Migraine

Headache is one of the most common cause of loss of work days. Migraine is a very common disease heard among the mass. Its also called as vascular haeadache because of suspected pathology. The typical migraine headache is unilateral pain (affecting one half of the head) and pulsating in nature, lasting from 4 to 72 hours; symptoms include nausea, vomiting, photophobia (increased sensitivity to light), phonophobia (increased sensitivity to sound), and is aggravated by routine activity. Approximately one-third of people who suffer from migraine headaches perceive an aura—unusual visual, olfactory, or other sensory experiences that are a sign that the migraine will soon occur.

But its very difficult for a qualified doctor to brand a headache as Migraine. As there is no direct test to proove a headache as Migraine, other than clinical symptom (which cant be taken for 100% sure scientific proof in the world of documentation), and there is possibility of more grave cause of headache and so greater cause of worry and anxiety to the patient and responsibility to the doctor; it becomes a diagnosis of exclusion.

So, yesterday when I got a young doctor as a patient with complaint of single episode of throbbing headache associated with nausea, vomiting and altered sensation on right arm (all features of raised intracranial tension present), lasting for more than 4 hours, I had no option but to evaluate it thoroughly because the presentation was more looking like aneurysmal bleed or possibility of sinus thrombosis was impossible to be ruled out clinically. Though all her reports came within normal limits, we could not have bypassed it.

The cause of migraine headache is unknown; the most common theory is a disorder of the serotonergic control system. Studies of twins indicate a 60 to 65 percent genetic influence upon their propensity to develop migraine headache. The cause of migraine headache is unknown; the most common theory is a disorder of the serotonergic control system. Migraine affects approximately equal numbers of prepubescent boys and girls; propensity to migraine headache is known to disappear during pregnancy, although in some women migraines may become more frequent during pregnancy. Alltogether its more common in women.

There are many types. Usually prophylactic medication is started after controlling the acute episode of headache. Usually the pain subsides over a period of few years as the patient age crosses 40 years. Anxiety and hormonal status is supposed to have profound role. Its a bnign disease with almost no mortality but a big nuiance.