Migraine as a Chronic Incapacitating Neurological Condition - Essay Example

Migraine al Affiliation Migraine Introduction Migraine can be characterized as a chronic incapacitating neurological condition. It is associated with the intense perpetual headache which usually occurs in certain side of the head and sometimes escalates to the neck or further down portion of the body (NHS Choices, 2014). Migraine often starts in childhood or early teenage and later lasts for lifetime. The chronic condition is more evident among women than men. According to the official data of National Health Service (NHS), it is estimated that 1 in every 5 women and 1 in every 15 men are affected by migraine in the world (NHS Choices, 2014). In the US, over 32 million people are diagnosed with migraine. As migraine starts mainly in reproductive and productive phases (18 to 50 years old), it causes massive socioeconomic impact on the patients’ quality of life (Aukerman et al., 2002, p. 2123). Medically, there are various types of migraine, consisting migraine with aura, migraine without aura, and migraine without headache. In migraine with aura, the patient gets warning signs like, seeing intense flashing lights before the start of migraine. Migraine without aura occurs without any pre-warning signs, while silent migraine or migraine without headache occurs with aura and other major migraine symptoms, but a headache doesn’t exist. Migraine without aura (also known as common migraine) is the most identified and commonest type of migraine (NHS Choices, 2014). The purpose of this paper is to identify basic causes, precipitating factors, symptoms, treatment of migraine. Also, the role of analgesic drugs in the management of migraine will be analyzed. Causes Some people suffer from migraine constantly, up to many times a week, while other people only sporadically have a migraine. It is even possible that several years might pass between consecutive migraine attacks (NHS Choices, 2014). Considering the vast number of precipitating factors of migraine and different triggering factors for different people, the exact causes of migraine are still unknown. The researchers found that migraine occurs due to abnormal brain activities that temporarily affect the blood vessels, chemicals, and nerve signals in the brain (NHS Choices, 2014). The abnormal brain activities are triggered by various precipitating factors which differ for each person. According to the medical experts, migraine attack starts in the brain, involving chemicals and nerve pathways. Such sudden changes significantly affect the blood flow process in the brain and other tissues around it, causing intense headache in that particular part of head (Campellone et al., 2013). Migraine is not a consequence of brain tumor or other severe health issues. Only a specialist health care provider can identify if the symptoms are from migraine or other health condition (Campellone et al., 2013). Precipitating Factors There are various precipitating factors that can trigger migraine. Migraine triggers differ for each person. Sometimes migraine may occur due to combination of different precipitating factors. For instance, a hectic working day followed by a glass of wine and later oversleeping or lack of sleep at night could trigger migraine in the next morning, whereas a glass of wine at lunch on a usual working day may have no impact (Headache Australia, 2014). Migraine is strongly associated with the diet choices and lifestyle of a person. Dehydration and alcohol are some of the major factors that can trigger a migraine. Precipitating factors of migraine are mainly distinguished as dietary (skipping meals, insufficient eating, bad eating habits), environmental (weather changes, particular smell, smoke, loud sounds, pollution, high altitude, travelling), physical (hard work, sexual intercourse, painful muscles, dental, spinal, or eye problems, flu, cold, high blood pressure), emotional (stress, trauma, crying, sleep disturbance), and hormonal (menstruation cycle in women, ovulation, pregnancy, hormone replacement theory, medications) (Headache Australia, 2014). Fasting is considered as one of the major triggering factors of migraine. Also, certain foods such as, chocolate, aged cheese, monosodium glutamate (MSG), aspartame, bananas, avocados, beer, red wine, vinegars, soy sauce, pork and other processed meat, peanut butter, are regularly mentioned as potential precipitating factors of migraine (Headache Australia, 2014). Besides dietary factors, physical and emotional factors significantly trigger migraine among people. Depending on triggering factors, migraine treatment is identified for each person (Headache Australia, 2014). Symptoms Migraine generally develops in 4 different stages, namely, prodromal, aura, headache stage, and resolution stage (NHS Choices, 2014). However, these stages may not be identified among all people. In prodromal stage low level of energy, rapid changes in mood, appetite and behavioral changes identified several hours before a migraine attack. Flashes of lights or blind dark spots are experienced for few minutes to an hour during the aura stage. In the headache stage, patient experiences intense throbbing ache on a side of the head, followed by vomiting, nausea, and/or high sensitivity to loud sounds and bright lights, lasting for around 4 to 72 hours. In resolution stage, the major headache and other symptoms slowly disappear, but patient experiences tiredness for at least few days after the attack (NHS Choices, 2014). Intense headache at one or both side of the head is the major symptom of migraine. The pain is generally too intense to allow the person to carry regular activities normally; it gets worse when the person moves or tries to work. About one third of migraine patients have aura as the warning symptoms before migraine attack. The symptoms include visual problems, tingling sensation, numbness, eye pain, difficultly in speaking, and dizziness (Campellone et al., 2013). Other general symptoms of migraine include chills, increased urination, loss of appetite, fatigue, vomiting, nausea, numbness, concentration problems, sweating, and sensitivity to loud sound and bright light (Campellone et al., 2013). One should consult general practitioner (GP) if the regular and severe migraine symptoms are indentified and couldn’t mange with the dose of painkillers like, paracetamol (NHS Choices, 2014). Symptoms such as, paralysis, slurred speech, intense headache that results in blinding pain, and headache with a fever, mental confusion, stiff neck, rash, double vision, or seizures are considered to be a sign of more serious condition like, a meningitis or stroke, and should be examined by a doctor as soon as possible (NHS Choices, 2014). Treatment There is no particular cure for migraine. The objective of migraine treatment is to treat migraine symptoms and avoiding further complications. The treatment of migraine is mainly focused on identifying and preventing triggering factors of migraine. In case of regular migraine attacks, doctor may prescribe medicines like, antidepressants, seizure medicines, and blood pressure medicines to reduce the frequency of attacks (Campellone et al., 2013). Botolinum toxin type A (Botox) injections are given when migraine occurs more than 15 days in a month (Campellone et al., 2013). Medications for migraine are given once the migraine attack has started (acute treatment) and other medications are prescribed for daily intake to lower the number of migraine attacks (prophylactic treatment) (Headache Australia, 2014). Acute treatment includes analgesics or pain killers such as Paracetamol, aspirin, and analgesics in combination with codeine (for e.g., Panadeine) or with sedative (for e.g., Fiorinal, Mersyndol), non-steroidal anti-inflammatory drugs (NSAIDs) (for e.g., Nurofen) (Headache Australia, 2014). Prophylactic treatment includes medicines such as, pizotifen, beta blockers, valproate, topiramate, methysergide, and feverfew (Headache Australia, 2014). For pregnant and breastfeeding women, migraine treatments are mainly limited to avoiding triggering factors rather than prescription of strong analgesic drugs. If medication is necessary, then doctor may prescribe low analgesics like, Paracetamol (NHS Choices, 2014). Besides medication, alternative therapies such as, acupuncture, biofeedback, chiropractic therapy, homeopathy, hydrotherapy, massage, osteopathy, and physiotherapy are recommended to ease the stress and fatigue, and lower the frequency of migraine (Headache Australia, 2014). The Role of Analgesic Drugs Analgesic drugs (painkillers) such as, Asprin, Ibuprofen, Diclofenac, Naproxen, Tolfenamic acid, and Paracetamol are used to reduce stiffness and pain related to migraine (The Migraine Trust, 2012). Analgesic drugs are more effective when consumed in an effervescent or soluble form as they are absorbed quickly in the body. Codeine is an effective analgesic drug that block pain signals in the brain and spinal cord. In case of mild headache, combination of caffeine with an analgesic drug proves to be an effective solution (The Migraine Trust, 2012). Analgesic drugs are the most effective medication treatment for migraine. However, regular or daily consumption of analgesic drugs causes opposite reaction, perpetuating the migraine condition. These drugs may lower the intensity of pain for a few hours, but they seem to enter the pain structure in such a manner that further chronic headache may escalate, leading to the medication overuse headache (MOH) condition (National Headache Foundation, 2014). Overuse of analgesic drugs nullifies the effect of other medication take to treat or prevent the headaches. The chronic headache continues until the overused analgesics are strictly discontinued. Often, when analgesic drug consumption is suddenly stopped, headache becomes more intense and patient may experience vomiting or nausea. However, the intensity of symptoms lowers after the period of 3 to 5 days (National Headache Foundation, 2014). The overuse of analgesic drugs may increase the risk of relapsing and addiction to such drugs. Medications such as triptans, ergots, barbiturates, and opioids shouldn’t consume for more than 10 days in a month. It is necessary to consume proper dose of analgesic drugs under the guidance of doctor for its positive effect on migraine management (National Headache Foundation, 2014). Conclusion Migraine is common health issue in today’s rapid and modern world. The dietary and lifestyle choices significantly trigger the migraine condition. Though it can’t be cured, it is possible to prevent or lower the frequency by means of effective medication and proper management techniques. It is necessary to consult doctor before taking any type of analgesic drugs for the treatment of migraine. Adoption of healthy lifestyle, regular exercise, meditation, and yoga can be helpful to prevent migraine and enjoy healthy life. References Aukerman, G., Knutson, D., & Miser, W. F. (2002). Management of the acute migraine headache. American Family Physician, 66 (11), 2123-2131. Retrieved from http://www.aafp.org/afp/2002/1201/p2123.html Campellone, J. V., Zieve, D., & the A.D.A.M. editorial team. (2013, October 29). Migraine. PubMed Health. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001728/ Headache Australia. (2014). Migraine: ‘a common and distressing disorder.’ Retrieved from http://headacheaustralia.org.au/headache-types/17-migraine-a-common-and-distressing-disorder National Headache Foundation. (2014). Analgesic rebound headaches. Retrieved from http://www.headaches.org/education/Tools_for_Sufferers/Headache_-_Frequently_Asked_Questions/Analgesic_Rebound_Headaches NHS Choices. (2014, April 14). Migraine. Retrieved from http://www.nhs.uk/Conditions/Migraine/Pages/Introduction.aspx The Migraine Trust. (2012). Medication for migraine. Retrieved from http://www.migrainetrust.org/medication Read More