Migaine is classified into two major sub groups

1. classical migraine: it is” migraine with aura”,  which is  a pre-headache phenomenoa

2. migaine without aura

Diagnostic criteria for migraine without aura

• At least five attacks which is fulfilling below criteria
• Headache lasts 4 to 72 hours, which is untreated or unsuccessfully treated.
• Headache has atleast two of the following characteristics

– Unilateral location, pulsating quality, Moderate to severe intensity, which prohibits daily activities, Aggravation by routine physical activity

• During headache, there is Nausea /vomiting or photophobia/phonophobia.
• Migraine most commonly seen in the women, as it is thought to reflect the aggravating influence of
• Estrogen on the central migraine mechanisms.
• Location of headache: it is mostly unilateral, it is over frontal or temporal.

Factors triggering migraine

• Hunger
• Organic odors
• Certain food products like chocolate, cheese, wine, sea food
• Disturbed sleep
• Hormonal changes due to the menstrual cycle or hormone medication
• Any other triggering factor with which the patient is hypersensitive.
• Lack of fluid intake

Headache can run in cycles of several months to years. Migrains are also very common. A typical migrain is one-sided and throbbing. Indeed , headache that is one-sided, throbbing and make you feel sick , are more likely migraine. Migraine are often severe, enough to be disabling. Some patients need to go bed to sleep off their headache.

Migraine can last anything from four hours to three days. They are often made worse by movements or sound. Patients often feel sick ( nausea) or are sick ( vomit), even if the pain is not severe. Often patients find bright light and even tv makes headache worse. Most people with migraine have 4 to 5   attacks a month.

About a third of people have migraine with ‘’ aura ‘’  or “classical migraine” . in this condition ,warning symptoms( the aura) occur before the migraine.  These most commonly consist of flashing lights, often in the shape of zigzags. They are sometimes described as being firework displays. They tend to occur on side of the vision only ( although affecting both eyes at same time). Some people lose half of their vision completely. Others experience tingling or weakness on one side of the body or slurring of speech. These warning symptoms can last for upto an hour, are generally followed by headache.

Typically the headache is on the opposite side to the visual symptoms.

What is the treatment for migrains?

Migrains can improve with rest, sleep, darkness and quiet. Drinking water can help, if you don’t feel sick, and simple pain killers such as paracetamol and ibuprofen can be effective for many people.

Doctor can prescribe special migraine medication, when you have a headache.

Non-pharmacological method:

Relaxation and bio-feedback training have shown to be of benefit.

Pharmacological method:

This is the best way to control migaine at root level

It helps a lot in 60 to 80 % of the patients and by treatment it reduces the intensity of pain.

Prophylaxis should be given , those who have 4 to 6 attacks per month.and it takes 4 to 6 weeks to show effects.

Aim of drug therapy:

Reduce frequency of attacks by 50%.

Reduce severity of attacks, when it occurs

Medications used to treat migraine

B blocker, Anti-convulsants, anti-depressant, ergotamine.

Prophylaxis for migraine

The drugs used for prophylaxis might have to be continued for 6 to 12 months