Migraine

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Migraine is a neurological syndrome characterized by altered bodily perceptions, headaches, and nausea. Physiologically, the migraine headache is a neurological condition more common to women than to men. Etymologically, the French word migraine derives from the Greek hemicrania (half skull) and the Old English megrim (severe headache).

The typical migraine headache is unilateral and pulsating, lasting from 4 to 72 hours; [1] symptoms include nausea, vomiting, photophobia (increased sensitivity to bright light), and hyperacusis (increased sensitivity to noise); [2][3][4] approximately one third of people who suffer migraine headache perceive an aura — visual, olfactory — announcing the headache. [5]

Initial treatment is with analgesics for the head-ache, an anti-emetic for the nausea, and the avoidance of triggering conditions. The cause of migraine headache is unknown; the accepted theory is a disorder of the serotonergic control system, as PET scan has demonstrated the aura coincides with diffusion of cortical depression consequent to increased blood flow (up to 300% greater than baseline). There are migraine headache variants, some originate in the brainstem (featuring intercellular transport dysfunction of calcium and potassium ions) and some are genetically disposed. [6] Studies of twins indicate a 60 to 65 per cent genetic influence upon their developing propensity to migraine headache. [7][8] Moreover, fluctuating hormone levels indicate a migraine relation: 75 percent of adult patients are women, although migraine affects approximately equal numbers of prepubescent boys and girls; propensity to migraine headache is known to disappear during pregnancy.[citation needed]

The International Headache Society (IHS) classifies migraine headache. [9]

The IHS defines the intensity of pain with a verbal, four-point scale: [10]

The common form of migraine headache; the patient primarily suffers migraine without aura, and might also suffer migraine with aura. The International Classification of Headache Disorders[9] definition is:

When these criteria are partially fulfilled, there are alternative diagnoses, i.e. “probable migraine without aura” or “episodic tension-type headache”.

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