Symptoms and Diagnosis of Migraine

Symptoms

1. Headache The characteristics of migraine pain are as follows.

· Moderate or severe headaches that often interfere with daily life. · The pain may be felt on only one side of the head, or it may occur across the entire head. · The headache is typically pulsating, like a throbbing or pounding sensation. · When you exercise during a migraine, the headache becomes worse. · In severe cases, the pain is so intense that it makes normal daily activities impossible.

If left untreated, a migraine usually lasts from 4 to 72 hours. In some cases, a severe headache persists for more than 72 hours without subsiding, making normal life impossible. This is called status migrainosus and requires treatment. The frequency of migraines varies greatly from person to person. Some people have migraines every day, while others have them only once or twice a year.

2. Associated symptoms The symptoms that accompany a migraine can be just as distressing as the pain itself.

· The most common associated symptoms are gastrointestinal symptoms. When a headache occurs, digestion becomes poor, nausea develops, and in severe cases vomiting may occur.    Many migraine patients often say that they get a headache when they have indigestion. · During a migraine, people become sensitive to sound and light. Sounds may be bothersome not only when they are loud, but also when they are music. · Sensitivity to odors increases. Patients may find certain smells unpleasant, such as tobacco or oil, or even perfume; the specific smell varies by person. Sound, light, and odors can sometimes trigger headaches as well. · Migraine patients often complain of dizziness during a headache. In severe cases, they feel as if the world is spinning.

3. Aura Most migraine patients do not have aura symptoms; this is called migraine without aura. However, some people experience aura, and this type is called migraine with aura.

In migraine with aura, aura symptoms are felt before the migraine begins. As the name suggests, aura refers to symptoms that occur before a migraine and usually last less than one hour. In rare cases, aura may occur without a headache and then disappear, or it may continue after the headache appears, or even begin after the headache starts.

1. Visual aura · Flashes of light or spots blink in front of the eyes. · Zigzag lines appear in the visual field. · Circles, ovals, or castle-like shapes appear in the field of vision and gradually grow larger over time.

2. Sensory aura · Usually, one side of the face or hand feels tingling, numbness, or a dull sensation.

3. Speech aura · Speech disturbance may occur, such as difficulty finding words.

Meanwhile, separate from aura symptoms, the following prodromal symptoms may appear 2 to 48 hours before a migraine begins. · Indigestion · Fatigue and reduced concentration · Stiff neck or shoulders · Yawning, drowsiness, etc.

Diagnosis

Migraine is diagnosed based on symptoms rather than tests, so taking a medical history is very important. In addition to the diagnostic criteria below, migraine is diagnosed by considering the family history of migraine, a history of headaches during menstruation, and the response to medications such as triptans.

However, if the pattern of the migraine is not typical and the headache starts suddenly or is very severe, the following tests may be needed. These tests are not used to diagnose migraine itself, so they are not performed on every patient. They may be done to confirm and differentiate other conditions that can cause headaches, such as brain tumors, nervous system infections, or brain hemorrhage, when these are strongly suspected.

1. Computed tomography (CT) Computed tomography, also called CT, is a test that uses X-rays to obtain cross-sectional images of the brain. Computed tomography is especially useful for accurately and quickly checking for brain hemorrhage in the early stage, so it may be performed first in patients in whom brain hemorrhage is suspected as the cause of the headache.

2. Magnetic resonance imaging (MRI) Magnetic resonance imaging, better known as MRI, is a test that uses magnetic fields to obtain cross-sectional images of the brain. MRI is more accurate than CT in detecting abnormalities in brain tissue, so in most cases other than acute hemorrhage it is more useful than CT. In addition, MR angiography (MRA), which uses MRI to image blood vessels in the brain, is now also widely performed.

So far, we have explained the symptoms and diagnosis of migraine. In the next post, we will look at the treatment of migraine.

Source: Korea Disease Control and Prevention Agency, National Health Information Portal