Migraine Headache (cont.)

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What are some of the variants of migraine headaches?

Complicated migraines are migraines that are accompanied by neurological dysfunction. The part of the body that is affected by the dysfunction is determined by the part of the brain that is responsible for the headache.

Vertebrobasilar migraines are characterized by dysfunction of the brainstem (the lower part of the brain that is responsible for automatic activities like consciousness and balance).

The symptoms of vertebrobasilar migraines include:

  • fainting as an aura,
  • vertigo (dizziness in which the environment seems to be spinning), and
  • double vision.

Hemiplegic migraines are characterized by:

  • paralysis or weakness of one side of the body and
  • symptoms that mimic those of a stroke.

The paralysis or weakness is usually temporary, but sometimes it can last for days.

Retinal, or ocular, migraines are rare attacks characterized by repeated instances of scotomata (blind spots) or blindness on one side, lasting less than an hour, that can be associated with headache. Irreversible vision loss can be a complication of this rare form of migraine.

How is a migraine headache diagnosed?

Migraine headaches are usually diagnosed when the symptoms described previously are present. Migraine generally begins in childhood to early adulthood. While migraines can first occur in an individual beyond the age of fifty, advancing age makes other types of headaches more likely. A family history usually is present, suggesting a genetic predisposition in migraine sufferers. The examination of individuals with migraine attacks usually is normal.

Patients with the first headache ever, worst headache ever, a significant change in the characteristics of headache, or an association of the headache with nervous system symptoms -- like visual or hearing or sensory loss -- may require additional tests to exclude diseases other than migraine. The tests may include blood testing, brain scanning (either CT or MRI), and a spinal tap.

Formal diagnostic criteria for migraine have been established by the International Headache Society. According to these criteria, migraine is present when an individual has had five or more episodic headaches lasting from 4 to 72 hours with TWO of the following characteristics: unilateral (one-sided), throbbing, moderate or severe, and worsened by movement; plus any ONE of the following: nausea or vomiting, phonophobia (decreased tolerance to sounds), or photophobia (decreased tolerance to light).

Medically Reviewed by a Doctor on 12/4/2012

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