THE HEADACHE OF OUR LIVES: MIGRAINE

Headaches are a complaint as old as human history. They are one of the most common reasons for visits to outpatient clinics. The causes are many and varied. They can occur in children, adolescents, adults, and the elderly—at any age. Whether they occur at an early or late age, they are a condition that requires special attention. Migraine is a chronic, recurring condition characterized by headaches, and a significant life-threatening condition.

The main symptom of migraine, which develops in attacks, is the headache. 30-35% of all headaches are migraine headaches. They occur more frequently in women than in men. Migraine attacks are usually throbbing and can be aggravated by activity. Symptoms such as nausea, vomiting, and sensitivity to light, sound, and smells may also occur. Many patients experience pain on one side of the head and can switch sides; it is generally more pronounced on one side than the other. It is often localized in the temples and sometimes around the eyes or behind the eyes. The forehead, the back of the head, and just behind the ear are the most common locations for migraine headaches. In younger women, when hormones are active, the incidence is three times higher than in men.

While the primary cause of migraines hasn’t been fully elucidated, chronic inflammation is the most prominent hypothesis. Other mechanisms include irregular electrical conduction in the brain and excessive nerve cell stimulation. There are certain factors that trigger migraines. However, these factors may not apply to all migraine sufferers. Stress, excessive excitement, changes in sleep patterns, strenuous activity, hunger, cigarette smoke, strong and pungent odors, certain foods such as chocolate, moldy cheese, and nuts with rinds, alcoholic beverages, menstruation, or sudden changes in weather can trigger migraine attacks.

Migraine attacks can be divided into two categories: with and without aura. Certain neurological symptoms that occur immediately before the pain are called “auras.” Symptoms such as flickering lights, dizziness, excessive smell, and numbness in the arms and legs may occur before the pain begins or during its initial development. Patients often sense that a migraine attack is imminent when they experience these symptoms. In migraine without aura, these symptoms are absent.

A clinical diagnosis is made after a doctor evaluates migraine patients’ symptoms. Brain imaging, EEG, or blood tests may be necessary to rule out other headaches.

The first step in migraine treatment is to identify triggers and avoid preventable ones. This alone will significantly reduce the number of attacks. With appropriate treatment, patients can achieve complete relief from migraine attacks.

If migraine is diagnosed and pain is infrequent, crisis treatment is planned to alleviate the pain attacks. Preventive treatment should be administered for attacks that occur once or twice a week or more. Furthermore, because they negatively impact quality of life and reduce productivity, treatment options should be sought. Sometimes, simply eliminating triggering factors (such as hunger, insomnia, and hormone use) can eliminate pain attacks or reduce their frequency and severity. Furthermore, the interventional neurological treatments we offer to our patients can contribute to migraine treatment. Treatment is supported by approaches that eliminate chronic inflammation. A holistic approach to treatment allows for migraine relief.