The Inevitable Pain, Migraine

This migraine article was published in JoSS's 31th Issue on www.joyofsharingscience.com

Introduction:

From a widely known angle, migraine is something that makes us sick by giving us headaches accompanied by different kinds of pains. From a biological angle, migraine is a neurological disorder causing varied symptoms, but a main symptom: headache. From its first occurrence on Earth, migraine is not curable because its cause is still unknown; there are some theories present but they are not proven completely right. So, what is this migraine?

What is this migraine?

Migraine is a familial (genetic, inherited) episodic neurological disorder which is mainly marked with headache. It has many more associated symptoms accompanying headaches such as nausea, vomiting, light sensitivity, sound sensitivity and so on. This disorder creates disturbance in the central nervous system’s functioning and its exemplar symptom is “pain”. (Goadsby)

Migraine is divided into two main titles: migraine with aura, and migraine without aura. Auras are neuronal disturbances signaling migraine’s arrival.

Migraine Stages and Symptoms and Environmental Causes

First Stage, Prodrome: In this stage, migraine shows itself and says, “I am coming for you.” In this stage, some symptoms are:

Food cravings
Depression
Fatigue or low energy

In this stage, in migraine with aura, the “aura” takes place. These auras, neuronal

disturbances can be problems with vision, sensation, movement and speech. (Nall)

Second Stage, Attack: In this stage, actual headache, migraine takes place. This stage can last hours to days. In this stage, the symptoms are:

Light and sound sensitivity
Nausea
Pain on head, mostly on forehead
Vomiting

Third Stage, Postdrome: This stage can occur, it is not a “must”. In this stage, the person experiencing the second stage experiences varied feelings:

One minute the person is happy,
Another minute the person is moody.

What causes migraine environmentally: Mostly; bright light, severe heat, dehydration, hormonal changes, stress, and loud sounds cause migraine.

Different Migraine Types

These types of migraines mentioned below are recognized by the International Headache Society.

Chronic and acute migraine: This type is a combination of mixed headaches, both due to migraine and tension. Also, the chronic migraine can occur due to medication overuse. This type of migraine can have both migraine with aura or without aura. Acute migraine is the type other than chronic migraine.
Vestibular migraine: This type is the migraine that causes vestibular symptoms such as balance problems, dizziness, or both.
Optical (eye) migraine: This type is the migraine that causes migraine with aura, yet this type only affects one eye. Pain in this type is not specifically intense.
Menstrual migraine: This type of migraine is related to menstrual period in women, linked to the estrogen. They can occur with or without an aura. In 60% of women, this type of migraine is present in the menstrual period; after, during or before.
Acephalgic migraine: This type of migraine is the migraine with aura, but without headache. The aura symptoms occur but migraine does not occur.

What causes migraine?

The cause of migraine is discussed and studied recently, but it is not necessarily known what causes it. There are some theories: fluctuations in blood flow to the brain, chemical effects by serotonin, and aura-site stimulation (cortical spreading depression).

Early theories:

Blood flow theory: This theory is an old theory and it suggests that fluctuations of blood in the brain cause migraine.
Serotonin theory: This theory is linked with vessel dilution and serotonin. As migraine is triggered, serotonin is secreted and it dilutes blood vessels and in return creates pain. As the serotonin is stimulated, the resulting pain becomes migraine.

Last known theory:

Aura-site (cortical spreading depression) theory: This theory is about an area in the occipital cortex (visual cortex, at the back) of the brain. In this theory, the auras are explained more compared to migraines. The area in the occipital cortex is a very hypersensitive area and when it is stimulated, it gives the same response with an aura’s response in a person who has migraine. After this aura-stimulation, the person whose occipital cortex is stimulated starts to have dilution in vessels which in return creates pain, and the stimulation in the occipital cortex is found to be a reason for the secretion of serotonin.

What can be a way out from migraine?

The symptoms of migraine can be controlled by different medications, diets or different physical exercises, yet the below-mentioned “way-outs” are cure-like “way-outs” from migraine.

Transcranial magnetic stimulator: This device is used to direct the aura stimulating neurons’ stimulation far away from the occipital cortex for the aura to not occur. Thus the migraine might be prevented. This device’s misdirection of stimulation process is widely used in epileptic people because in epileptic people the cortical spreading depression, aura site theory is present, too.
Nasal spray: This nasal spray is designed to spray carbon dioxide into sinuses where the carbon dioxide interrupts cortical spreading depression, aura-site stimulation, by irritating nerve endings which are leading to the brain.

Referances:

“How a Migraine Happens.” Johns Hopkins Medicine, www.hopkinsmedicine.org/health/conditions-and-diseases/headache/how-a-migraine-happens.

Fisher, Marshall Jon. “The Biology of . . . Migraines.” Discover Magazine, Discover Magazine, 12 Nov. 2019, www.discovermagazine.com/health/the-biology-of-migraines.

Nall, Rachel. “Everything You Want to Know About Migraine.” Healthline, Healthline Media, 20 Dec. 2017, www.healthline.com/health/migraine.

Goadsby, Peter J. “Pathophysiology of migraine.” Annals of Indian Academy of Neurology vol. 15,Suppl 1 (2012): S15-22. doi:10.4103/0972-2327.99993

Figure References

“Headaches and Migraines Mount Prospect.” Innate Concepts Chiropractic, 20 July 2016, www.innateconceptschiro.com/headaches-migraines/.

Wilson, Dr. Damien Jonas. “What Foods Can Cause Migraines?” News, 23 Jan. 2020, www.news-medical.net/health/What-Foods-Can-Cause-Migraines.aspx.

“Migraine, Headache and Facial Pain: Nuvance Health.” Health Quest Patient Center, 18 Nov. 2020, patients.healthquest.org/services/neurosciences