Migraine is a strong headache occurring in bouts. It affects both sexes but women are more frequently suffering from its symptoms. It is assumed that one in five women in developed countries suffers from migraine. The migraine attacks may occur several times a month and they can significantly impair the quality of life.


There is probably a genetic precondition that plays role in the occurrence of migraine. The exact cause is unknown, but it seems that the major role could have the hypersensitivity of certain brain centers and serotonergic system in the brain. Serotonin is one of the main neurotransmitters, i.e. substances found in the brain mediating the signal transmission between nerve cells.


The migraine seizures are usually preceded by a pre-migraine phase that can last hour or even a whole day. The patient suffers from mental fatigue and sometimes from excessive irritability. The migraine bout itself may start with a migraine aura, typically a visual (seeing flashing lights, disorders of the visual field, etc.) but many times there is no aura present. The migraine bout is accompanied by a very strong headache. The pain is unpleasant, vibrant and very often affects only one half of the head. It is followed with photophobia, sensitivity to loud noises, nausea and vomiting. After the end of the seizure, the patient may suffer from fatigue.


The diagnosis is confirmed by presence of the symptoms and exclusion of any organic brain disease. It is wise to do a computed tomography (or MRI) of brain in a person experiencing his or her first attack of suspected migraine to rule out other pathologies (brain tumors, subarachnoid hemorrhage, etc).


The emergence of the disease itself can not be avoided, but it is possible to reduce the frequency of migraine attacks. The patient is recommended to sleep and take rest regularly and reduce (or avoid) the alcohol intake. It there are any situations triggering the migraine, it is advisable to avoid them as well.


During the acute attack of migraine, bed rest is recommended. In addition, we administer non-steroidal anti-inflammatory drugs. More severe cases require more effective drugs known as triptans that help to suppress the irritated serotonergic system in the brain. They not only treat the symptoms but also decrease the risk of other attacks, thus acting as prevention.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources