The pain and associated symptoms of migraines are often debilitating and can impede daily life. Migraines do not discriminate and can affect people of all races, economic backgrounds, ages, and genders. However, the definition of migraine can be difficult to capture because it can take many forms. Simply put, a migraine is defined as an extremely severe headache, but those who have experienced them know a migraine is so much more than “just a headache.”
Those who suffer from migraines may endure hours or days of symptoms. These symptoms often hinder the quality of life and, in severe cases, can make it impossible to participate in routine activities like working or driving. Although the frequency and severity of migraine symptoms will differ between individuals, the most common symptom is a headache that causes severe pain. If you are dealing with persistent migraines, a knowledgeable plastic surgeon in collaboration with a headache specialist could potentially provide relief. Dr. Guyuron, Dr. Totonchi, and Dr. Ansari are all available to help.
Migraines may start with a warning stage called prodrome, then progress through aura, headache, and lastly, postdrome. Not every migraine sufferer will experience these four defined stages.
A couple of hours to days before a migraine, some individuals might notice warning signs indicating an impending episode. Symptoms associated with the prodrome stage of migraine include, but are not limited to:
- Mood changes or irritability
- Increased yawning
- Constipation or diarrhea
- Increased urination or thrust
- Cravings for certain food
- Neck stiffness
These signs are subtle and can easily be missed. A migraine journal may allow for patients to pick up on these early symptoms and preemptively treat them.
Neurological symptoms, usually seeing bright flashes/dots/lines or even transient vision loss, are common during the aura stage. Some patients have even described seeing shapes like a kaleidoscope. Sufferers might also observe numbness or tingling anywhere on the body, or speech difficulty. This symptom can sometimes be mistaken with stroke. The aura stage can last five minutes to one hour and occurs just prior to the headache. Migraines with aura are also known as “classic migraine,” although some providers refer to it as a “complex migraine” which is not a correct term and does not exist.
The headache stage is the hallmark of migraines and causes severe pain lasting several hours to days. Patients frequently define this migraine pain as throbbing or stabbing, and the pain is often unilateral. However, the patient may experience bilateral pain as well. Along with an unbearable headache, individuals may experience nausea or vomiting, sensitivity to light and noise, sensitivity to smells, and dizziness. This list of symptoms is not exhaustive.
During the postdrome phase of a migraine, patients describe feeling exhausted, depressed, euphoric, or unable to concentrate. The intense pain of a migraine may return momentarily during abrupt head movements. This final stage can affect patients for 24 to 48 hours.
Migraine Causes and Treatments
The first step to overcoming this ailment is obtaining a correct diagnosis by a headache specialist who understands the definition, treatments, and fundamentals of migraines. We need to be sure that the diagnosis of a migraine is correct since not every severe headache is a migraine. Migraines are usually over-diagnosed but under-treated.
The cause of migraines is not clear, although it is a genetic disorder. Also, the exact mechanism for migraine headache is not completely understood, but the trigeminal nerve appears to play a critical role. It is understood that migraine pain originates from the trigeminal system due to inflammation. Branches of trigeminal nerves become sensitive and tender to pressure, and create migraine trigger points due to compression from surrounding structures such as muscle, bone, fascia, or vessels. Local anesthetic (trigger point injection or nerve block) or Botox can transiently bring relief. Permanent relief of this trigger points can be achieved with surgical decompression.
Release of these “sensitive nerves” through minimally invasive surgery has shown a reduction in frequency and severity among migraine sufferers. Migraine decompression surgery is generally performed on those who have not had adequate resolution with conventional treatments.
Ask an Expert About the Migraine
Migraines are common and occur across the world. If you are suffering from them, no matter where you live, you are not alone. If you have not experienced a migraine, you likely know someone who has. Although living with debilitating migraines can be difficult, there is hope. With a better understanding of migraines and their causes, more treatments have become available, and therefore more physicians trained on the techniques shown to bring relief. Call us at our San Diego clinic to learn how we could help your situation.