Tips For Dealing With A Silent Migraine
Silent migraines are those without pain. Apart from the lack of pain, they share similarities with standard migraine attacks and can be just as debilitating. In a typical migraine attack, its not just the pain sufferers have to deal with. There are many other severe symptoms that manifest over a period of hours or days.
What Happens In The Brain During A Migraine
Until the 20th century it was a mystery what caused migraine and what happened in the body during an attack. However, in recent years scientists have discovered many of the mechanisms that are involved when migraine attacks start and develop. This article will describe the most important of these mechanisms.
What Happens In Your Brain During A Migraine
Scientists used to think migraines were caused by blood vessels on the surface of your brain dilating and constricting, leading to the pulse of pain people often experienced. They saw migraines as being primarily a vascular disorder. Thats changed. We now know that these changes are the end result of a more complex nerve pathway in the brain.
Today, researchers believe migraines are a neurological disorder thats largely genetically based. They still dont understand everything that happens during a migraine, such as why certain symptoms occurbut they are closer to untangling the mystery of the migraine.
Heres what researchers believe happens inside your brain to cause the symptoms you are experiencing.
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A Trigger Starts A Reaction
First, nerve cells within your brainstem are activated or triggered. This activation can occur for a variety of reasons, including lack of sleep, food or water, for example. A drop in magnesium levels, abnormal calcium channels on the surface of the neuron, mitochondrial changes or other genetic abnormalities are all possible factors.
Once activated, the neurons send messages along the trigeminal nerves, a major pain pathway that starts in the brain stem and travels along your face, teeth, eyes, sinuses and forehead, as well as to blood vessels on the surface of the brain. These blood vessels expand or dilate in response.
Activity then occurs across the surface of the brain, called a spreading cortical depression. This spread moves like a slowly advancing thunderstorm, traveling from the back to the front of your brain. As it passes over the brain, blood vessels constrict, limiting oxygen flow.
Researchers believe the cortical may be the cause of the visual auras that some people with migraine experience. These auras result in people seeing dark or colored spots, sparkles, or other visual disturbances.
How Long Does A Hemiplegic Migraine Last
This can be a frightening experience for the individual as these symptoms are similar to those of a stroke. This weakness may last from one hour to several days, but usually it goes within 24 hours. The head pain associated with migraine typically follows the weakness, but the headache may precede it or be absent.
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Who Is At Risk For Migraines
About 12% of Americans get migraines. They can affect anyone, but you are more likely to have them if you
- Are a woman. Women are three times more likely than men to get migraines.
- Have a family history of migraines. Most people with migraines have family members who have migraines.
- Have other medical conditions, such as depression, anxiety, bipolar disorder, sleep disorders, and epilepsy.
How Do You Treat Hemiplegic Migraines Naturally
Natural remedies for migrainesAcupressure. Acupressure therapy may help relieve some migraine symptoms. Diet changes. Many people who get migraines notice certain foods can trigger them. Essential oils. Ginger. Stress management. Yoga or stretching. Biofeedback therapy. Acupuncture.More itemsAug 20, 2018
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Migraines With Similar Symptoms
Along with the typical aura onset, a number of different types of migraines typically share similar symptoms. With this one, you may experience symptoms similar to a stroke. There is also the familial hemiplegic migraine which has to do with weakness on one side of the body. This can last for a while, with some reported cases even lasting a few weeks. Difficulty moving half of ones body is often accompanied by the other symptoms mentioned, making the FHM a truly debilitating condition.
There is also the sporadic hemiplegic migraine , which is much the same in that it affects one area of the head. This is also often accompanied by FHM symptoms and is always preceded by the experience of an aura.
If you are unsure of which ailment it is you are experiencing it is best to seek medical help right away.
What Are The Treatments
Finding effective treatments for migraine has been a challenge. Fifteen years ago, triptans represented an important step toward migraine attack resolution and symptomatic treatment. Triptans are drugs which bind to and activate specific serotonin receptors called 5-HT1B and 5-HT1D.
Activating these receptors with triptans can have multiple effects. Triptans can impact trigeminal nerves involved in pain by decreasing the release of CGRP and substance P, a chemical known for its pain producing properties. Triptans can also modulate the activity of certain brain areas and induce vasoconstriction.
Five years ago botulin toxin, also known as BoTox®, was introduced as the first treatment for chronic migraine. BoTox® is usually thought of as a substance used for cosmetic surgery, but there is also evidence for its clinical potential. Botulin toxin may help headaches through multiple mechanisms. One mechanism describes how upon injection botulin toxin is taken up by cranial nerves in the face and travels up the trigeminal nerve into the central nervous system. Botulin toxin then reduces inflammation and inhibits the release of CGRP.
Five years ago botulin toxin, also known as BoTox®, was introduced as the first treatment for chronic migraine. BoTox® is usually thought of as a substance used for cosmetic surgery, but there is also evidence for its clinical potential.
