What Is Migraine?
MEDICAL ANIMATION TRANSCRIPT: To sense the world, your nerves send electrical signals to and from your spinal cord and brain. Sensors throughout our body collect information about our surroundings. This information is sent by signals to our brain through a series of nerve cells. Each electrical signal is carried from one end of a nerve cell to the other using passageways called ion channels. Charged particles, called ions, pass through the channels along the nerve, which helps generate the electrical current. At the end of the nerve, the signal moves to the next via chemicals called neurotransmitters. Communication with the brain occurs via pathways and nerve centers at the base of the brain, called the brain stem. The brain stem helps control sleep, heart rate, and breathing. Migraine is a disease where one or more parts of this communication system does not function properly. Many sections of DNA, called genes, program ion channels, neurotransmitters, and other structures that support these nerve pathways. In some with migraine, inherited changes to genes, called mutations, can cause the communication system to become hypersensitive. Most mutations do not directly cause migraine, but, in combination, may explain why there are so many forms and symptoms of migraine disease. These mutated genes affect the function of other parts of the body. As a result, people with migraines may also have anxiety, depression, strokes, epilepsy, hypothyroidism, irritable bowel syndrome, pelvic floor pain, fibromyalgia, Sjogren’s disease, and others. Each attack typically has three or four phases. The typical phases of a migraine attack are prodrome, starting hours before a headache, aura, headache, and postdrome. Prodrome includes subtle symptoms, such as yawning, fatigue, or moodiness. Experienced only by some, auras may be short term visual changes, such as flashes of light, zigzags, or blind spots. Auras can also include numbness, confusion, vertigo, or even muscle weakness. Pounding headaches may occur on only one side of the head, often lasting four to seventy-two hours. Other possible symptoms include light and noise sensitivity, or nausea. Finally, during postdrome, a person feels like they have hangover, which lasts another day or two. Migraine attacks are often brought on by specific stimuli, or triggers, such as: increased stress, weather change, too much or too little sleep, or certain foods. Since it may be a cumulative effect of several triggers, avoiding as many known triggers as possible can help reduce the number of attacks. It is important for treatment planning to distinguish migraine on the basis of frequency and character of attacks. Less than fifteen headache days per month is episodic migraine. Fifteen or more headaches per month is chronic migraine. Every year about three percent of those with episodic migraine become chronic. This worsening of symptoms may be due to changes in hormones or accumulated brain damage from years of migraine attacks. While migraine is rarely deadly, it is an invisible disease that can steal years of quality time. For more information about migraine, talk to your healthcare provider, or visit migrainedisorders.org.