Dr. Ashley Russell, ND

One of the biggest pet peeves of any migraine sufferer is how loosely the term “migraine” is used. It appears that, for some, migraine has become synonymous with having a really bad headache. But for those with this invisible condition, a migraine is so much more than just head pain.

In the United States, more than 36 million adults, predominantly women, are affected by migraines.1 While it may seem like a modern disease, migraines have actually been recognized for millennia. Migraines were first described by Aretaeus of Cappadocia, a Greek physician during the 2nd century, and was originally termed “heterocrania.” He described a migraine as follows:

…in certain cases the whole head is pained; and the pain is sometimes on the right and sometimes on the left side, or the forehead, or the fontanelle; and such attacks shift their place during the day … This is called Heterocrania, an illness by no means mild … It occasions unseemly and dreadful symptoms … nausea; vomiting of bilious matters; collapse of the patient … there is much torpor, heaviness of the head, anxiety; and life becomes a burden. For they flee the light; the darkness soothes their disease; nor can they bear readily to look upon or hear anything pleasant… the patients are weary of life, and wish to die.”

In general, migraines are one-sided intense headaches that throb or have a pulsating quality to the pain. However, in 50% of migraine cases, non-throbbing head pain is experienced. During a migraine attack, people often also experience nausea and vomiting, and exposure to light, sounds, or smells can make their symptoms worse. Movement can also worsen the head pain. This is why it is common for someone with a migraine to want to lie in a dark and quiet room, and avoid food or drink. In addition, people may also have difficulty speaking or understand language (aphasia), become lightheaded, or experience numbness and confusion during a migraine.

Migraines can last anywhere from 4 to 72 hours, which does not include the prodrome and postdrome. A prodrome includes symptoms that a person may experience before their migraine, essentially alerting the individual that a migraine is on its way.   It may be of benefit for a person to try to identify their prodrome symptoms so they can quickly implement abortive therapies and prevent a full-blown attack. These prodrome symptoms can include mood changes, diarrhea or constipation, excessive thirst or fatigue, and increased sensitivity to sound, light, or smells. However, little research has been spent investigating the full range of prodomic symptoms, so this list is by no means complete.

And after the migraine storm has passed, there is a postdrome period that prevents people from being able to quickly resume normal daily activities and make up for the time they just lost. A postdrome are symptoms that occur post-migraine and can include muscle weakness, food cravings, extreme fatigue or euphoria, irritability, and diminished appetite. This postdrome period is also referred to as a migraine hangover (quite an apt description), and it can last 24 hours or so.

Migraines can be further broken down into two major types: classic migraines and common migraines. Classic migraines are those where a person has an aura either before or during their migraine. An aura can include one or any combination of visual, motor, or sensory symptoms such as blindness, tunnel vision, numbness, or speech disturbance.2 Common migraines are migraines without auras and more prevalent than classic migraines.

Migraines are diagnosed clinically, meaning that your doctor can diagnose you with a migraine based on your history and symptoms and no blood work or imaging is required. That being said, depending on the presentation of your migraines, your doctor may need to order tests to rule out other more concerning diseases or conditions, such as a brain tumor, aneurysm, or vasculitis. And as if getting migraines wasn’t bad enough, depending on your type of migraine, it may put you at higher risk for other diseases, such as strokes, so it is important to be correctly diagnosed.3

Now that we understand what a migraine is, in the next article in this series we’ll contrast how the cause and treatment of migraines are viewed conventionally and naturopathically. In the meantime, you may want to rethink that Facebook post about your horrible migraine, because, as you now know, if you can look at your phone or computer, then you most likely don’t have a migraine, just a really bad headache.


_TLB3420Dr. Ashley L. Russell graduated from the Southwest College of Naturopathic Medicine in Arizona where she received training as a primary care physician. She received her B.S. in Applied Ecology from the University of California, Irvine. She is a naturopathic doctor at Serenity Natural Health Center in Frederick, Maryland, with a focus on young women’s health and is also co-founder of LovempoweR, an organization dedicated to changing women’s health care. Dr. Russell is passionate about helping women reclaim their menstrual cycle by alleviating all kinds of menstrual issues including PCOS, infertility, endometriosis, PMS, and painful or irregular periods. In her spare time, Dr. Russell enjoys baking vegan, gluten-free treats, hiking, and spending time with her dog, Honey.


References:

  1. Migraine Research Foundation. Migraine Fact Sheet. Available at: http://www.migraineresearchfoundation.org/fact-sheet.html. Accessed March 4, 2015
  2. International Headache Society. IHS Classification ICHD-II: Migraine. IHS Web site. http://www.ihs-classification.org/en/02_klassifikation/02_teil1/01.00.00_migraine.html. Accessed March 5, 2015.
  3. Schürks, M. et al. Migraine and cardiovascular disease: systematic review and meta-analysis. BMJ. 2009: 339.
  4. Migraine Headache Clinical Presentation. http://emedicine.medscape.com/article/1142556-clinical Accessed February 15, 2016.
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