Neurologist & Migraine

Migraines are neurological syndromes that cause severe headaches. These headaches are caused by altered bodily perception, resulting in pulsating pain, sensitivity to light and sound, and nausea. Neurologists can help diagnose and treat these migraines with a professional knowledge of neurological functions. A migraine sufferer should see a neurologist to diagnose these headaches as migraines, and not another condition, such as sinus headaches or something more serious.

Symptoms

• The symptoms of migraines are classified under four different phases. The first phase is known as the prodrome. These symptoms occur days before the migraine and can include depression and irritability, drowsiness, and muscle stiffness. The second phase is the aura phase. This occurs roughly an hour before the migraine begins. Symptoms of an aura include disturbance of vision resulting in flashes of color and blurred vision, tingling or numbness in the limbs, and vertigo. The third phase is pain. This is when the migraine has hit head-on. Symptoms include nausea and vomiting, sensitivity to light, sound, and smell, extreme pain in the temple, and stiffness of neck. The fourth and final phase is the postdrome phase. This causes the sufferer of a migraine to feel "hung over." Symptoms include cognitive difficulties, depression, and, in some cases, euphoria.

Neurological Pathophysiology

• There are several neurological theories as to how migraines come about. The neural theory states that migraines begin when there is irritation in the brain stem. The bodily response is a flushing of chemicals throughout the bloodstream which causes inflammation of blood vessels, further causing the symptoms of the migraine. Another theory is the vascular theory. This theory involves blood vessels in the brain expanding inappropriately. This expansion leads to the irritation of the nerve roots in the brain, causing the symptoms of migraines.

Diagnosis

• Because migraines can often be misdiagnosed as cluster headaches, the International Headache Society has a list of symptoms which culminate in a diagnosis of a migraine. These criteria include: 5 or more attacks, 4 to 3 days in duration, 2 or more of the following symptoms: unilateral (meaning that it attacks one half of the head), pulsating sensation, moderate to severe pain intensity, and avoidance of everyday activities. There also must be 1 or more of the following: nausea and/or vomiting and sensitivity to light and sound.

Treatment

• There are both medicinal and traditional therapeutically ways of treating migraines. Over the counter analgesics can help relieve the pain of a migraine. Certain over the counter medicines, such as Excedrine Migraine, Motrin Migraine, and Advil Migraine are easily available. These contain aspirin, acetaminophen, and caffeine, which have been shown to assist in migraine pain. Prescription medicines are also readily available with a wide arrange of medical agents in them, such as analgesics, muscle relaxants, and medicines to reduce nausea and vomiting. Patients are also advised to stay in dark, cool, silent rooms to avoid over-stimulation.

Prevention & Triggers

• Lifestyle alterations are the main preventative measure against migraines. Certain foods and lifestyles can lead someone to become prone to migraine. Certain foods have been shown to leave people to be susceptible to migraines. These include gluten, MSG, and caffeine or caffeine withdrawal. Triggers for migraines vary widely. They include changes in weather--specifically, changes in barometric pressure and high humidity. Another major trigger of migraines is sleep deprivation or a significant change in one's sleep cycle; for example, someone suffering from jet lag.