Migraines

Pulsating and sharp headache that is moderate to severe, generally on one side of the head, which can last from hours to days. It affects a significant proportion of the population, with a global prevalence estimated at nearly 15%, making it the second most disabling condition for any activity, both physical and mental, worldwide.

The cause of migraines is not fully understood, but it is believed to result from temporary abnormal brain activity affecting nerve signals, chemicals, and blood vessels in the brain, which may be determined by genetics and environmental factors. However, a number of triggering factors for this condition have been suggested that may or may not affect the development of a migraine.

• Fluctuations in estrogen during menstrual periods, pregnancy, and menopause seem to trigger headaches in many women.
• Alcoholic beverages, especially wine, and caffeine-containing drinks.
• Stress, anxiety, or other emotional problems.
• Sensory stimuli such as bright lights or loud sounds. Strong odors (perfumes, solvents) and tobacco smoke can also be triggers for some people.
• Lack of sleep, sleeping too much, or having irregular sleep patterns.
• Intense physical exertion, including sexual activity.
• Changes in weather or atmospheric pressure.
• Oral contraceptives mainly based on estrogen, and vasodilators (nitroglycerin for heart conditions) may worsen migraines.
• Skipping meals, dehydration, as well as certain foods like aged cheeses, salty or processed foods, and food additives including the sweetener aspartame, the preservative glutamate, or nitrates and nitrites.

Currently, certain risk factors for predisposition to migraines have also been described:

• Gender: women are three times more likely to be affected.
• Age: the highest incidence usually occurs during adolescence, reaching maximum intensity at 30, and then decreasing in intensity and frequency from this point, although they can occur at any age.

The main symptom is a headache that feels like a throbbing or pulsing, which can be mild, moderate, or severe. It can move from one side of the head to the other, affect a specific area, or extend to the face and neck. Migraines can go through four stages: prodrome, aura, attack, and postdrome, although not all individuals have to experience all four:

• Prodrome: one or two days before, subtle indicative changes may be perceived, such as constipation, mood changes, food cravings, muscle stiffness, fluid retention, and increased urination or frequent yawning.
• Aura: this can occur before or during the attack. It consists of a visual symptom, such as flashes, spots of light, shapes, or loss of vision, which may be accompanied by other alterations such as tingling in the arms or legs, numbness or weakness on one side of the face or body, difficulty speaking, dizziness, or imbalance, and less frequently loss of consciousness. Often, each manifestation develops within a few minutes and can last up to 1 hour.
• Attack: this can last from hours to 3 days if left untreated, with variable frequency among individuals. In addition to the pain that worsens with head movement, there may be sensitivity to light, sound, smells, or touch, as well as nausea and vomiting.
• Postdrome: after the attack, one may feel exhaustion, confusion, or weakness, and occasionally euphoria.

Other symptoms of migraines include 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 triggers that can provoke an attack and try to avoid them. Maintaining healthy lifestyle habits, regularly monitoring weight and overall health (blood pressure, blood sugar) is essential.

Engaging in physical exercise, as long as it is not harmful or a trigger, can help limit stress and improve overall well-being.

Diet is an aspect that has been associated with migraines, but this is specific to each individual, so it is recommended to keep a record of foods that trigger a migraine attack to avoid them in the future.