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1- Introduction

2- Pathophysiology

3- Symptoms

4- Treatment


Migraines are neurological conditions characterized by recurrent, intense headaches often accompanied by other symptoms such as nausea, sensitivity to light and sound, and sometimes visual disturbances. These headaches can be debilitating, affecting daily activities and quality of life for those who experience them. Migraines are believed to involve abnormal brain activity, and they can be triggered by various factors such as stress, hormonal changes, certain foods, or environmental stimuli. Treatment approaches may include medications to manage symptoms and prevent attacks, as well as lifestyle adjustments to reduce triggers and improve overall well-being.

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Migraines are complex neurological disorders characterized by recurring episodes of moderate to severe headaches that can last from hours to days. The exact physiological mechanisms underlying migraines are not fully understood, but they are believed to involve a combination of genetic, environmental, and neurological factors.

During a migraine attack, changes in the brain’s chemical and electrical activity lead to inflammation of blood vessels and nerves around the brain. This process, known as neurogenic inflammation, contributes to the throbbing pain typically associated with migraines. The trigeminal nerve, a major cranial nerve responsible for sensation in the face and head, becomes sensitized and releases neuropeptides that further amplify pain signals.

Migraines often present with additional symptoms beyond headache pain, such as nausea, vomiting, sensitivity to light (photophobia), and sound (phonophobia). Some individuals also experience aura, which consists of temporary sensory disturbances like visual changes (flashes of light, blind spots) or tingling sensations in the limbs.

Triggers for migraines can vary widely among individuals and may include hormonal changes, certain foods (such as aged cheeses or processed meats), stress, sleep disturbances, sensory stimuli (like strong smells or bright lights), and environmental factors. Identifying and avoiding triggers can help reduce the frequency and severity of migraine attacks.

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  • Prodrome Phase:

    • This phase can occur hours to days before the headache begins.
    • Symptoms may include mood changes (irritability or depression), food cravings, increased thirst, fatigue, or neck stiffness.
    • Some people experience subtle warning signs like yawning, increased urination, or sensitivity to light and sound.
  • Aura Phase (if present):

    • Not all migraine sufferers experience aura.
    • Visual disturbances are common, such as flashes of light, zigzag lines, blind spots, or temporary vision loss.
    • Sensory disturbances like tingling or numbness in the face or limbs, and difficulty speaking or understanding speech may occur.
    • These symptoms usually develop gradually over a few minutes and can last up to an hour.
  • Headache Phase:

    • Typically throbbing or pulsating pain, often on one side of the head, but it can affect both sides.
    • Pain intensity ranges from moderate to severe and can worsen with physical activity.
    • Sensitivity to light (photophobia), sound (phonophobia), and sometimes smells (osmophobia).
    • Nausea and vomiting are common accompanying symptoms.
    • Duration of the headache phase can vary from a few hours to several days.
  • Postdrome Phase:

    • Often referred to as the “migraine hangover.”
    • Feelings of exhaustion, weakness, or confusion.
    • Mood changes, such as feeling elated or depressed.
    • Difficulty concentrating or processing information.


  • Acute Treatment:

    • Pain Relief Medications: Over-the-counter pain relievers such as acetaminophen (Tylenol), nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, or combination medications formulated specifically for migraines (e.g., Excedrin Migraine).
    • Triptans: Prescription medications like sumatriptan, rizatriptan, or eletriptan that work by narrowing blood vessels and reducing inflammation in the brain. Triptans are effective for many people with moderate to severe migraines.
    • Anti-nausea Medications: Medications such as metoclopramide or ondansetron may be prescribed to alleviate nausea and vomiting associated with migraines.
  • Preventive Treatment:

    • Medications: If migraines are frequent or severe, preventive medications may be prescribed. These include beta-blockers (e.g., propranolol), antidepressants (e.g., amitriptyline), anticonvulsants (e.g., topiramate), and CGRP inhibitors (e.g., erenumab, fremanezumab), which specifically target molecules involved in migraine pathophysiology.
    • Botulinum Toxin Injections: Injections of botulinum toxin (Botox) around the head and neck muscles may be recommended for chronic migraines.
    • Supplements and Vitamins: Some people find benefit from taking magnesium supplements, riboflavin (vitamin B2), or coenzyme Q10, though evidence for their effectiveness varies.
  • Lifestyle and Home Remedies:

    • Identifying Triggers: Keeping a migraine diary to identify triggers such as certain foods, stress, hormonal changes, or sleep patterns can help manage migraines.
    • Managing Stress: Stress reduction techniques such as relaxation exercises, meditation, yoga, or biofeedback may help prevent migraines.
    • Healthy Lifestyle: Regular exercise, adequate sleep, and maintaining a regular eating schedule can also help reduce the frequency and severity of migraines.
    • Avoiding Known Triggers: Limiting exposure to triggers identified through a migraine diary, such as specific foods, strong smells, or bright lights.
  • Alternative Therapies:

    • Acupuncture: Some people find relief from migraines through acupuncture, a traditional Chinese medicine technique involving the insertion of thin needles into specific points on the body.
    • Herbal Remedies: Butterbur and feverfew are herbs that have been studied for their potential migraine-relieving properties, but caution is advised due to potential side effects and interactions with other medications.
  • Behavioral Therapies:

    • Cognitive Behavioral Therapy (CBT): CBT can help individuals manage stress and develop coping strategies to reduce the impact of migraines on daily life.
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