Term Paper on "Migraine Headache"

Term Paper 15 pages (4204 words) Sources: 1+

[EXCERPT] . . . .

million Americans suffer from migraine headache, which is the most common neurological disorder in the modern world and modern times. This affliction reduces work performance by 50% and accrues to wasted resources and a generally low-quality of life. The more common type of migraine afflicts 80% of all sufferers, who mostly do not consult with physicians. At present, migraine attacks are managed with pain-killers, herbal medications, and alternative therapies. But research continues to discover more effective, safer and readily available modes to its control

An estimated 28 million Americans suffer from migraine headaches and this affliction accounts for much loss of time from work, school and daily activities (Khosh 2002). Many sufferers report severe disability at 80% and 23% have taken recourse in emergency room treatment, while 39% of them said they are bedridden for a number of days. Migraine has remained prevalent since 1989 in spite of unprecedented medical and technological advancements and discoveries. Migraine affects one in every four household members. If left untreated or un-prevented, it can lead to a substantial reduction in the quality of life. Migraine accounts for a huge loss of time at work, school and daily activities: 51% of sufferers report a 50% or more of lost work and/or school productivity and 66% report a 50% or more reduction in household work. A substantial number of them say they must be bedridden because they are unable to control the pain and the symptoms. Approximately 80% of them experienced severe aches and 23% of them were prompted to seek emergency treatment, while 39% of them say their condition gets so bad that they must be bedridden for a number of days (Khosh).

Migraine is a debilitating type of headache that usually affects only one side of the head (USA Today 2004, Robinson 1999, Rowland 2001). There are two types of migraine, the common type and the classic type. There are no known and definite causes but these seem to develop from triggers. Current management or treatment modes, therefore, use appropriate pain killers, such as acetaminophen and ergotamine. There are non-medical approaches to its treatment and prevention, including a natural method, acupuncture, coenzyme Q10 and lisinopril, an angiotensin enzyme converting inhibitor. A holistic approach is seen as the best mode of management in its control and prevention.

Materials and Methods

Belinda Rowland (2001), Richard Robinson (1999) and USA Today (2004) provided basic information on the nature, causes, diagnosis and management of migraine headache. Anne Walling (2002) wrote about migraine in women in the American Family Physician Journal. Constance K. Cottrell et al. (2002) wrote about the perceptions and needs of migraine sufferers Life Sciences and Biotechnology Update (1999) discussed the utilization and costs involved in caring for patients with chronic migraine patients. Sadovsky (2003) discussed pharmacologic management options and prevention; Huffman (2002) suggested triptans as treatment while Vickers et al. (2004) called attention to acupuncture as another mode of treatment and Khosh (2002) suggested a natural approach. Other options under study included Angiotensin, as discussed by Schader (2001) and Singer (2003). Gaby (2003) discussed prevention with the use of coenzyme Q1 and Rose (1999) explored the efficacy and appropriateness of Botulinum Toxin A as treatment. Polizzotto (2002) wrote about treating the adult patient of migraine.

This paper used the descriptive-normative method in recording, describing, interpreting and analyzing gathered information from the authoritative sources mentioned. It focuses on the nature and incidence of migraine headache and the available treatments and management approaches to its control and prevention.

Results

Migraine is a debilitating type of headache, three times more common in women than in men (USA Today 2004, Rowland 2001, Robinson 1999). It is the most serious neurological condition in the modern world and modern times. Its cause is unknown but associated with triggers, which are of various kinds. Those who suffer from it report that at least half of the work they do is lost to migraine and only 23% of them secure medical advice. Current management includes taking prescribed painkillers, such as acetaminophen, aspirin and caffeine. One of the most trusted is ergotamine. But there have been reliable management approaches to controlling migraine pain and these include herbs, biofeedback, hydrotherapy, acupuncture, TENS and Botulinum Toxin A.

