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Headaches and migraines can vary drastically depending on their duration, specific symptoms and the person they are affecting. The more you know about your specific type of headache or migraine, the better prepared you will be to treat them—and possibly even prevent them. The two types of migraine are-
- Migraine without aura: The majority of migraine sufferers have Migraine without Aura.
- Migraine with aura: Migraine with Aura refers to a range of neurological disturbances that occur before the headache begins, usually lasting about 20-60 minutes.
Symptoms of migraine vary and also depend on the type of migraine. A migraine has four stages: prodrome, aura, headache and postdrome. But it is not necessary that all the migraine sufferers experience all the four stages.
Prodrome: The signs of this begin to appear a day or two days before the headache starts. The signs include depression, constipation, food cravings, irritability, uncontrollable yawning, neck stiffness and hyperactivity.
Migraine Aura: Auras are a range of symptoms of the central nervous system. These might occur much before or during the migraine, but most people get a migraine without an aura. Auras usually begin gradually and increase in intensity. They last for an hour or even longer and are
- Visual: Seeing bright spots, various shapes, experiencing vision loss, and flashes of light
- Sensory: Present in the form of touch sensations like feeling of pins and needles in the arms and legs
- Motor: Usually related with the movement problems like the limb weakness
- Verbal: It is related with the speech problems
Headache: In case of a migraine attack one might experience:
- Pain on both sides or one side of the head
- Pain is throbbing in nature
- Vomiting and nausea
- Sensitivity to smells, sound and light
- Vision is blurred
- Fainting and lightheadedness
Postdrome: This is the final phase of the migraine. During this phase one might feel fatigued, though some people feel euphoric.
Red flags that the patient may be having underlying serious disorder not migraine
- Onset of headaches >50 years
- Thunderclap headache - subarachnoid haemorrhage
- Neurological symptoms or signs
- Immunosuppression or malignancy
- Red eye and haloes around lights - acute angle closure glaucoma
- Worsening symptoms
- Symptoms of temporal arteritis
Diagnosis of Migraine: Usually migraines go undiagnosed and thus are untreated. In case you experience the symptoms regularly then talk to the doctor, who evaluates the symptoms and can start a treatment. You can also be referred to a neurologist who is trained to treat the migraines and other conditions. During the appointment the neurologist usually asks about the family history of headaches and migraines along with your symptoms and medical history.
The doctor might advise for some tests like:
- Blood Tests: These reveal problems with the blood vessel like an infection in the spinal cord and brain.
- CT scan: Used to diagnose the infections, tumors, brain damage, and bleeding that cause the migraines.
- MRI: This helps to diagnose the tumors bleeding infections, neurological conditions, and strokes.
- Lumbar Puncture: For analyzing infections and neurological damages. In lumbar puncture a thin needle is inserted between the two vertebrae to remove a sample of the cerebrospinal fluid for analysis.
Migraine treatments can help stop symptoms and prevent future attacks.
Many medications have been designed to treat migraines. Some drugs often used to treat other conditions also may help relieve or prevent migraines. Medications used to combat migraines fall into two broad categories:
- Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
- Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines.
Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions.
Some medications aren't recommended if you're pregnant or breast-feeding. Some medications aren't given to children. Your doctor can help find the right medication for you. If you wish to discuss about any specific problem, you can consult a Neurologist.
What is Spinal Stenosis ?
The narrowing of the gaps in the spine or the backbone is called as Spinal stenosis. This leads to pressure on the nerves and the spinal cord. 5% of cases of spinal stenosis are seen in the low back of the lumbar spine. In some cases the narrowing of the spine leads to the compressing of the nerve root, which leads to pain in the leg.
Causes of spinal stenosis
It can be caused by aging, arthritis, trauma to the spine, spondylolisthesis and tumor of the spine
Symptoms of spinal stenosis
There is constant pain in the back and legs as stenosis pinches the nerve responsible for sensation and muscle power. Other symptoms are numbness and tingling in the legs, frequent falling and pain while walking.
Treatment of spinal stenosis
- A routine program with exercises and physical therapy are the best treatment for spinal stenosis. The exercises are not a complete cure but they are beneficial in keeping the patient active. A physical therapy can be supervised and once the period of the same is over people easily transition to the exercise program. The key for exercise is starting slowly in order to build strength.
- Generally, the patients are counseled not to perform strenuous activities as that might worsen the symptoms of spinal stenosis. In case of lumbar stenosis, patients find it comfortable when they are flexed forward. The doctor might recommend walking while being bent over and leaning when using a walker if not walking upright; sitting in recliners is also recommended instead of straight back chairs.
- Injections of cortisone are usually given in the epidural space. This is believed to relieve the symptoms of spinal stenosis temporarily. Though there have been studies which question the use of these injections as they lead to the risk of osteoporosis related fractures. This is still being pondered over by the doctors as a suitable treatment option as it has its own benefits and risks.
- Medications such as the antiinflammatory medicines like ibuprofen or aspirin are helpful in controlling the symptoms of spinal stenosis. Narcotic drugs might also prove to be helpful if used with care and for a short while. This is helpful for severe pain related to the nerves. Anti-epileptic like gabapentins might also be recommended. In some case anti depressants might also be given to provide relief from pain.
Though side effects are a concern when using these medications and the patient should let the doctor knows about their allergies.