Migraine overview: Difference between revisions
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Migraine is widespread in the population. The majority of migraine (as it is referred to commonly) is actually mixed [[Headache]]. In the U.S., 18% of women and 6% of men report having had at least one migraine episode in the previous year<ref>. Silberstein S. "Migraine". ''Lancet'' 2004;363:381-391</ref> According to reports, 10% of people have been diagnosed with migraine and 5% have migraine but have not been diagnosed, with seriousness varying from a rare annoyance to a life-threatening and/or daily experience. | Migraine is widespread in the population. The majority of migraine (as it is referred to commonly) is actually mixed [[Headache]]. In the U.S., 18% of women and 6% of men report having had at least one migraine episode in the previous year<ref>. Silberstein S. "Migraine". ''Lancet'' 2004;363:381-391</ref> According to reports, 10% of people have been diagnosed with migraine and 5% have migraine but have not been diagnosed, with seriousness varying from a rare annoyance to a life-threatening and/or daily experience. | ||
==Laboratory Findings== | == Diagnosis == | ||
=== Laboratory Findings === | |||
[[Lumbar puncture]]: When your [[headache]] is suspected [[meningitis]], the doctor may order this test. During this procedure, the patient lies on the side, with knees pulled up toward the chest, and chin tucked downward. After injecting the anesthetic into the lower spine, the doctor insert a spinal needle into the lower back area to measure [[CSF]] pressure and collect a sample. The patient is often asked to lie down for a while after the process. | [[Lumbar puncture]]: When your [[headache]] is suspected [[meningitis]], the doctor may order this test. During this procedure, the patient lies on the side, with knees pulled up toward the chest, and chin tucked downward. After injecting the anesthetic into the lower spine, the doctor insert a spinal needle into the lower back area to measure [[CSF]] pressure and collect a sample. The patient is often asked to lie down for a while after the process. | ||
Revision as of 19:52, 19 February 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Migraine is a neurological disease best known for severe headaches that are its most salient symptom.[1][2][3]. Usually migraine causes episodes of severe or moderate headache (which is often one-sided and pulsating) lasting between several hours to three days, accompanied by gastrointestinal upsets, such as nausea and vomiting, and a heightened sensitivity to bright lights (photophobia) and noise (phonophobia). Approximately one third of people who experience migraine get a preceding aura.[4] Migraines' secondary characteristics are inconsistent. Triggers precipitating a particular episode of migraine vary widely. The efficacy of the simplest treatment, applying warmth or coolness to the affected area of the head, varies between persons, sometimes worsening the migraine.[5] A particular migraine rescue drug may sometimes work and sometimes not work in the same patient. Some migraine types don't have pain or may manifest symptoms in parts of the body other than the head. Available evidence suggests that migraine pain is one symptom of several to many disorders of the serotonergic control system, a dual hormone-neurotransmitter with numerous types of receptors. Two disorders — classic migraine with aura (MA, STG) and common migraine without aura (MO, STG) — have been shown to have a genetic factor.[6] Studies on twins show that genes have a 60 to 65% influence on the development of migraine[7][8]. Additional migraine types are suspected and could be proven to be genetic. Migraine understood as several or many disorders could explain the inconsistencies, especially if a single patient has more than one genetic type. However, still other migraine types might be functionally acquired due to hormone organ disease or injury. Three quarters of adult migraine patients are female, although pre-pubertal migraine affects approximately equal numbers of boys and girls. This reveals the strong correlation to hormonal cycling and hormonal-related causes or triggers. Hormonal migraine is a likely consequence of periodically falling hormone levels causing reduction in protein biosynthesis of metabolic components including intestinal tract serotonin.
Historical Perspective
The word migraine is French in origin and comes from the Greek hemicrania, as does the Old English term megrim. Literally, hemicrania means "half (the) head".
Epidemiology and Demographics
Migraine is widespread in the population. The majority of migraine (as it is referred to commonly) is actually mixed Headache. In the U.S., 18% of women and 6% of men report having had at least one migraine episode in the previous year[9] According to reports, 10% of people have been diagnosed with migraine and 5% have migraine but have not been diagnosed, with seriousness varying from a rare annoyance to a life-threatening and/or daily experience.
Diagnosis
Laboratory Findings
Lumbar puncture: When your headache is suspected meningitis, the doctor may order this test. During this procedure, the patient lies on the side, with knees pulled up toward the chest, and chin tucked downward. After injecting the anesthetic into the lower spine, the doctor insert a spinal needle into the lower back area to measure CSF pressure and collect a sample. The patient is often asked to lie down for a while after the process.
CT
Head images such CT and MRI are needed to rule out other possible causes of headache.
Cost-Effectiveness of Therapy
Treatments are typically expensive. Periodic or unpredictable disability can cause impoverishment due to patients' inability to work enough or to hold a job at all.
References
- ↑ "NINDS Migraine Information Page". National Institute of Neurological Disorders and Stroke, National Institutes of Health. Retrieved 2007-06-25.
- ↑ "Advances in Migraine Prophylaxis: Current State of the Art and Future Prospects" (PDF). National Headache Foundation (CME monograph). Retrieved 2007-06-25.
- ↑ "Migraine: diagnosis, management, and new treatment options, Gallagher RM, Cutrer FM, University of Medicine and Dentistry of New Jersey, School of Medicine, Stratford, USA". The American Journal of Managed Care, PMID: 11859906. Retrieved 2007-06-25.
- ↑ "Guidelines for all healthcare professionals in the diagnosis and management of migraine, tension-type, cluster and medication-overuse headache, Jan 2007,British Association for the Study of Headache" (PDF). Retrieved 2007-06-25.
- ↑ The Essential Book of Herbal Medicine (also known as Out of the Earth) by Simon Y. Mills, Viking Arkana, 1994(1991). Mills is former president of the UK licensed medical herbalists association. Mills' point is the traditional classification of migraines into "hot" and "cold" types, meaning that one's migraine type is determined by whether one's pain is reduced by hot/warm versus cold water.
- ↑ Ogilvie AD, Russell MB, Dhall P, et al. "Altered allelic distributions of the serotonin transporter gene in migraine without aura and migraine with aura." Cephalalgia. 1998 Jan;18(1):23-6. PMID 9601620
- ↑ Ulrich V, Gervil M, Kyvik KO, Olesen J, Russell MB (1999). "The inheritance of migraine with aura estimated by means of structural equation modelling". Journal of Medical Genetics. 36 (3): 225–7. PMC 1734315. PMID 10204850. Retrieved 2012-08-30. Unknown parameter
|month=ignored (help) - ↑ Gervil M, Ulrich V, Kaprio J, Olesen J, Russell MB (1999). "The relative role of genetic and environmental factors in migraine without aura". Neurology. 53 (5): 995–9. PMID 10496258. Retrieved 2012-08-30. Unknown parameter
|month=ignored (help) - ↑ . Silberstein S. "Migraine". Lancet 2004;363:381-391