Migraine: The Neurological Disease

Migraine: The Neurological Disease.

Thesis Statement: Migraine isn’t just a simple headache, it can affect our brain and body, but it can be treated in several ways.

I. What is Migraine?

A. Migraine: Description.

B. Triggers of migraine.

II. Effects of migraine.

A. Migraine as a trigger for other diseases.

B. How migraine can change the brain as time passes by.

III. Treatments

A. Natural treatments for migraine.

B. Synthetic treatments for migraine.

I. What is Migraine?

A. Migraine: Description.

It is an extremely debilitating collection of neurological symptoms that usually includes a severe recurring intense throbbing pain on one side of the head (although in 1/3 of migraine attacks, both sides are affected). Attacks last between 4 and 72 hours and are often accompanied by one or more of the following: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Of course, everyone is different, and symptoms vary by person and sometimes by attack. (Novartis Pharmaceuticals Corporation, http://www.migraineresearchfoundation.org/about-migraine.html)

Migraine is three times more common in women that in men. Some people can tell when they are about to have migraine because they see flashing lights or zigzag lines or they temporarily lose their vision. (NIH: National Institute of Neurological Disorders and Stroke, http://www.nlm.nih.gov/medlineplus/migraine.html)

B. Triggers of Migraine.

“Triggers” are specific factors that may increase your risk of having a migraine attack. The migraine sufferer has inherited a sensitive nervous system that under certain circumstances can lead to migraine.

Triggers do not ‘cause’ migraine. Instead, they are thought to activate processes that cause migraine in people who are prone to the condition. A certain trigger will not induce a migraine in every person; and, in a single migraine sufferer, a trigger may not cause a migraine every time. By keeping a headache diary, you will be able to identify some triggers for your particular headaches.

Once you have identified triggers, it will be easier for you to avoid them and reduce your chances of having a migraine attack. (American Council for Headache Education, 12)

Some of the triggers of migraine may be:

- Hormonal changes in women. Fluctuations in estrogen seem to trigger headaches in many women with known migraines. Women with a history of migraines often report headaches immediately before or during their periods, when they have a major drop in estrogen. Others have an increased tendency to develop migraines during pregnancy or menopause. Hormonal medications — such as oral contraceptives and hormone replacement therapy — also may worsen migraines, though some women find it's beneficial to take them.

- Foods. Some migraines appear to be triggered by certain foods. Common offenders include alcohol, especially beer and red wine; aged cheeses; chocolate; aspartame; overuse of caffeine; monosodium glutamate — a key ingredient in some Asian foods; salty foods; and processed foods. Skipping meals or fasting also can trigger migraine attacks.

- Stress. Stress at work or home can instigate migraines.

- Sensory stimuli. Bright lights and sun glare can induce migraines, as can loud sounds. Unusual smells — including pleasant scents, such as perfume, and unpleasant odors, such as paint thinner and secondhand smoke — can also trigger migraines.

- Changes in wake-sleep pattern. Either missing sleep or getting too much sleep may serve as a trigger for migraines in some individuals, as can jet lag.

- Physical factors. Intense physical exertion, including sexual activity, may provoke migraines.

- Changes in the environment. A change of weather or barometric pressure can prompt a migraine.

- Medications. Certain medications can aggravate migraines, especially oral contraceptives and vasodilators, such as nitroglycerin.

(Mayo Clinic Staff, http://www.mayoclinic.com/health/migraine-headache/DS00120/DSECTION=causes)

II. Effects of migraine.

A. Migraine as a trigger for other diseases.

There are conditions that tend to occur more often in people with migraine. These conditions are called co-morbid conditions. This means that they occur more commonly that you would expect by chance alone. These conditions include Raynaud’s disease, epilepsy, asthma, fibromyalgia, depression, anxiety and bipolar disorder. (Frontiers in Neurology, Marcus)

Heart disease has also been linked to migraine. Studies consistently show that people with migraine are at higher risk for having both heart disease risk factors, like high blood pressure, and stroke. Understanding this association is important if you’re a migraine sufferer. (Marcus, 2011)

After having high blood pressure, having migraine with aura was found to be the second strongest contributor to heart attack and stroke risk, according to researcher Tobias Kurth, MD, of Brigham and Women’s Hospital in Boston and the French National Institute of Health.

Migraine with aura was found in the study to be a bigger risk factor for these cardiovascular conditions than having a family history of early heart disease or having diabetes or being obese or a smoker. (Gilbert, 2010)

B. How migraine can change the brain as time passes by.

White matter is tissue found in the brain. It contains nerve fibers. Many of these nerve fibers (axons) are surrounded by a type of fat called myelin. The myelin gives the white matter it's color. Myelin acts as an insulator. It plays an important role in the speed of nerve signaling. (Calabresi PA. Multiple sclerosis and demyelinating conditions of the central nervous system. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 419)

MRI scans may reveal white matter lesions in young persons with migraine. These can be and are often are confused with white matter lesions due to multiple sclerosis or white matter lesions that occur in older people (periventricular white matter lesions). (Palm-Meinders, I. H., H. Koppen, et al. (2012). "Structural brain changes in migraine." JAMA 308(18): 1889-1897.)

While it is not clear that these lesions directly cause brain dysfunction, they are at least good indicators. There is a clear connection between them and a decrease in brain volume, loss

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