Migraine: complex brain disorder

Man supporting his sore head. (picture: Uta Herbert/pixelio.de)
As if fit explodes: Migrain attacs are very painful. (picture: Uta Herbert/pixelio.de)

Headaches are a common disease. They come in different Types, intensities and causes. The most common ones are so-called primary headaches such as migraine.

Headaches are not a phenomenon of modern times. Reports of headache symptoms can be traced back to the sixth millennium BC. Migraine too is known from ancient times: Hippocrates describes a typical migraine attack around 400 BC. The term migraine comes from the Greek word "hemicrania" (half of head).

Women are more often affected than men

About ten percent of the population suffer from migraine. Statistically, women are affected about three times as often as men. Most migraine attacks occur between the 35th and 45 year of age.

By definition, a migraine is an intermittent malfunction of the brain, with an increased nerve excitability and increased release of pain-causing neurotransmitters in the brain. The pain response causes a temporary inflammation of blood vessels in the brain.

Causes of migraine is not fully resolved

Migraine is considered one of the most common neurological diseases. The causes that lead to complex functional disorder of the brain are still not definitely clarified. What is certain is that migraine is a mosaic of many sub-mechanisms.

A migraine is manifested by a sharp, usually unilateral and throbbing pain. This often comes with additional vegetative symptoms such as nausea, vomiting, light or noise sensitivity. The attacks last from four to 72 hours. This is preceded by a pre phase, and after the migraine attack a regression phase, when the symptoms decrease followed by a recovery phase.

Man rubbing his temples. (picture: Uta Herbert/pixelio.de)
Migraine patients suffer from sharp, usually unilateral and throbbing pain. (picture: Uta Herbert/pixelio.de)

Migraine with or without aura

In about 15 percent of those affected experience a so-called aura phase. In migraine with aura, visual disturbances are often perceived as glare sensation, vision loss, double vision or flashes of light. In addition, cognitive disorders can occur as an increase or decrease of perceived objects and disorders of colour sense.

Many also suffer from single-sided numbness in face and arm, from speech impairments or motor disorders to paralysis.

Headaches are not simply headaches

Important is the delineation of migraine headaches from others as there are about 250 different Types of headaches. The International Headache Society classifies since 1988 not from the cause but the Type and frequency of symptoms. Since 2003, the following distinction is the international standard:

Primary headaches

This includes migraine, tension headaches as well as cluster headaches. The commonality is that the cause of headaches is not clearly known. However, it is assumed that various mechanisms in the brain itself contribute to the development of headaches.

Secondary Headache Disorders

This includes a variety of headache syndromes. The form of pain occurs as a side effect of another illness. Causes of secondary headache are, for example injuries, tumours, eye disease, high blood pressure, or misaligned teeth.

Other Headaches

In the third group there are different kinds of headaches, their formation is triggered by very specific mechanisms.

About 90% of all headaches are migraine and tension headaches from the "primary headache" group. It is important to distinguish between these two Types of headaches.

Tension headaches are improving at a moderate physical activity whereas a migraine attack is aggravated by physical activity. In tension headaches, a dull aching pain is perceived, however, that normally does not hinder us from performing everyday tasks. And unlike in migraine, usually there are no accompanying symptoms such as nausea, vomiting or sensitivity to light.


Text: Patrick Gunti - 09/2011

Translation: MPL

Picture: pixelio.de