Symptoms, treatment of migraine

By Lee Sung-hun

One of my regular patients visited the clinic a few weeks ago with a sudden and severe headache. He said he saw a bright light reflected in his rearview mirror and his vision turned dark, after which a severe migraine started. It came with severe nausea and pain that made him vomit.

Migraine headaches are one of the primary headaches that do not have a diagnosable cause even with a thorough medical examination such as a Magnetic Resonance Imaging. Many migraine patients complain of nausea, vomiting or hypersensitivity to light as part of their symptoms.

For most, migraines first appear between the ages of 10 and 45. They are more common among women than men, and may run in the family. A migraine can be triggered by various factors that cause abnormal brain activity, but the exact mechanism of how it is triggered is yet to be fully identified. The most recent explanation proposed by medical experts is that they start in the brain and affect neural pathways and chemicals, whose change affects the blood flow in the brain and its surrounding tissue.

Tension-type headaches, which are the most common type of primary headaches, are caused by muscular tension around the head, neck and shoulders, and are different from migraines.

Migraines often occur at the back of the eyes or back of the head, or the neck. Most sufferers feel recurring pain in the same area. About half of them feel a throbbing pain that seems to pulsate with the heartbeat, and the remainder report tightening or explosive sensations. Commonly, the pain is worse on one side than the other. It comes on gradually, worsens within minutes to hours, and lasts anywhere between four and 48 hours. The pain can be so severe and debilitating that even day-to-day activities become difficult tasks. The most commonly associated symptoms are nausea and vomiting, which 90 percent and 50 percent, respectively, of migraine patients suffer. Others display chills, increased urination, tiredness, loss of appetite, numbness, tingling sensations, weakness, lack of concentration, difficulty with words and hypersensitivity to light or sound.

A migraine can be foreshadowed by an aura, which works out to be a warning sign for the migraine patient. An aura may occur 10 to 15 minutes prior to the headache itself, and in some reported cases, it can occur 24 hours before the onset of headaches. Migraine headaches are not always preceded by an aura, and in fact migraines not preceded by auras are more common. An aura can be visual, sensory or verbal in nature, with visual effects being the most common. Vision disturbance commonly starts out as blurred vision, which is followed by flickers or zigzag lines that leave a temporary blind spot. Other types of aura can include yawning, difficulty concentrating, nausea and trouble finding the right words.

There are many triggers that are known to induce migraine headaches. Typically, stress, alcohol, specific scents, loud noises, bright lights and cigarette smoke are known to cause migraines. Withdrawal symptoms from cutting out caffeine, hormonal changes due to menstrual cycles or use of contraceptives, changes in sleeping patterns, exercise and physical strain, and even skipping a meal can trigger a migraine headache.

Certain foods can also cause a migraine headache. MSG, chocolates, nuts, peanut butter, dairy products, red wine, aged cheese, smoked fish, avocado, banana, citrus fruits, meats containing nitrates and onions may trigger a migraine. The specific trigger foods are different from patient to patient, and finding out and avoiding the exact food that causes the migraine is an important step for prevention.

In Oriental medicine, the treatments for migraine differ according to the causes. For the most common, stress-induced migraines, oriental treatment seeks to lower the fire-qi that has accumulated in the body. Food-induced migraines are viewed as the result of lowered stomach functions, and the treatments focus on restoring them. To improve the blood flow into the brain, adjustment of the jaw (temporomandibular joint) or the upper cervical spine can be administered, which can lessen the painful migraine.

Contrary to some misconceptions, migraine headaches are not a result of brain tumors or other serious illnesses. However, they are difficult to cure and become chronic in many cases. If you are suffering from a migraine, you should seek professional counsel, and oriental treatments can be a viable option.

The writer practices Korean Oriental medicine at the UN Oriental Medical Clinic in Hannam, Seoul. He can be reached at sung_hun@naver.com.