Explore chapters and articles related to this topic
Migraine Headaches
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
The aura is a phase of the migraine that consists of symptoms other than pain that usually show up just before the headache itself (Russell & Olesen, 1996). The three major types of aura symptoms are visual, sensory, and aphasic, and a person can experience more than one type (Eriksen et al., 2004).
Neurologic disorders in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Robert Burger, Terry Rolan, David Lardizabal, Upinder Dhand, Aarti Sarwal, Pradeep Sahota
Migraine headaches are usually a moderate or severe unilateral or bilateral throbbing or pulsating headache with associated increased sensitivity to light, noise, or physical movement and may be accompanied by nausea and vomiting. Migraine pain also commonly involves the neck and medial shoulders in addition to the head. The usual duration of a migraine headache is 4 to 72 hours. Up to 25% of migraine headaches may be preceded or accompanied by an aura. The aura is due to neuronal dysfunction that is thought to move through the cortex and is accompanied by decreased regional blood flow (1).
Neurology
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
The differential diagnosis for a headache is wide (Table 6.5.1). The most common differentials include tension-type headache and cluster headache. The diagnostic criteria are different depending on the presence/absence of aura.
Is now the time to reconsider risks, benefits, and limitations of estrogen preparations as a treatment for menstrually related migraine?
Published in Expert Review of Neurotherapeutics, 2023
Lara Tiranini, Laura Cucinella, Silvia Martella, David Bosoni, Ellis Martini, Rossella E. Nappi
Estrogen withdrawal is the most accepted hypothesis linking menstruation to migraine, even though the pathogenesis of head pain seems to be far more complex [30–32]. In 1972, Somerville demonstrated that the intramuscular injection of high dose of estradiol valerate (E2V) shortly before menstruation could delay the onset of MRM by artificially increasing serum E2 levels in a cohort of vulnerable women [33]. Moreover, estrogen-primed women reported the occurrence of MRM below 45–50 pg/ml of circulating E2 [33]. The exogenous progesterone did not exert the same effect [34]. Over the years, other studies supported the estrogen withdrawal theory, but pinpointed a possible role of estrogen fluctuations across the menstrual cycle and during the perimenopausal years [23,35]. Indeed, stabilizing estrogens with an add-back therapy in women with medically induced menopause reduced the frequency of migraine [36]. On the other hand, timing and rate of estrogen withdrawal before menstruation differed between women with migraine and controls and represented a marker of neuroendocrine vulnerability [37]. As far as aura was concerned, it frequently occurred in the presence of high estrogen levels, as during pregnancy or ovulation, or under the use of CHC or hormone replacement therapy [38].
Atogepant: an emerging treatment for migraine
Published in Expert Opinion on Pharmacotherapy, 2022
Cecilia Rustichelli, Rossella Avallone, Anna Ferrari
Approximately 18.9% of women and 9.8% of men, especially young adults, suffer from migraine causing reduced quality of life and workplace productivity, worldwide. The resulting social costs are high [1]. Migraine is a primary recurrent headache consisting of attacks that last about 4–72 h, with unilateral localization, pulsating quality, and moderate to severe intensity; it is associated with nausea, photophobia, and phonophobia. Additionally, some people experience migraine with aura, which includes visual or sensory disturbances that precede or accompany an attack. Depending on the frequency, migraine can be episodic or chronic (headache that occurs ≥15 days/month for at least 3 months). Chronic migraine can be complicated by medication-overuse headache (MOH), a disabling daily headache caused by overtaking acute medications [2]. The pathogenesis of migraine is not entirely understood. It has been suggested that the brain stem, specifically the hypothalamus [3], is a generator and activator of the trigeminovascular system that releases calcitonin gene-related peptide (CGRP), other mediators, and neuropeptides, which in turn induce vasodilation, neurogenic inflammation of the meninges, and pain [4].
The current state of acute treatment for migraine in adults in the United States
Published in Postgraduate Medicine, 2020
Wade Cooper, Erin Gautier Doty, Helen Hochstetler, Ann Hake, Vincent Martin
The two major subtypes are migraine with aura and without aura. Migraine with aura includes neurological disturbances characterized by visual symptoms such as seeing spots, lines, or gray patches; sensory symptoms including tingling or numbness; or difficulty speaking that usually precede the headache and last for up to an hour [2]. Aura usually begins with visual and then sensory symptoms followed by difficulty speaking or understanding language. Sensory aura is most commonly unilateral affecting the face and arm, and less commonly in the trunk and leg. About one-third of people with migraine experience aura before or during the attack. Migraine without aura does not include the above symptoms, although migraine attacks of both types may be accompanied by photo- or phonophobia, nausea, and/or vomiting.