What is Migraine? Migraine refers to a transient throbbing or pulsating headache that is not brought about by any organic disorder or structural defect. It affects more than twice as many women as men. It occurs at any age, but usually attacks begin between the ages of 10 and 40 and diminish after age 50. The frequency of migraine attacks varies from person to person. They can occur as often as several per month or as infrequently as once every several years. Symptoms of Migraine Typically, a migraine headache starts in a specific area of one-side (left or right) of the head (though it is not uncommon for the headache to be generalized) that is aggravated by physical activity, coughing or straining. Over a period of one to two hours, it spreads and increases in intensity before gradually and spontaneously subsiding. It is often associated with a variety of other signs and symptoms such as loss of appetite, nausea, vomiting, numbness, tingling, weakness and dislike for sound, light and certain smells. At times, there are other associated neurological signs including temporary paralysis of a limb, ringing of the ear, speech difficulty, temporary blindness, confusion and disorientation. A migraine headache usually lasts a few hours, but it can persist up to 24 hours and in some cases, several days. It is frequently debilitating and it leaves the patient feeling tired and weak after the attack. In classical migraine, the headache is preceded (by 20-60 minutes) by an aura that often consists of a visual disturbance like blurring of vision, or perception of flashes of lights, halos, stars, blind spots, etc. In most cases, however, migraine does not follow this classic pattern. Thus, more often than not, the headache is not heralded by an aura. By the way, there is such a thing as headache-free migraine. This form of migraine is characterized by the presence of an aura but without headache. Causes and Triggers of Migraine The physiologic mechanisms that are involved in migraine are not known yet. The currently accepted view is that migraine is a neurovascular disorder where a series of events in the central nervous system that are caused by triggers (i.e., changes in the body or in the environment) results in changes in the blood vessels within the pain producing structures. People who suffer from migraine have a family history of the disorder. Thus, it is possible that people with migraine inherit their sensitivity to triggers from their parents. The trigger for a migraine attack varies from person to person. It could be one or a combination of a variety of conditions: Emotional or physical stress, lack or excess sleep, hunger, intake of certain foods (e.g., MSG, chocolate, cheese), intake of alcoholic beverages or certain medications, certain smells (perfume, for example), exposure to intense light or glare and environmental changes such as in weather, altitude or time zone. In some women, a sudden drop in the blood level of the female hormone estrogen that occurs just before menstruation can also serve as a trigger for migraine (menstrual migraine). Treatment of Migraine The treatment strategy for migraine is two-pronged: 1) prevent the attack; and, 2) if an attack occurs, to relieve the symptoms of the attack. There is no single drug that is universally effective in relieving the headache of an acute migraine attack. Over the counter pain relievers (analgesics such as acetaminophen and aspirin and ibuprofen) if taken immediately at the start of an attack are usually effective in relieving the headache, if it is mild. However, severe attacks with accompanying symptoms may require prescription medications. Non-drug measures that may also help alleviate symptoms of an acute migraine attack include resting in bed in a dark and quiet room and applying cold compress on the affected area of the head. Another modality that can help ease the pain in migraine is acupuncture. In migraines with aura, ergotamine when taken at the start of the aura often prevents or at least alleviates the headache. Most people with migraine know what their trigger is for an attack. For these people, the best way to prevent an attack is to avoid the trigger. For people who have frequent attacks, that is three or more a month, a variety of drugs that are designed to prevent such attacks are available in the market. But all these drugs have adverse effects. They are prescription drugs that should be taken only under a physician's supervision. certify this article is my own original work, has never previously been published and grant MgrCentral Pty Ltd 100% copyright and ownership in this article. I am claiming $5 as full and complete recompense for this article. I understand that if accepted I have no rights to re-publish or distribute it.