Migraines and Primary Headaches

Scientific research on headaches is expanding our knowledge of the subject all the time. As such, twelve overarching classes for headaches have been established by the International Headache Society, based on well-defined criteria. Primary headaches, described below, comprise the most commonly encountered headache type and can be treated via natural care methods. Beyond this, there exists another category of headache, secondary headaches, that are much rarer but cannot be treated via natural means. These secondary headaches (eg., tumours, pathologies, etc.) require medical treatment. This classification is used worldwide. Here is a description of the most common headache types.

Migraines

Migraine is a neurological syndrome characterized by altered bodily experiences, painful benign and recurring headache. It is a common condition which affects three times more women than men. This particular headache type can often be triggered by certain specific activating stimuli.

Migraine triggers or activators :

Food triggers already identified are glutamate, amines, fatty and sugary or sweet foods, caffeine and alcohol. Here is a list of some of the main problem foods; cocoa, chocolate, citrus fruits, alcohol, red wine, sour cream, yoghurt, ice cream, aged or overripe cheeses, overripe or bruised fruit or vegetables, sauerkraut, broad beans, yeast and yeast extract, all varieties of nuts, peanut butter, saltfish, dried, marinated or smoked fish, sausages, meat extracts, aged or rotting meat, liver (except when very fresh), greasy or fried food, coffee and very sweet or sugary foods (e.g., desserts).

The other main triggers are hormonal changes, stress, anxiety, changes in daily routine, and changes in the environment (atmospheric pressure, cold, heat, light).

Migraines can be divided into two major sub-types :

Migraine without aura
(Common migraine, hemicrania simplex)

Description :

• Any age; high prevalence among young adults and children.
• Adults: women > men      Children: girls > boys
• Recurrent headache disorder manifesting in attacks lasting 4 to 72 hours.
• Headache usually frontotemporal.  Unilateral pattern in adulthood and late adolescence.  Bilateral pattern in young children.
• Premonitory symptoms of fatigue, difficulty in concentrating, neck stiffness, sensitivity to light or sound, nausea, blurred vision, yawning and pallor occurring hours to a day before a migraine attack
• Pulsating quality
• Moderate or severe pain intensity
• Aggravation by or causing avoidance of routine physical activity
• Nausea and/or vomiting
• Photophobia and phonophobia

Migraine with aura
(Classic or classical migraine, ophthalmic, hemiparaesthetic, hemiplegic or aphasic migraine, migraine accompagnée, complicated migraine)

The aura is a complex of temporary neurological symptoms that occurs 5 to 20 minutes before the onset of the migraine and lasting for less than 60 minutes.  The typical aura consists of visual and/or sensory symptoms.  Approximately 20% of migraine-sufferers experience aura.

Visual aura is the most common type of aura, often presenting as a scotoma called fortification spectrum (scintillating dots, zigzag figures and “C” shaped broken lines), it arises from dysfunction of occipital lobe neurons.

Sensory aura gradually appears in the form of pins and needles (paresthesia) moving slowly from the point of origin and affecting a greater or smaller part of one side of the body and face.  Numbness may occur in its wake, but numbness may also be the only symptom.  Less frequent are speech disturbances (dysarthria) and aphasia.

Description :

• Any age; high prevalence among young adults and children.
• Adults: women > men      Children: girls > boys
• Recurrent headache disorder manifesting in attacks lasting 4 to 72 hours.
• Headache usually frontotemporal.  Unilateral pattern in adult and late adolescence.  Bilateral pattern in young children.
• Premonitory symptoms of fatigue, difficulty in concentrating, neck stiffness, sensitivity to light or sound, nausea, blurred vision, yawning and pallor occurring hours to a day before a migraine attack
• Pulsating quality
• Moderate or severe pain intensity
• Aggravation by or causing avoidance of routine physical activity
• Nausea and/or vomiting
• Photophobia and phonophobia
• Visual and/or sensorial aura
• Speech disturbances

Typical aura may occur occasionally without headache or with a non-migraine headache.

Complications of Migraine

Chronic migraine: Migraine headache occurring on 15 or more days per month for more than 3 months in the absence of medication overuse..

Status migrainous: A debilitating migraine attack lasting for more than 72 hours.

Cervicogenic headache

is a common form of headache arising from structures in the neck. It is a 'side-locked' or unilateral fixed headache characterized by a non-throbbing pain that starts in the neck and spreads to the ipsilateral oculo-fronto-temporal area and is aggravated by neck motions, head posture or muscles from the neck. Segmental vertebral dysfunction in the neck causes recurrent and chronic headaches.

Tension-type headache
(Tension headache, muscle contraction headache, psychomyogenic headache, stress headache, ordinary headache, essential headache, idiopathic headache and psychogenic headache)

is a frequent headache (at least 10 episodes) lasting minutes to days and often occurring daily.  The pain is typically bilateral, pressing or tightening in quality and of mild to moderate intensity, and it does not worsen with routine physical activity.  The pain is located in the neck, in the temporal or frontal zones. Anorexia, photophobia or phonophobia may be present.  When chronic, the tension-type headache occurs more than 15 days per month on average for more than three months (≥ 180 days/year).

Definitions

Aphasia

Partial or total loss of the ability to articulate ideas or comprehend spoken or written language, resulting from damage to the brain caused by injury or disease.

Bilateral

On both sides.

Cephalalgia :

Pain in the head. Technical name for headache.

Dysarthria:

Motor speech disorder resulting from neurological injury, characterized by poor articulation

Dysphasia:

Language disorder in which there is impairment of both speech and of comprehension of speech

Myofascial trigger points :

Hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers.

Paresthesia

Sensation of tingling, pricking, or numbness of a person's skin with no apparent long-term physical effect. It is more generally known as the feeling of "pins and needles" or of a limb being "asleep"

Phonophobia

An abnormal fear of noise.

Photophobia

An abnormal sensitivity to or intolerance of light.

Pulsative

Throbbing or varying of the heartbeat.

Segmental dysfunction (vertebral)

Modification of the physiological segmental function in terms of hypo- or hypermobility.

Stimuli (plural)

An agent, action, or condition that elicits or accelerates a physiological or psychological activity or response

Unilateral

On one side.