Conditions

There are various types of migraine as mentioned below: Migraine without aura – the most common type of migraine with a pulsating headache on one side of the head. Migraine with aura – headache affected by flashing or wavy lights. Older people are more prone to it. An aura can manifest as visual disturbances like flashes of light or blind spots or other symptoms such as difficulty in speaking and tingling on face or arm or leg. Chronic migraine – occurs 15 days per month over three months or…

How is Migraine diagnosed? Migraine cannot be diagnosed clearly by neuroimaging yet. Neuroimaging, like MRI, is done to exclude other conditions associated with headache, like a blood clot in the brain. Migraine diagnosis is based on history taking. The clinical criteria to confirm migraine are: Migraine without aura At least 5 headache attacks (in 15 days or more per month for more than 3 months) fulfilling 2 to 4 of the criteria given below. Headache lasting 4 to 72 hours The headache has…

Causes of Migraine Causes are multifactoral with various genetic and environmental factors playing important roles. The patient may have a history of migraine in the family. Mutations of the gene in chromosome 1 and 19 are responsible for positive family history. Disturbances in the release of certain brain chemicals called serotonin and dopamine may also cause migraine. Migraine has two parts: 1) the aura and 2) the headache. (Symptoms of aura are mentioned below.) Cerebral blood vessels…

Treatment Options for Migraine Acute medicines: taken at the time of an attack Analgesics like paracetamol for pain Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen Anti-emetics to prevent nausea and vomiting Triptans to treat an acute attack Ditans  like lasmiditan Dihydroergotamine like prochlorperazine Gepants – Ubrogepant, Atogepant and Rimegepant, these don’t cause rebound or medication overuse headache like some other drugs. Combination of these acute medicines for…

How to effectively manage migraine Patient education and trigger avoidance: The patient needs to understand the nature of the headache and what triggers it. The triggers need to be avoided. To help, the patient can keep a pain diary to record the features, duration and intensity of pain, along with trigger factors and associated symptoms. The treatment options are listed here Know your support team: Who can help General practitioners Neurologists Internal medicine specialists Specialists in…

The central nervous system is made of numerous cells called neurons. Neuron consists of 2 parts - cyton (cell body) and axon. The axon is covered by myelin, which helps in the conduction of nerve impulses or signals between the neurons. In multiple sclerosis, myelin in certain parts of the central nervous system is destroyed thereby impairing the conduction of nerve impulses. The exact cause of MS is not known, but some factors like immunity and genes are thought to play a role.  MS could…

There are mainly two types:  1. Relapsing-remitting type 2. Progressive type The relapsing-remitting type is characterised by unpredictable relapses (worsening symptoms) followed by periods of remission (improvement from symptoms). It is the most common type and is seen in 80-90% of patients with MS.  The remaining 10-15% of MS patients have progressive type where the disease keeps on getting worse without any remission. There are 2 sub types in this progressive type. Primary…

The clinical signs and symptoms of MS depend on the site of the loss of myelin in the central nervous system. The lesions may occur almost anywhere in the central nervous system, but they have a predilection for certain areas.  More than 60% of individuals with MS have visual problems caused by demyelinating lesions (loss of myelin) of the optic nerve, which is the nerve concerned with vision. The loss of vision usually occurs over a period of several days, with partial recovery within 1…

Diagnosing multiple sclerosis  There is no single specific diagnostic test available, but in practice, the diagnosis is done typically based on the presenting signs and symptoms, in combination with supporting medical imaging and laboratory testing.  Clinical data alone may be sufficient for a diagnosis of MS if an individual has had separate episodes of neurologic symptoms characteristic of the disease. In those who seek medical attention after only one attack, other testing is…