Oh, yay! A migraine! Said no one ever…

By Mehak Mukhtar

Migraine is one of the ancient disorders that have inflicted man. Migraine headache is much more than pain. The underlying pathophysiology of migraine is complex and the exact mechanism is still not known. However, neuronal dysfunction is now accepted as a primary cause of this pain.

The word migraine has Greek origin and it means half skull. This name is attributed to the unique property of this monster that attacks one side of your head. Migraine can be described as a recurring headache of moderate to severe intensity that is associated with gastrointestinal, neurologic and some other symptoms. Simply migraine attack is like an earthquake of devastating intensity inside your head or a hurricane would be a better word. But the irony is that this isn’t it. The pain accompanies nausea, vomiting, sensitivity to sound and light. You know you are in pain when the sun is so bright. Dark karen isay!

Nowadays every other person around us diagnoses himself and I have come across many people who would say, “I am having a migraine”. I think people do so out of a habit of exaggeration. Migraine attack cripples the person mentally. In early age, migraine was thought to be caused by evil spirits that take control of your head. People had very strange traditional treatments for getting the evil spirits out of the head. One that would make a migraineur (a person who has migraine) realizes how lucky he is that he was not born then!

Before the age of twelve years, migraine is more common in boys than in girls but prevalence increases in girls after puberty. Genetic factors play an important role in making a person more prone to migraine attacks. Half of the migraineurs have a genetic-based migraine attack. But there is considerable variability in the sensitivity of the brain to migraine-specific triggers. As far as the migraine-specific triggers are concerned, they are numerous and vary from person to person. These triggers are of various nature i.e. FOODS e.g. chocolate, caffeine, oranges, preserved foods, yogurt, cheese, ENVIRONMENTAL FACTORS e.g. weather changes, bright lights, loud noise, stress, depression, HORMONAL CHANGES e.g. pregnancy, LIFESTYLE e.g. dieting, skipping meals, fatigue, smoking, excess or insufficient sleep. Some medicines also precipitate a migraine attack.

Migraine is more common in people having low socioeconomic status. This is due to stress and malnutrition. The duration of migraine headache ranges from minutes to 72 hours. There is a complication in which migraine headache lasts more than 72 hours despite treatment. Migraine attacks are of two types: migraine with aura, and migraine without aura. Aura is basically a complex of neurologic symptoms. These symptoms either occur before the attack or accompany it. Mostly migraineurs experience visual aura. Some can see a false spot, mark or a spectrum while others have scotomas i.e. visual acuity is disturbed. Oh, your headache only lasts one day? Amateur.

There are mainly three phases of migraine attacks. In the first phase or the prodromal phase, migraineurs suffer from any of these symptoms. These prodromal symptoms vary among persons but are consistent in one person: phobia of light, phobia of sound, difficulty in concentrating, sleepiness, depression, anxiety, irritability, restlessness or euphoria (floating sensation). Some people also experience frequent urination, yawning, food cravings, anorexia, stiffness of the neck. The prodromal stage occurs in hours or days before the migraine pain.

The second phase of migraine is the headache. This can occur at any time of the day but mostly after awakening in early morning hours. Pain is moderate to severe. It gradually starts and intensifies with time. The patient becomes intolerable to light and sounds. Sometimes over sweating, diarrhea, constipation, nausea, and vomiting also occur. After the pain stops there comes a prodromal phase. In this phase, the patient becomes exhausted and pain recurs by rapid head movements. The patient may become lazy and be very much irritated. It is frustrating that he cannot explain to people what it feels like. Being hit in the head by a spinning fan blade maybe.

There are several medications for the alleviation of migraine pain but some non-drug approaches may also be helpful. First of all, it’s important for a migraineur to recognize the factors that trigger a migraine attack. Make a record of your headache in a notebook and then assess what changes in your routine cause your migraine. This will also help you analyze the frequency of migraine attacks. Note your dietary habits, mood changes, environmental influences that make your normal day a migraine day. I migrained all day and now I am all migrained out. No migraining for me tomorrow. Hopefully. No migraine. Hear that brain?

Although migraine triggers are numerous there are some factors that are sure culprits. Sleep deprivation and stress are two of them. In my opinion, early to bed and early to rise habit can be a sure help. Wind up your chores before 9 pm and be in bed before 10 pm. This time should be followed as strictly as possible. The day should be started at 5 am. This is only possible when you do your daily activities vigilantly and eliminate extra burden e.g. television, Facebook, etc. Yes, I called them a burden. If you’re typing a status update that says you have a migraine, then you clearly don’t know what a migraine is.

Being a part of this terror-stricken nation, stress has become a sure companion of each one of us. Stress and depression both occur when we occupy our thoughts with the things that are not under our will. One of my teachers says that we are stressed when we compare ourselves to others. So keep calm and don’t compare yourself with others. Everyone has got a different situation to deal with.

Point out the food items that trigger a migraine. Avoid eating them. Meditation and yoga can also help. When you are having a migraine attack, massage the sides of your head gently with the index finger and middle finger. It would be best if you manage to get yourself into a dark room and wrap yourself in the blanket. Nevertheless, it is not possible for most of us because migraine is an uninvited guest who can knock at your door any time. All you can do is to recognize your migraine triggers and avoid them in the first place. Lastly, it is a fact that remedies for all the diseases that have ever stricken mankind were present before the diseases were discovered. I hope science will one day discover the main reason and the remedy of this disorder. In Shaa Allah!

You thought Migraine was just a headache? Really. And I suppose Godzilla is just a lizard.

Mehak Mukhtar is doing MPhil in Pharmacy (pharmacology) from the Punjab University in Lahore and can be contacted through mehakmukhtar@gmail.com

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