Discussion

Migraine is an intensely debilitating kind of headache, the most common neurological disorder in the modern world, that afflicts 24 to 28 million people in the United States alone (Rowland 2001, Robinson 1999, USA Today 2004). It comes from the Greek word hemikrania, which means "half a head," because it is characterized by intense and throbbing pain on one side of the head. A migraine becomes worse with movement and is often accompanied by nausea, vomiting and extreme sensitivity to light and sound. An attack can last many hours and many days. Statistics say that migraine costs billions of dollars in lost work, poor job performance and medical expense (Rowland). Figures also show that 18% of women and 6% of men suffer at least one migraine attack each year. At present, one in every 11 Americans experiences an attack. Women develop migraine three times more than men and mostly before the former enter the pre-menopausal stage. Migraine often starts in adolescence and seldom extends beyond 60 (Rowland). It is more common than diabetes, epilepsy and asthma combined, with more than half of the cases left undiagnosed. Assistant neurology professor Dion Graybeal of the University of Texas Southwestern Medical Center in Dallas noted that 75-85% of those who experience chronically recurring headaches go through migraine rather than tension or sinus headaches (USA Today).

There are two types of migraine. One is common migraine or migraine without aura, which occurs in approximately 80% of sufferers and the other is classic migraine or migraine with aura (USA Today 2004). Classic migraine is accompanied or preceded by visual or other sensory disturbances, such as hallucinations, partial obstruction of the visual field, numbness, tingling or a feeling of heaviness. The ache on one side of the body starts as early as 72 hours before the actual migraine attack (Rowland). Common migraine is often characterized by an increase in mood or energy level up to a day before the attack or by fatigue, depressive and excessive yawning (Robinson 1999). The sensations that characterize classic migraine may also spread and be accompanied by weakness or heaviness on that limb. The throbbing pain ranges from mild to incapacitating. Vision may also become blurred. During an attack, the sufferer is weak, weary and sensitive to sudden movements of the head.

The cause of migraine is difficult to establish. Some believe that genetics seems to play a part in many sufferers but there are many other potential stimuli that can trigger a migraine attack (Robinson 1999). But most medical experts agree that a migraine attack develops from pain-sensing nerve cells in the brain, called nociceptors, which release chemicals called neuropeptides. They also believe that the unbearable pain comes from the combination of pain sensitivity, tissue and vessel swelling and inflammation. They likewise maintain that it tends to run in families, wherein a child of a migraine sufferer has as much as 50% chance of developing the same affliction in that family members are exposed to and predisposed to the same environmental factors and personal experiences. The genes responsible have, however, not been identified. Certain foods, drugs, environmental "cues" and personal events have triggered migraine attacks, such as cheese, alcohol, coffee drinking or withdrawal, chocolate, intensely sweet foods, dairy products, fermented or pickled foods, citrus fruits, nuts, processed foods - especially those containing nitrites, sulfites or monosodium glutamate - stress or time pressure, menstrual periods or menopause, sleep changes or disturbances or oversleep, prolonged or overexertion or an uncomfortable posture, hunger or fasting, odors, smoke or perfume, glare or strong lights, and certain drugs (Robinson).

The diagnosis of migraine includes a careful medical history, lab tests and imaging studies, like a computer tomography or a magnetic resonance imaging scans (Robinson 1999). Diagnostic procedures must first rule out brain tumors and structural changes.

Conventional treatment for migraine involves placing the person in a dark and quiet room in order to reduce painful stimuli (Robinson 1999). Non-steroidal anti-inflammatory drugs or NSAIDS have been found useful in the early and mild stages and these include acetaminophen, ibuprofen and naproxen. Recent studies show that a combination of acetaminophen, aspirin and caffeine has proved effective against migraine. One effective over-the-counter preparation is Exedrin Migraine. More severe or resistant attacks may be managed with drugs that act on serotonin receptors in the smooth muscle surrounding cranial blood vessels. Serotonin, or 5-hydroxytruptamine, constricts these vessels and relieve migraine pain as do drugs that imitate the action of serotonin. One old drug is ergotamine, which is derived from a common grain fungus, and dihydroergotamine. Either may be used to control or prevent migraine attacks. For acute attacks, meperidine and metoclapramide are also helpful. Other drugs that can be used with fewer side effects are available in the form of nasal sprays, intramuscular injections and rectal… READ MORE

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