About Migraine
Migraine is one of the most common of all human diseases. It is a chronic, often inherited disease that makes your entire nervous system more sensitive to stimulus.
The disease causes headaches, but also many other symptoms. Its effect on daily function varies greatly.
It can transform from one set of symptoms to another during a lifetime. Migraine is often misunderstood and is not given the respect or attention it deserves. Consider becoming an advocate
Our understanding of migraine disease has changed while there is much yet to learn.
Let us review some of the most important principles about this medical condition Migraine is a disease of the nervous system.
In the past we believe that migraine headaches were caused by changes in blood vessels in the brain
Now it is clear that what happens in the brain is much more complicated the underlying problem with migraine sufferers is that their nervous system is too sensitive or too jumpy, it reacts to small or normal stimulation with an exaggerated response.
Those triggers may be the result of something we consume excess stress, a lack of sleep or a change in the weather and how hypersensitive the nervous system is, and what triggers the nervous system varies between people, in other words, migraine disease is not a single disease but a spectrum with symptoms ranging from mild and occasional to debilitating and daily.
Genetics play a part in migraine disease
Why is these genetics play a part in migraine disease? let's remind ourselves about how the nervous system works.
If we look at what we think of like a nerve we see how it is made up of a bundle of similar neuron search, the individual neuron has a cell body with long extensions.when specialized sensors are stimulated an electrical message, starts on its way to the brain but it is actually the flow of the charged sodium ions into the cell ,
Through ion channels followed by the passing of potassium through separation channels out of the cell that generates the electrical signal an electrical wave, then moves rapidly towards the brain at some point each neuron reaches its limit and the signal must be transferred to the next set of neurons.
Here calcium channels open and secondarily cause the release of chemicals called neurotransmitters into the synapses where receptors on the adjacent neurons must detect the neurotransmitters and regenerate the electrical signal.
It is during this complex process that mistakes can be made, think of a genetic defect as a mixed-up message about how the cell is to make things, for example, one of the known genetic defects of migraine is one where the cell is instructed to produce a protein that can not fold into its normal three-dimensional shape.
When positioned in the cell membrane and an electric signal comes along the defective protein may open up and let calcium ions into the cell but it might not be able to snap back into a fully-closed position allowing too much of the electrically charged calcium into the neuron.
In this case, the neuron would keep releasing neurotransmitters and the next cell would generate an exaggerated response, the consequence is that the neuron has overreacted to a stimulus this is not just theoretical, there are known genetic defects of ion channels in families who suffer from migraines.
Additionally research has revealed genetic mistakes affecting how neurotransmitters are made released and inactivated
Therefore each individual inherits a mixture of genetic error this may partly explain, the broad spectrum of migraine symptoms and how between individuals migraine might affect a lot of different parts of the nervous system, not just the pain pathways to illustrate this
Let's look at the trigeminal nerve this nerve has branches that innervate facial muscle temporal-mandibular joint paranasal sinuses and teeth
When stimulating branches of the trigeminal nerve to transmit information back to the brain, through the trigeminal nucleus in the brainstem from, here this message is sent to other parts of the conscious brain that acknowledge the pain and the need for action.
But for a migraine sufferer, the threshold for initiating this distress signal is lower than normal and the amplitude of the warning is abnormally high.
Cortical spreading depression
So what causes the intense headache of migraine?
The current theory is that a trigger either in the brainstem or in the periphery sets off an abnormal electrical event called a cortical spreading depression this is a wave of electrical activity that sweeps slowly across the surface of the cortex a cortical spreading depression first initiates flashing lights or abnormal smells followed by an intense headache.
Electrical depolarization results in a release of neurotransmitters and other molecules that cause secondary inflammation, a person then experiences slight sensitivity nausea foggy thinking, and fatigue for hours by mechanisms, that are still to be defined the chemical reactions of a cortical spreading depression appear to affect the dura.
Where blood vessels dilate and contract must cells release their potent inflammatory chemicals and trigeminal nerve fibers send signals back to the brain stem.
While cortical spreading depressions cannot explain many of the symptoms of migraine disease, it is likely an important event in generating the most familiar brief intense experiences of migraine suffered migraine has a chronic form central sensitization
It has been observed that migraine sufferers have scarring within the brain this may be a complication from the repeated inflammation associated with cortical spreading depression or other migraine events.
