstairs. Nausea, vomiting, diarrhea, facial pallor, cold
hands, cold feet, and sensitivity to light and sound commonly accompany migraine
headaches. As a result of this sensitivity to light and sound, migraine
sufferers usually prefer to lie in a quiet, dark room during an attack. A
typical attack lasts between 4 and 72 hours.
An estimated 40%-60% of migraine attacks are preceded by premonitory
(warning) symptoms lasting hours to days. The symptoms may include sleepiness,
irritability, fatigue, depression or euphoria, yawning,
and cravings for sweet or salty foods. Patients and their family members usually
know that when they observe these warning symptoms that a migraine attack is
beginning.
An estimated 20% of migraine headaches are associated with an aura. Usually,
the aura precedes the headache, although occasionally it may occur
simultaneously with the headache. The most common auras are 1) flashing,
brightly colored lights in a zigzag pattern (fortification spectra), usually
starting in the middle of the visual field and progressing outward and 2) a hole
(scotoma) in the visual field, also known as a blind spot. Some elderly migraine
sufferers may experience only the visual aura without the headache. A less
common aura consists of pins-and-needles sensations in the hand and the arm on
one side or pins-and-needles sensations around the mouth and the nose on the
same side. Other auras include auditory (hearing) hallucinations and abnormal
tastes and smells.
Complicated migraines are migraines that are accompanied by neurological
dysfunction. The part of the body that is affected by the dysfunction is
determined by the part of the brain that is responsible for the headache.
Vertebrobasilar migraines are characterized by dysfunction of the brainstem (the
lower part of the brain that is responsible for automatic activities like
consciousness and balance). The symptoms of vertebrobasilar migraines include fainting as an aura, vertigo (dizziness in which the
environment seems to be spinning) and double vision. Hemiplegic migraines are
characterized by paralysis or weakness of one side of the body, mimicking a stroke. The paralysis or weakness
is usually temporary, but sometimes it can last for days.
For approximately 24 hours after a migraine attack, the migraine sufferer may
feel drained of energy and may experience a low-grade headache along with
sensitivity to light and sound. Unfortunately, some sufferers may have
recurrences of the headache during this period.
Next: How is a migraine headache diagnosed? »
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