Moderate to severe throbbing and throbbing headache usually on one side of the head that can last from hours to days. It affects a significant proportion of the population, with a global prevalence estimated to be close to 15%, making it the second most disabling disease for any activity, both physical and mental, worldwide.
The cause of migraines is not fully understood, but it is believed to be the result of temporary abnormal brain activity affecting nerve signals, chemicals and blood vessels in the brain that could be determined by genetics and environmental factors. However, a number of triggers for this pathology have been suggested that may or may not affect the development of migraine.
- Estrogen fluctuations from menstrual periods, pregnancy and menopause seem to trigger headaches in many women.
- Alcoholic beverages, especially wine, and caffeinated beverages.
- Stress, anxiety or other emotional problems.
- Sensitive stimuli such as bright lights or loud sounds. Strong odors (perfumes, solvents) and tobacco smoke may also be triggers in some people.
- Lack of sleep, oversleeping or irregular sleep patterns.
- Intense physical exertion, including sexual activity.
- Changes in weather or atmospheric pressure.
- Oral contraceptives based mainly on estrogens, and vasodilators (nitroglycerin for heart conditions) can aggravate migraines.
- Skipping meals, dehydration, as well as certain foods such as aged cheeses, salty, processed foods, and food additives including the sweetener aspartame, the preservative glutamate, or nitrates and nitrites.
Currently one has also been described as a risk factor for migraine predisposition:
- Gender: women are three times more prone.
- Age: the maximum incidence usually occurs around adolescence, reaching its maximum intensity at 30, and decreases in intensity and frequency from this point, although they can occur at any age.
The main symptom is headache as a mild, moderate or severe throbbing or throbbing. It may move from one side of the head to the other, affect a specific area or spread to the face and neck. Migraines may go through four stages: prodrome, aura, attack and postdrome, although not all migraines have to go through all four:
- Prodrome: one or two days before, subtle indicative changes such as constipation, mood changes, food cravings, muscle stiffness, fluid retention and increased urination or frequent yawning may be perceived.
- Aura: may occur before or during. It consists of a visual symptom, such as flashes, points of light, shapes or loss of vision, which may be accompanied by other alterations such as tingling in arms or legs, numbness or weakness on one side of the face or body, or difficulty speaking, dizziness or imbalance and less frequently loss of consciousness. Often each manifestation develops within a few minutes and may last up to 1 hour.
- Seizure: it can last from hours to 3 days if not treated with a variable frequency among individuals. In addition to the pain itself, which worsens with head movement, there may be sensitivity to light, sound, smell or touch, nausea and vomiting.
- Postdrome: exhaustion, confusion or weakness, sometimes even euphoria, may be felt after the attack.
Other symptoms of migraines are loss of appetite, feeling very hot (sweating) or cold (chills), pallor, diarrhea (rare) or fever.
One of the best ways to prevent migraines is to recognize the things that trigger an attack and try to avoid them. Take care of your lifestyle, check your weight and general health regularly (blood pressure, blood glucose).
Do physical exercise as long as it is not harmful or a trigger to limit stress and improve the general state of health.
Diet is an aspect that has been related, but this is specific to each individual, so it is recommended to record those foods that trigger a migraine attack in order to avoid them later.
13.5 million variants
Burch RC et al. Migraine: Epidemiology, Burden, and Comorbidity. Neurol Clin. 2019 Nov;37(4):631-649.
Gormley P et al. Meta-analysis of 375,000 individuals identifies 38 susceptibility loci for migraine. Nature Genetics. 2016 Aug;48(8):856-866.