Migrane Headache

This could be said to be a collection of symptoms usually involving severe recurring headache, thought to be vascular (constriction usually followed by dilation of the blood vessels to the brain) in origin, in a person where full investigations fail to reveal an organic cause and where typical symptoms accompany different phases of the attack. For example, mood changes in the prodromal (warning) phase, followed by severe headache, with or without digestive symptoms such as nausea, vomiting, bloating and diarrhea, and also neurological symptoms (in classical migraine), which include visual disturbances, paraesthesia (pins and needles), clumsiness or transient paralysis. Recovery is usually after the 'hangover' phase, in which the sufferer feels exhausted. The sequential nature of each set of symptoms plus the length of time of each phase clearly distinguishes it from other types of headaches such as muscular (tension) headaches, although it is possible for a migraine sufferer also to be prone to tension headaches, and at times they might even coexist.

The term 'migraine' 'is of French origin, but its root is from the Greek term hemicranias, meaning affliction of half of the head.

Attitudes to migraine

Migraine attacks have been recorded historically for over two thousand years. It is astonishing that for a condition, which has been around for so long and affects 10 per cent of people in the United Kingdom alone, there is limited understanding and still no medical cure. Prescribed drugs help some people to lead near-normal lives but many of them bring their own problems. What is even more unfathomable than the limited help available is the archaic attitude towards the condition. It is generally regarded just as a tiresome headache, visited upon tiresome people, who through their tiresomely regular visits to the surgery, their frequent absences from work ('she’s he’s having another one of her/his migraines'), their frequent retreats to lie down in a darkened room, deliberately make life tiresome for those around them. If your pancreas fails to secrete insulin and you develop diabetes you are unlikely to encounter any problems - swift diagnosis, effective treatment, continued support. The same happens if you develop another 'respectable' condition like pernicious anaemia - injections of vitamin B 12, continued care no hint that you are malingering. Better still if some part of you can be replaced, removed or treated with some high-tech medicine - all very respectable.

Migraine could be described as a disorder of arousal. Placid people are less likely to suffer but are not immune. The brain stem, the oldest part of the brain, controls the autonomic nervous system, which oversees body functions such as the muscular activity of the digestive system, breathing, circulation and sensory perceptions, sound, touch, taste, hearing and smell. It also includes the reticular activating system (RAS). This mechanism determines how much stimulation is allowed to reach the brain. For example, two people who go to the same party will have RAS systems which react differently. A has an RAS system which is partly closed but still alert enough to react if there was danger such as a fire in the building. B has an RAS system, which is wide, open and reacts much more to the stimuli around him. A is likely to go home and relax into a sound sleep. B is likely to be over stimulated long after leaving the noise and excitement of the party. The inability to relax might make him resort to tranquillizers or alcohol to induce sleep. A and B have both had the same stimulation but react differently.

The lymbic system is controlled by the hypothalamus, which prompts the release of chemicals from the pituitary and adrenal glands. It is unable to distinguish between the signals of fear or pain and pleasure or excitement. When the senses are not being stimulated the hypothalamus reduces the supply of stress hormones and secretes endorphins which produce a state of relaxation. The hypothalamus has a high concentration of the neurotransmitter serotonin , which is a chemical messenger between nerve cells.

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