Within the brain eventually, parts of the damaged nervous system simply generate low-grade frequent unwelcome symptoms such as increased sensitivity to touch or light daily headaches tinnitus or diminished cognitive functions.
Central sensitization partly explains why migraine sufferers have different symptoms at different stages in their lives also the damage to blood vessels from inflammation may explain the higher rates of stroke.
In migraine sufferers and head trauma to the hypersensitive central nervous system may make migraine sufferers more vulnerable to chronic headache syndromes the brainstem may be the core of migraine disease.
Another factor in migraine disease is that abnormal electrical activity of one set of neurons may affect the behavior of adjacent ones the brain stem is the crossroads of much of our brain circuitry it is here that information controlling many body functions congregates in clusters of cell bodies called nucleus.
When electrical messages arrive in one nucleus they may be rerouted to other parts of the brainstem hypothalamus thalamus and cortex these nerve centers have exotic names such as the trigeminal nucleus pol Vinerdorsal raphe and locus Karolis.
While the trigeminal nucleus is the control center for headache pain these adjacent nuclei control stress balance mood sleep and the autonomic system an example is the generation of symptoms from the nasal and sinus region
Many people mistake their chronic migraine symptoms for recurring infection, in fact, one form of chronic migraine disease is where the trigeminal nucleus generates signals that the brain interprets as abnormal pressure or pain from within the paranasal sinuses, teeth or eyes adjacent to the trigeminal nucleus is the superior salivatory nucleus this nerve center controls the production of nasal secretions
And the size of the turbinates within the nose a migraine sufferer not only feel sinus pressure but also experiences nasal congestion and the runny nose the interplay between these nuclei may be another explanation for why some migraine sufferers have so many related symptoms many of which do not involve pain.
Female hormones affect migraine disease
Sex hormones as estrogen and progesterone have a profound but poorly understood effect on our nervous system sex hormones affect the nervous system of all women.
But for migraine sufferers, their rise and fall throughout a lifetime helps to explain why the symptoms of migraine change so dramatically for women estradiol better known as an estrogen has a complicated role, in our nervous system for example for anyone neuron their ares per dial receptors on the nucleus.
As well as the surface of the cell and we, know of genetic defects of both these receptors independent of the hormone receptors .we know that estrogen also sensitizes our body to pain while we still have a lot to learn about sex hormones.
We do know that they play a critical role in the waxing and waning of migraine disorders the several biological mechanisms that describe how migraine disorders occur explain, why there are different strategies for treating migraine disease, and why no one approach works for everyone.
Preventive - Lifestyle For Migraine
There are a number of ways to reduce the triggers that set off your symptoms. A simple approach is to minimize variations in your daily routine.
How and why people react to different foods is not yet well understood. However, it is worth trying to identify if you have a food trigger and then avoid it. In general, food triggers fall into three main categories:
- Byproducts of food aging and fermentation: red wine, aged cheeses, yeast, and yogurt
- Foods with ingredients that affect our nervous system: coffee, chocolate, MSG, aspartame, citrus fruits and the nitrates used as preservatives in many prepackaged foods, particularly cured meats
- Foods you have mild or silent allergies or sensitivities to: such as milk, corn, soy and wheat (gluten). Gluten sensitivity is particularly a common issue for those with migraines.
Blood tests for food allergies may or may not identify a food trigger. The use of an elimination diet - a careful removal of specific foods over a specific time period, followed by a reintroduction of the food - is the most reliable method to identify dietary migraine triggers.
Simple rules: Buy fresh foods only - No deli or cheese
Ginger: Use capsules, tea or in water.
Be careful not to combine ginger supplements with blood thinners because of potential drug interactions.
Comfort measures: ice packs, menthol creams, massage
Natural Products: caffeine, ginger
Here is an acronym SEEDS to remember possible lifestyle changes.
S - Sleep
E - Eat
E - Exercise
D - Diet
S - Stress
Keep to a sleep routine Eat at least 3 meals daily, at the same time Maintain regular exercise, good posture & healthy weight.
Be aware of your dietary triggers (MSG, alcohol, etc), processed & aged food
Reduce stress - meditation, acupuncture,chiropractic care, health coach, psychologist(cognitive behavioral therapy, biofeedback,
relaxation training, physiotherapy and other complementary medicine therapies.
Avoid bright lights, loud noises, perfumes & chemicals. Online resources for relaxation music and yoga.
Source - www.migrainedisorders.org
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