Chronic Migraines: Is the relief possible?

This disorder isn't caused by the frequent use of painkillers as some people think. The word migraine comes from the Greek word- hemicrania, which means literally, “half of the head" because the pain is often localized in one side of the head only. Chronic migraines may occur from overuse of migraine medications (rebound headache) or may develop over time (transformed migraine).

Signs and symptoms of migraine

Although the signs and symptoms of migraine vary among patients, there are four common characteristic phases in most patients:

1. The prodrome, which occurs hours or days before the headache
2. The aura, which immediately precedes the headache
3. The headache phase
4. The postdrome

The prodrome phase

Prodromal symptoms occur in 40% to 60% of patients that suffer from migraines. What are the characteristic symptoms of this phase? It is mostly characterized with:

• altered mood,
• irritability,
• depression or euphoria,
• fatigue,
• yawning,
• excessive sleepiness,
• craving for certain food and
• other vegetative symptoms

A typical patient is experiencing these symptoms about several hours or days before the real headache, so he or she can tell that the migraine attack is near.

The aura

This phase appears gradually over 5 to 20 minutes before the headache and usually subsides just before the headache begins. Symptoms of migraine aura can be different:

Visual aura

It is the most common and it is accompanied by the disturbance in vision consisting usually of unformed flashes of white or rarely multicolored lights. Some patients complain about blurred or cloudy vision, as though they were looking through thick or smoked glass.

The Somato-sensory aura

The most common symptom of Somato-sensory aura is a feeling of pins-and-needles experienced in the hands and arms as well as in the nose-mouth area. These sensations migrate up the arm and then extend to involve the face, lips and tongue.

The headache

The headache is often very characteristic. The typical migraine headache is unilateral, throbbing, with moderate to severe pain and can be aggravated by physical activity, but patient must realize that not all of these features are necessary. The pain may be bilateral at the onset, or start on one side and become generalized, usually alternating the sides from one attack to the next. The onset is usually gradual. The pain peaks and then subsides, and usually lasts between 4 and 72 hours in adults and 1 to 48 hours in children. The intensity of pain can also vary. There are some conditions that may accompany migraine. Anorexia is common, and nausea occurs in almost 90 percent of patients, while vomiting occurs in about one third of patients.

Many patients experience sensory disorders such as:

• photophobia,
• phonophobia,
• osmophobia

That’s why they seek a dark and quiet room. Beside the strong headache patients often experience

• blurred vision,
• nasal stuffiness,
• diarrhea,
• polyuria,
• sweating,
• edema of the scalp or face,
• scalp tenderness,
• prominence of a vein or artery in the temple,
• stiffness and tenderness of the neck.

The postdrome phase

After this strong headache, the patient often feels tired, irritable, and listless and may have impaired concentration, scalp tenderness or mood changes.