Migraine is a severe headache caused by a disorder of the vascular system. It is largely an inherited disorder and in excess of 70% of patients have at least one parent who has the complaint. Please note that the migraine is no ordinary headache. At the onset of an attack the arteries in the scalp stretch and contract and cause an extremely painful, throbbing headache. Along with the headache comes a whole host of other symptoms such as visual disturbances (or scotoma), nausea, vomiting, numbness, trembling, unusual pallor or redness, speech difficulties and mood changes. When migraine occurs in children the headache may be less severe or not present at all. Instead the pain may be felt in the stomach.
Two types of migraine occur and these are 1) ‘classic’ and 2) ‘common’ migraine.
Classic Migraine
This kind of migraine occurs in 15-20% of patients and has two different stages, a stage known as the pre-headache stage and the headache phase. In the pre-headache phase visual disturbances are likely to occur. This is called scotoma and is temporary in nature. The vision may be blurred or exhibit increased sensitivity to light or you may have blind spots, brightly flashing lights or zigzag patterns across the field of vision.
Although alarming, these effects are a normal part of classic migraine and are caused by the high levels of a brain chemical called serotonin experienced during an attack. Blood flow to the brain is temporarily restricted as the blood vessels of the scalp are tightly squeezed.
You may also feel numbness, tingling or weakness on one side of the body and your speech may become slurred or otherwise impaired. You may also feel very cold or very warm. Stage one can from five minutes to an hour, peaking and then receding as the headache phase begins.
The headache stage starts when serotonin levels in the brain drop to very low levels and the blood vessels expand and become larger. The headache may be felt on both sides of the head in children but in adults is usually one-sided and felt around the eyes, over one eye or over one or both temples.
In children the pain may be felt over the eyes, the cheeks, nostrils, ears, jaw and the gums. This phase could last for few hours or even several days and is made worse by moving the head or jerking the body. There may be nausea or vomiting during this stage and aches and pains in the back and limbs or you may feel feverish with chills and heat over the forehead. Diarrhea or constipation may also occur.
