What is a migraine?
A migraine is not just a headache.
To sense our world, your nerves send electrical signals to and from your spinal cord and brain. Sensors throughout our body collect information about our surroundings. This information is sent as signals to our brain through a series of nerve cells. Communication with our brain occurs via pathways and nerve centers at the base of our brain, called the brain stem. The brainstem helps control sleep, heart rate, and breathing. Migraine is a disease where one or more parts of this communication system do not function properly.
Around 9.2% of Asians experience migraines. Migraine affects over 200 million people in India alone.
Migraine is a type of neurological headache that can cause severe pain. Neck pain may be the most common migraine symptom, beginning at the same time as the headache. In order to be diagnosed with migraine disease, patients must have had at least 5 headache attacks that lasted 4–72 hours.
An episode usually occurs in stages and can last for several days. Severe cases can affect a person’s daily life, including their ability to work or study. Some people have more than one episode each week, while others have them only occasionally. Migraine can affect people in different ways, and the triggers, severity, symptoms, and frequency can vary
It is important to understand that a migraine episode is different from a typical headache. The experiences are different, and they can have different causes.
Migraine-like sinus headaches
Sinusitis is another cause of headaches. It may resemble migraine and is usually misdiagnosed.
When a nerve inside the nose is compressed, it can cause headaches or other types of facial pain, which is known as Sluder's neuralgia. This might be caused by a deviated septum in the nose, which would cause nerve compression.
How does Sluder's neuralgia present?
Sluder's neuralgia starts at the
1.Base of the nose,
2. Moves towards and around the eye on the same side,
3. Effects on the upper jaw and teeth, as well as the lower jaw and teeth on occasion
4. It occasionally reached the ear and beneath the cheek.
5. The back of the head, neck, shoulder, chest, shoulder blade, and so forth could all experience pain.
6. It can spread to the arm, forearm, hand, or angular joints and cause a painful throat
7. Patients can feel numbness along soft palate, oropharynx and tonsils
How to differentiate between migraine and Sluder's neuralgia?
The majority of the time, migraine headaches are brought on by a trigger and may or may not be accompanied by an aura. Aura refers to visual or auditory sensations experienced before the start of a migraine. Migraine headaches may be unilateral and can last for 4-72 hours.
On the other hand, Sluder's neuralgia causes radiating headache/facial pain, dull aching, and can last for several days. They rarely have triggers and are not associated with auras.
Medical Management of Migraine
During an acute episode of migraine, your doctor may prescribe drugs to reduce headache and other symptoms (Abortive therapy).Long term treatment of migraine aims at reducing the frequency of migraine attacks and reducing the intensity of headache (Preventive therapy)
Management of Sluder's Neuralgia / Migraine-like Sinus Headache :
The main objective of treatment is to relieve nerve compression and reduce headache intensity. Therefore, the compression-causing factor is surgically fixed, such as a deviated septum touching the lateral wall of the nose. When the compression is released, the pain immediately goes away. Today, ENT surgeons perform endoscopic septoplasty that is painless and scarless.
When should you seek medical attention ?
Seek immediate medical attention if your headache is accompanied by - sudden onset headache or a sudden change in baseline headache; neck stiffness; a high fever; muscle weakness; changes to speech or vision; numbness or tingling sensations; convulsions; confusion; or changes in awareness.
Headaches and their accompanying symptoms can occasionally be a sign of a more serious underlying medical emergency, like a stroke.
Also, if you have a history of stroke, heart disease, or diseases of the liver or kidneys, take extra precautions. A changing headache could indicate a life threatening emergency.
- Dr. Prashanth R Reddy
“E.N.T. health – ENTry for better senses
