Migraines are a type of headache that can be disabling. It is a common disorder especially in women. It is present in 28 million Americans. Women are more likely to suffer from migraines than men. Women also tend to have a more severe type of migraine. Treatment is available. New research suggests a pain generator in the trigeminal nerve, which can sensitize the parts of the brain called the locus cerulas, causes migraines. Many migraine sufferers needlessly suffer in silence.
Migraines are a particular type of headache that can last 4-72 hours often accompanied by nausea, vomiting, and sensitivity to light. Many migraineurs (people with migraines) seek out a cool, dark, quiet room to lie down in when they are stricken with a migraine. Some migraineurs have an aura or symptoms that occur before the headache and associated symptoms set in. Auras can be bright flashing dots or light, wavy lines, or blind spots in the field of vision. Some women are stricken by a migraine with every menstrual period. These migraines are called menstrual migraines or catemenial migraines.
Migraines have many triggers, such as caffeine or alcohol. Emotional stress is a common trigger. MSG in Chinese food can trigger a migraine. As noted, menstrual periods can trigger a migraine in susceptible women. Other triggers include skipping meals, weather changes, excessive fatigue, and chemicals such as preservatives in foods. Nitrates, which are common in pepperoni, hot dogs, and other luncheon meats, as well aspartame, which is an artificial sweetener, can trigger a migraine. Many times the migraine occurs after a stressful event is dealt with. The same chemicals in the brain responsible for the fight or flight response can trigger a migraine.
The cause of migraines is not completely understood. Previously it was thought that migraines are caused by expanding and constricting blood vessels around the brain’s surface. Now, new evidence points to migraine pain generator in the trigeminal nerve. The trigeminal nerve connects the brain to the parts of the head including the face, scalp, and jaw. A migraine begins when “hyperactive” nerve cells send out impulses that release chemicals that cause inflammation, which leads to a headache. With continued irritation from the pro-inflammatory chemicals, the blood vessels and covering around the brain become more sensitized and more inflamed which leads to a more intense headache.
The migraine pain generator sends out impulses to the blood vessels. Serotonin and other inflammatory substances are released that causes the blood vessels to be reactive with painful pulsations. Another substance called calcitonin gene-related peptide is released from the trigeminal nerve. GRP is a potent vasodilator of vessels in the brain and vessels surrounding the brain. GRP may also sensitize parts of the brain to become irritable causing neuogenic inflammation.
Treatment of migraines starts by making the right diagnosis. Several newer medications are very effective at treating migraines. Other medications can prevent a migraine from occurring. The new class of migraine medications is called Tryptans. These medications increase the serotonin in and around the brain. The increased serotonin relieves the pain and headache.
Migraines in women are an important women’s health issue. See your health care provider to evaluate your headaches. Proper evaluation can lead to effective treatment. Effective treatment can prevent many lost days due to the disabling symptoms of migraines.
Dr. Hardy is the solo physician with Atlantic Ob/Gyn with locations in Va. Beach and Chesapeake. Call 757-463-1234 or 757-548-0044 or visit www.atlanticobgyn.com.