Abstract
Migraine headaches are a severe type of headaches which makes the lives of the people it affects to be almost unbearable especially when they strike. This is so since this type of a headache is usually severe as other disturbing side effects accompany it. Some of these accompanying side effects include numbness on one side of the body from the feet to the face which can cause a lot of discomforts. Additionally, migraine headaches are usually followed by a feeling of nausea causing more discomfort to an already uncomfortable situation. Migraine headaches account for almost 4.4% of total consultations in general medical practice and a further 5% of the patients being admitted to hospitals. Additionally, Migraine tends to affect at least 20% of people at one point in their lives. More so an additional 1% of the global population has a chronic migraine (Weatherall, 2015). Migraine headaches cost many economies a lot of money I term of management diagnosis and treatment in addition to the loss of working hours especially for the time spent seeing for treatment. According to Weatherall, 2015 it is estimated that at least $17 Billion is dedicated to migraine headaches without including the social costs.
Migraine headaches can complicate individuals' life by making them unproductive and as such proper diagnosis should be made to find the real issue. As such it is vital for physicians to establish the pattern that a particular migraine takes before it can be treated. Research shows that various factors are at interplay when it comes to what causes a migraine. According to Sun-Edelstein and Mauskop (2009), migraine headache could be triggered by some foods and thus recommends the use of food diaries to manage migraine headaches. Migraine headaches can be treated using their different approaches according to Weatherall (2015). These treatment options include trigger management, preventive treatments as well as acute treatments based on the diagnosis given earlier. In conclusion, the article will give way forward in managing migraine headaches as new research into this condition continues to be conducted.
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Introduction
A migraine can be defined as a complex disorder that manifests by recurrent episodes of headaches that are unilateral. The headaches sometimes are associated with visual or sensory symptoms that are accompanied with the headache. A migraine causes a severe throbbing and a pulsing sensation and is often accompanied by vomiting, nausea, and sensitivity to light and sound. The headache can last for hours to days and is capable of causing pain that is disabling.
Historically, migraine headaches were treated based on the limited understanding of the disease at that time. The procedures for treatment were based on superstition and witchcraft. Evidence from skulls from 9000 years ago shows drilled holes to allow for the escape of evil spirits which were perceived to cause the headache. Migraine is one of the oldest diseases known to humankind as shown by the Egyptian medical records and documents that showed headache with neuralgia among ancient Egyptians. Hippocrates also delved into this disease when he described the visual aura that comes before the onset of migraine headache and the relief associated with vomiting which released bad vapours. Sun-Edelstein and Mauskop (2009) asserted that Aretaeus and Cappadocia are regarded as the discoverers of migraine headache as they were the first to describe symptoms of a unilateral headache that caused vomiting and had headache-free periods between the attacks.
Body
Migraine headache is a common complaint encountered in the neurology practice. The World Health Organization (WHO) ranked migraine as one of the most prevalent health disorders globally, and a frequent cause of headache in Americas, Europe and South-East Asia. In 1989, the American Migraine Study estimated the prevalence of migraine in the United States. Using a sample of 20,000 individuals, the study found out that the prevalence of migraine was 18% for women and 6% for men over a period of one year. The American Migraine Prevalence and Prevention study recently confirmed that the overall prevalence among the U.S. population is at 12%. The rates of migraine headaches are higher among the white and black population and also among the lower income earners. The U.S. census claimed that over 37 million people suffer from migraine. Migraine headaches can attack an individual at any age, but the incidences peak during the adolescent stage (Guyuron, et al. 2011). Stages have also highlighted the frequency and duration of the migraine episodes. 63% of patients will experience 1-4 episodes in a month, and 14% will experience 1 episode a week. Migraine has some genetic trend as an estimated 90% of sufferers exhibit a family history of the disease (Kirthi, et al. 2010).
The annual healthcare expenditure for migraine is estimated to be $35 billion annually in the U.S. Medical costs for the treatment of chronic migraines were at $5.4 billion in the year 2015. Families with individuals suffering from migraine spend 70% higher than those with non-sufferers. Migraine sufferers experience high cost of medical treatment and limited access to health care.
The cause and aetiology of migraine headache are not properly understood, but genetics and environmental factors have been heavily implicated. With regards to anatomy, migraines could be as a result of alterations in the brainstem and its interactions with the trigeminal nerve which serves a major pain pathway. Brain chemicals may also exhibit imbalances such as with serotonin, which helps in regulating pain in the nervous system. Levels of serotonin decrease during migraine attacks leading to release of neuropeptides which travel to the meninges causing pain ( Scher, et al. 2009).
Predisposing factors for migraine include hormonal imbalance, especially in women. Fluctuations in estrogen are a major cause of this type of headache. Foods such as cheese and salty foods may trigger migraines. Alcoholic drinks and caffeinated beverages have been implicated in cases of migraine. Other predisposing factors include stress, change in wake-sleep pattern, physical factors such as sexual activity, changes in the environment, and medication such as contraceptives.
Diagnosis may include blood tests to determine if the spinal cord or brain is infected or has toxins. The magnetic resonance imaging can be employed to give a detailed image of the brain to help detect tumours, bleeding, and other infections. The computer tomography scan also checks for tumours, infections, and brain damage. The lumbar puncture can be done to test for infections, bleeding or any other underlying condition. Treatment may include the use of pain-relieving medication to stop the symptoms. Preventive medication is geared towards reducing the severity and frequency of migraines. Lifestyle and home remedies such as relaxation and getting enough sleep can be important as pointed out by Guyuron, et al. (2011).
Conclusion
In conclusion, migraine headache is among the most prevalent conditions in the world. It mostly affects women than men, and the rates are highest among the adolescents. It has serious economic implications due to its expensive nature to treat. Whereas the cause is not understood, it has a wide array of symptoms that range from mild to chronic. The hope for the future is that the aetiology of the disease will be better understood hence leading to proper treatment techniques.
References
Guyuron, B., Kriegler, J. S., Davis, J., & Amini, S. B. (2011). Five-year outcome of surgical treatment of migraine headaches. Plastic and reconstructive surgery , 127 (2), 603-608.
Kirthi, V., Derry, S., Moore, R. A., & McQuay, H. J. (2010). Aspirin with or without an antiemetic for acute migraine headaches in adults. Cochrane Database Syst Rev , 4 (4).
Scher, A. I., Gudmundsson, L. S., Sigurdsson, S., Ghambaryan, A., Aspelund, T., Eiriksdottir, G.,..& Launer, L. J. (2009). Migraine headache in middle age and late-life brain infarcts. Jama , 301 (24), 2563-2570.
Sun-Edelstein, C., & Mauskop, A. (2009). Foods and supplements in the management of migraine headaches. The Clinical journal of pain , 25 (5), 446-452.
Weatherall, M.W. (2015). The diagnosis and treatment of a chronic migraine. Ther Adv Chronic Dis, 6(3), 115-123.