Interested in reading more? Be sure to check out the latest articles in BMC Neurology.
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Ion Channels The Cerebral Cortex And The Brain Stem
What is migraine? Migraine is a disease of the brain, and these three players are probably key in the start of a migraine attack.
We know that migraine brains react differently than non-migraine brains. The brain of a migraineur is hyper-excitable. It responds differently to stimuli . But why?
Ion channels are in all living cells, and in the membranes surrounding cells. Ion pumps are proteins that move ions. Regulating the flow of ions, they are key in the communication process of your nervous system. Malfunctions in certain types of ion channels may start the migraine chain-reaction by causing problems in the brain stem and cerebral cortex. If ion channels are to blame, we might call migraine a channelopathy a type of disease related to ion channel malfunctions .
We know that migraine symptoms can start in these two parts of the brain, though were not sure if ion channels are the root problem. In the cerebral cortex, a kind of “brain storm” happens which is called a cortical spreading depression . A wave of hyperexcitability an electrical wave spreads across the outer layer of the brain, releasing neurotransmitters. Next comes a prolonged period of suppressed activity. Changes in blood flow occur at this time.
A person who has migraine may be a person who gets these brain storms more easily than the average person. This could be because of lower levels of chemicals in the brain, and breakdowns of communication in the neurological system .
What’s Happening During A Migraine
Why do some people suffer from the agonizing head pain of migrainesand the nausea and sensitivity to light that can accompany themwhile others don’t? The answer, at the biochemical level, is complicated, but probably boils down to this: Migraine sufferers’ brains are simply more sensitive to outside stimuli than are other people’s brains.
Migraines used to be blamed on blood vessels in the brain dilating, or opening up. The newer thinking is that the expansion of blood vessels is the result of some other event, not the cause. The cause may in part be the excitation of a nerve responsible for sensation in the face.
“It’s called the trigeminal nerve,” explains Larry Newman, MD, director of the Headache Institute at St. Luke’s-Roosevelt Hospital Center in New York City.
When the trigeminal nerve is stimulated, it causes the release of a variety of neurotransmitters . These in turn cause the blood vessels that surround the brain to expand and inflame.
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“Those blood vessels are attached to nerve fibers which transmit the pulsations from the blood vessels back into the brain, where you then perceive it as pain,” says Dr. Newman.
Although some people experience a pre-attack aura, a typical migraine occurs in two steps.
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The Brain Before A Migraine Attack
The entire brain with all its neurons and ECF is covered by a membrane . Running on the outside of this membrane are the arteries that supply the brain with oxygen and blood sugar. The nerve cells in the brain cannot feel pain, but the arteries have pain-sensing nerve endings in them, so-called pain receptors.
In the normal case illustrated in the picture above, the concentration of K+ is very large inside the nerve cells, but very low outside in the ECF. For Na+ it is the other way around.
When a nerve cell sends a signal , some of the K+ inside leaks out of the cell into the ECF, and some of the Na+ outside leaks into the cell. In our dancer example, this is similar to how the dancer from time to time drops a marble on the floor.
The normal inside/outside concentrations are kept stable by microscopic Na+/K+ pumps in the nerve cells walls. These pumps are all the time pumping K+ out of the ECF and into the cells, and Na+ in the other direction. In our dancefloor example, these pumps are like the dancer continually picking up the marbles that she drops.
What Commonly Triggers A Migraine
People who get migraines may be able to identify triggers that seem to kick off the symptoms. Some possible triggers include the following:
- Stress and other emotions
- Biological and environmental conditions, such as hormonal shifts or exposure to light or smells
- Fatigue and changes in one’s sleep pattern
- Glaring or flickering lights
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How Can I Prevent Migraine Attacks
Not all migraine attacks have an obvious trigger, but sudden changes in daily routine can be a trigger. This includes a missed meal, a late night or doing more strenuous exercise than you normally do. To reduce your chance of having a migraine attack you may find it helpful to make the following lifestyle changes:
- Have regular meals.
- Drink enough water/fluid to stay hydrated.
- Do relaxation and exercises for stress .
- Aim for a regular sleep pattern and make sure you have enough sleep .
- Don’t do sudden strenuous exercise.
- Limit caffeine intake to no more than 2 cups of coffee a day.
Addressing other conditions that may be causing your migraine attacks is also important. These include stress, anxiety, depression, hormonal changes and head or neck trauma. If these are problems, talk to your doctor. They may be able to help you work out how to manage these things.Cognitive behavioural therapy , coping strategies and relaxation training are helpful for many people with migraine, especially if attacks are associated with anxiety or stress.
What Does An Attack Look Like
There are four distinct phases of a migraine attack: prodrome, aura, headache, postdrome. You dont have to experience all the phases. In fact, only about 20% of people with migraine have an aura. Understanding the phases can help you manage the disease better.
The prodrome and aura phases usually occur before the headache develops. Prodrome may precede the migraine attack by several hours or even days. Typical prodrome symptoms include extreme tiredness and yawning, irritability or moodiness, difficulty concentrating, and food cravings. About 75% of people with migraine experience a prodromebut often they dont recognize it as the beginning of an attack. Aura is rarer and usually begins just before the headache starts. Most people experience changes in their vision, while others notice tingling, numbness or trouble speaking.
These symptoms can serve as a warning sign and allow you to take acute medication before the headache begins. Identifying and treating a migraine early can even help prevent further symptoms in some people.
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Picturing A Migraine Attack
The brain works through many extremely complicated biochemical and electrical mechanisms, many of which are not even completely understood by science so it is no surprise that a description of what happens in the brain during a migraine attack is complicated! This article will try to make the process as clear as understandable as possible, even if you do not know a lot about cells and chemistry.
To start off, it can be helpful to use a mental picture that illustrates what is going on when migraine attacks are triggered: imagine a large troupe of gymnasts doing a dance routine to music, on a slick hardwood floor. The dancers are listening to music for their cues of when to do which dance move.
This wave of falling dancers is of course a bit silly, but the process has some similarity to the kind of chain reaction that takes place in the brain when a migraine attack is triggered, as we will see when we now dive into the actual biology of a migraine attack.
Chemicals Cause Additional Symptoms
Your brain also responds to the brainstem activation by releasing chemicals called neuropeptides, including serotonin, noradrenalin, prostaglandins and others. Once released, they travel to the outer layer of your brainthe meningeswhich results in inflammation and swelling of blood vessels, causing an increase in blood flow around the brain.
This is likely the cause of the throbbing, pulsing pain most people experience during . While the pain may be originating from the surface of your brain, you may feel it in your eyes, temple area, neck, face or sinuses. These neurochemicals also can transmit signals to the part of the brain that controls appetite, and .
Another phenomenon that occurs as a result of this inflammation and chemical interplay is skin super-sensitivity. About 80% of migraine sufferers experience whats called cutaneous allodynia that causes things like earrings, necklaces, neckties and eyeglasses to become painful. Some people say even their hair hurts this chemical reaction is why.
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What Happens To Me During A Migraine
Headaches are an unfortunate part of life, but for roughly 15% of the population, headaches are just the tip of the iceberg. Migraine headaches can bring a whole new level of pain into your life, with debilitating side effects which are often reoccurring problems, growing stronger with every new attack. But why do some of us find ourselves suffering over and over with migraine headaches while others have never had a single attack and what exactly is happening inside our bodies when a migraine strikes?
What Are The Treatments For Migraine
There is no absolute cure for migraine. However, lots of treatments are available to help ease the symptoms of a migraine attack.
When a migraine attack occurs, most people find that lying down in a quiet, dark room is helpful. Sleeping can also help. Some people find that their symptoms die down after they have vomited .
Most people affected by migraine will already have tried paracetamol, aspirin and perhaps anti-inflammatory drugs such as ibuprofen before they seek advice from their doctor. If ordinary painkillers alone are not relieving your symptoms, your GP might prescribe you a triptan to be taken in addition to over-the-counter painkillers . Triptans are available in different forms to suit individuals , although it is important to note that some people develop short-term side effects when taking triptans. Your doctor may also prescribe you anti-sickness medication. If your situation does not improve after treatment, you might be referred to a specialist migraine clinic.
It is important to avoid taking painkillers on more than two days per week or more than 10 days per month as this can in fact make things worse by triggering medication overuse headaches.
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What Is The Main Cause Of Migraines
Researchers and doctors are trying to understand more about how our brain and nervous system work. Migraines are still mysterious. In the early days, medications only targeted the blood vessels, aiming to minimize the pain. Then, new data comes into the light, allowing the medical community to understand that migraines also involve the nerve pathways and the chemicals in the brain.
In addition, migraines have a genetic link, as proven by at least half of migraine patients who have family members with the condition. However, this is just the tip of the iceberg. The other 50% of migraineurs do not have a genetic link. What might their migraine source be then? It means the environment plays a critical role in migraines as well.
What Are The Warning Signs
When you are suffering from a migraine, you are fully aware of the fact. The pain and inflammation in the head and face manifests itself as a severe and debilitating headache. However, the warning signs for the complex complicated migraine are numerous. These signs can present themselves as early as hours or even days before the onset of the ailment. The following symptoms are classified as part of the pre-headache phase:
- Stiffness in the neck and shoulder area
- Mood disturbances such as crankiness or jumpiness
- Onsets of food cravings
- Excessive yawning or fatigue
- Constipation, diarrhea, or the feeling of needing to urinate more frequently
However, symptoms can also be warnings for other ailments in the body. Because of this, it may only become clear to you after experiencing it a number of times as to whether or not this pre-headache phase applies to you, and how. A good idea is to keep a headache diary to keep track of everything that happens when you experience a migraine before, during, and after. This is also helpful when it comes to treatment, as it may be able to help your health care practitioner to better diagnose and treat you.