Headache and Migraine

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Overview

A headache is a very common symptom, experienced by almost all individuals, at least once in their lifetime. A headache could either be primary or secondary to some underlying disease. The following are the primary headaches:

  • Cluster headache
  • Tension headache
  • Migraine

Causes

The exact cause of migraine can not be pinpointed, however some of the following factors can trigger an attack:

  • Estrogen
  • Cheese
  • Chocolate
  • Stress
  • Changes in sleep pattern
  • Intense physical exertion

Symptoms

Migraine is the most severe of these headaches, some of the symptoms of which are discussed below:

  • Prodrome period – mood changes, food cravings, neck stiffness, increased thirst and hunger
  • Aura – visual disturbances, hearing noises, difficulty speaking, pins and needle sensation on the arms and legs.
  • Attack – throbbing pain on one or both sides of the head, nausea, vomiting, blurred vision, sensitivity to light and sound
  • Postdrome period – confusion, mood changes, sensitivity to light and sound, weakness

Diagnosis

The diagnosis of migraine is made mainly on the history and physical signs and symptoms, some of the following tests can aid in the confirmation of the diagnosis:

  • Blood tests
  • CT scan
  • MRI
  • Spinal tap

Treatment

Treatment is based on the use of medications to control the acute attack, and to prevent future attacks of migraine:

  • Acute attack – aspirin, acetaminophen, indomethacin, triptans, opioids
  • Preventive medicine – beta blockers, tricyclic anti-depressants, anti-seizure drugs
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