Migraine

Migraine
Migraine
 Definition of Migraine
      According to the International Headache Society (IHS) migraine is a vascular headache with recurrent pain attacks that lasts 4-72 hours. The pain is usually one sided (unilateral), its throbbing, pain is moderate to severe intensity, aggravated by activity, and can be accompanied by nausea and or vomiting, photophobia and phonophobia.


Epidemiology of Migraine
        Migraine can occur in 18% of women and 6% of men throughout their life. The highest prevalence is between the age of 25-55 years. Migraine occurs in 11% of the U.S. public that approximately 28 million people.

        The prevalence of migraine is diverse vary based on age and gender. Migraine can be occurred from the start of childhood to adulthood. Migraine is more common in boys than girls before the age of 12 years, but more often found in women after puberty, which is most often in the age group 25-44 years. The onset of migraine appears in people under 30 years in 80% of cases. Migraine rarely occurs after the age of 40 years. Pregnant women were not spared from the migraine attack usually strikes in the first trimester of pregnancy. Greater risk of experiencing migraine in people who have a family history of migraine sufferers


Etiology
       The exact cause of migraines is unknown, but 70-80% of migraine sufferers have a close family member with a history of migraine as well. The risk of migraine increased 4-fold in family members of patients with migraine with aura.

       However, in migraine without aura no underlying genetic linkages, although generally show an association between maternal history of migraine. Migraine with increasing frequency in people with mitochondrial disorders such as Melas (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke like episodes). In patients with a genetic disorder CADASIL (cerebral autosomal dominant infarcts and leukoencephalopathy Arteriopathy withsubcortical) tend to arise migrane with aura .

It is known there are several factors precipitating the onset of a migraine attack are:

1. Menstruation usually on or before the first day of menstruation (hormonal changes)
2. Stress and anxiety
3. Irregular eating schedule
4. Food and beverages, such as: alcohol, chocolate, milk, cheese and fruits.
5. Light flash or blink
6. The weather, especially at low pressure weather
7. Psychic events both in sorrow and happy events.
8. Lots of sleep or lack of sleep
9. Chronic diseases, such as chronic kidney disease
10. hereditary factors
11. Personality factors.


Classification of Migraine
Generally, migraine is divided into two, namely:

1. Migraine with aura
       Migraine with aura is also known as classic migraine. Preceded by a disturbance in nerve function, especially visual, followed by unilateral headache, nausea, and sometimes vomiting, these events occur sequentially and manifestations of headache is usually no more than 60 minutes which is about 5-20min.

2. Migraine without aura

        Migraine without aura is also known as common migraine. Almost the same headache with migraine with aura. The pain on one side of the section

According to the International Headache Society (1988), migraine classification is as follows:
1. Migraine without aura
2. Migraine with aura
    a. Migraine with typical aura
    b. Migraine with aura is extended
    c. Migraine with half body paralysis (familial migraine hemiphlegic)
    d. Basilar migraine
    e. Migraine aura without headache
    f. Migraine with acute onset aura
3. migraines ophtalmoplegic
4. retinal migraines
5. Migraines associated with intracranial disorders
6. Migren with complications
   a. Status migraine (migraine attacks with headache over 72 hours)
       - Without the excess use of drugs
       - Excess use of drugs for migraine
   b. infarction migraine
7. Disorders such as migraine is not classifiable

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