Alternative Names migraine with aura, neurologic migraine
Definition Classical migraine is a throbbing headache that occurs on both sides of the head, or sometimes just one side. It can last anywhere from a few hours to many days. It usually begins with visual sensations, called auras, that last from 5minutes to 30 minutes. Visual auras may include seeing flashing lights or wavy lines.
What is going on in the body? Experts generally believe that migraine pain is caused by chemical changes within the brain that cause blood vessels to widen.
What are the signs and symptoms of the disease? Symptoms of this classical migraine include:
throbbing pain on one or both sides of the head
visual auras, such as unformed flashes of white or coloured lights, wavy lines, or blurred, shimmering, or cloudy vision that last between 5 minutes and 30 minutes
numbness, tingling, speech disturbance, or confusion lasting between 5 minutes and 30 minutes
nausea
vomiting
sound and light sensitivity
What are the causes and risks of the disease? Migraines are probably inherited, although the exact cause is unknown. They can be triggered by:
stress
head or neck injuries
certain foods including caffeine, chocolate, and alcohol
weather changes
bright lights
poor sleep habits
hormonal changes in women, especially before or around the time of menstruation
Some women find that oral contraceptive pills ("the pill") worsen their headaches or migraines.
What can be done to prevent the disease? The best way to prevent a classical migraine is to:
avoid the triggers listed above
limit stress
exercise regularly
How is the disease diagnosed? According to the International Headache Society, a headache is diagnosed as a migraine if:
there are at least 5 episodes that last from 4 hours to 72 hours, accompanied by nausea, or an abnormal sensitivity to light and sounds.
it has at least two of the following characteristics: is located on one side or part of the head, has a pulsing quality, is of moderate or severe intensity, and is aggravated by physical activity.
What are the long-term effects of the disease? If the migraines are infrequent and mild, there are few long-term effects. If they are frequent and severe, they can greatly impair a person's ability to function or work. Rarely, a migraine can result in stroke.
What are the risks to others? Migraines are thought to be an inherited disorder.
What are the treatments for the disease? Acute migraine attacks are treated with medications including:
aspirin
ergotamines
NSAID's
triptans
DHE
paracetamol
Sometimes migraines can be prevented with these drugs:
beta-blockers
calcium channel blockers
tricyclic antidepressants, like amitriptyline
anticonvulsants, like sodium valproate
cyproheptadine
pizotifen
Although oral contraceptive pills may worsen migraines, some women may get some relief from taking oral contraceptives. In some women the pill helps reduce the changes in hormone levels that naturally occur throughout the month and this may lead to fewer migraine headaches.
Other non-medicinal treatments include:
avoiding triggers
biofeedback, a process where a person is taught how to relax when the body starts to show the signs of a headache
hypnosis
acupuncture, a therapy used to relieve pain by inserting thin needles into certain parts of the body
exercise
managing stress
What are the side effects of the treatments? Side effects depend on the medication used.
How is the disease monitored? This disorder is monitored by a person's doctor. Also, it can be useful for patients to keep a log of when their migraines occur, how severe they are, and what events led up to the migraine if any. This can help identify foods or other things that may be triggers for migraines. It is also important for women to log when their migraines occur to help determine if they are related to their menstrual periods.
Author: Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 7/11/2004 Contributors Potential conflict of interest information for reviewers available on request
