Introduction
Migraine is one of the most common forms of headache. It is usually described as an intense type of pulsating pain, which tends to arise slowly in the front or on one side of the head.
Migraine manifests itself with recurrent attacks, which occur with a very variable frequency: from a few episodes in a year to 2-3 crises per week. The migraine attack can last a few hours or, in the most serious cases, a few days. Some people also have other symptoms, such as nausea and sensitivity to light. This form of primary headache is more common in the female sex, it can affect all age groups and seems to recognize a family predisposition. Even if the migraine can seriously compromise the quality of life, fortunately treatments and effective methods for the management of the disorder are available, which can prevent and limit the discomforts.
Migraine with and without Aura
Migraine describes a group of headaches united by pain localized to the head, which is characterized by:
- Unilaterality : pain tends to affect only one side of the head, but there are also bilateral cases.
- Pulsating and intense pain, such as to reduce or prevent normal daily activity.
- Tendency to worsen with movement (unlike the tension headache that benefits).
Different subtypes of migraine are recognized, but the two most common forms are represented by migraine without aura and migraine with aura .
The aura defines a set of reversible neurologic symptoms, characterized by a scintillating sclerosis, a visual disturbance that precedes a migraine attack, most likely due to a wave of cortical depression. The migraine with aura is therefore presented with warning signs, which precede gradually (by 10 - 30 minutes) or accompany the attack of real headache. The most common manifestations that are associated with the aura are completely reversible visual symptoms: small dazzles (similar to those found after having fixed a light source for a long time), sparkling flashes of geometric shape, loss of sight in a limited area of the eye, darkening and fogging of the visual field. Occasionally, during the attack of headache with aura, symptoms such as reversible language disorders (to be understood as difficulty in expressing oneself), stiffness in the neck or shoulders, sensation of tingling and numbness or difficulty in movements of an extremity may also appear.
In a particular form - called migraine aura without headache and also known as silent migraine - typical aura symptoms arise but the subsequent onset of migraine crisis is missing.
Symptoms
To learn more: Symptoms Migraine
Migraine is a complex disorder, characterized by great clinical and secondary variability due to various triggering factors.
The migraine attack is defined by the presence of at least two of the following characteristics:
- Unilateral localization (sometimes, bilateral);
- Pulsating quality;
- Medium or strong intensity;
- Aggravated by routine physical activities (or limiting these benefits).
The conditions commonly associated with migraine are:
- Nausea : it can be felt in association with a condition of general malaise and can be followed by vomiting;
- Increased sensitivity : photophobia (sensitivity to light), phonophobia (sensitivity to sound) and / or osmophobia (sensitivity to odors) can be felt. For this reason, many people prone to migraines prefer to rest in a dark and silent room.
Other symptoms may also occur during a migraine attack. These include:
- Decreased concentration level;
- Sweating;
- Chills and pallor;
- Abdominal pain (which can be associated with diarrhea);
- Frequent need to urinate.
Sometimes, migraine attacks are anticipated by a series of symptoms that occur regularly before each crisis; these disorders in medical terms are called prodromal symptoms : tiredness, drowsiness, irritability and a tendency to change mood. Not all patients experience these symptoms when a migraine attack occurs and, as a rule, they do not all occur all at once: the attacks occur with frequency, duration and intensity extremely variable from person to person. The symptoms that accompany the migraine tend to disappear spontaneously, with the resolution of the headache, and can last from 4 hours to 72 hours, if not treated or successfully managed. When migraine without aura occurs for at least 15 days a month, for a period of at least 3 months, it is called chronic .
Aura symptoms
As seen above, about a third of people with migraine have reversible neurological symptoms that appear before migraine occurs. Aura symptoms usually start 15 minutes to an hour before the onset of headache. These include:
- Reversible visual problems : you can see the flickering lights, black and white or colored lines, zigzag patterns scattered on the sides of the visual field, blurred figures or blind spots. Vision disorders often identify with a scintillating scotoma, that is, a partial alteration of the visual field, which can interfere with a person's ability to read or drive;
- Sensory symptoms: hypoesthesia (decreased sensitivity and relative response to a specific stimulus), stiffness or a tingling sensation such as pinpricks and needles on the neck, shoulders or limbs;
- Coordination problems : the patient suffering from a migraine attack with aura may feel disoriented or feel a lack of balance;
- Difficulty speaking (reversible);
- Loss of consciousness : only in very rare cases.
