Migraine%20headache Signs and Symptoms

 Migraine Headache

• A common episodic primary headache that is disabling with associated nausea and/or light and sound sensitivity

 Phases of migraine attack

• Prodrome - appears 24-48 hours before headache occurs
• Aura - occurs in 25% of individuals with migraine which is often visual but can be sensory, verbal or motor disturbances
• Headache - usually unilateral with throbbing or pulsatile quality and accompanying nausea, vomiting, photophobia or phonophobia
• Postdrome

• Based on World Health Organization (WHO), 0.5-0.75 of adults aged 18-65 years old in the world have had headache in 2015 and ≥30% of them have reported having migraine headache
• Ranked as the 3rd most prevalent disorder in the world based on the Global Burden of Disease Survey 2010 (GBD 2010) and ranked as the 3rd-highest cause of disability in the world among males and females <50 years old based on GBD 2015
• According to the United Nations, there are 350 million individuals that have migraine headache in the Asia-Pacific region

• It is hypothesized that cortical spreading depression causes the aura of migraine, activates trigeminal nerve afferents and alter blood-brain barrier permeability by matrix metalloproteinase activation and upregulation
  • Activation of trigeminal nerve afferents causes inflammatory changes in the pain-sensitive meninges that generates the headache that occur in migraine through central and peripheral reflex mechanisms
• Pathophysiology of migraine includes activation of the trigeminovascular system and the pain of migraine is linked to the onset of neurogenic inflammation
• Clinical symptoms of migraine is due to the process called sensitization in which neurons become increasingly responsive to nociceptive and non-nociceptive stimulation

Premonitory and resolution symptoms include

• Hyperactivity
• Hypoactivity
• Depression
• Cravings for particular foods
• Repetitive yawning
• Fatigue
• Neck stiffness and/or pain