Traditionally headache disorders were classified into a primary group and a secondary group.
Primary headaches are idiopathic headache disorders, where the causes of headaches are not clear, such as for migraines, tension headaches, and cluster headaches.
Secondary headaches are those where the causes can be identified, such as vasculitis, infection, PFO, structural vascular lesions (e.g. arteriovenous malformations and aneurysms), tumors of the brain, ear and eye abnormalities, systemic metabolic and endocrinologic disorders.
These classifications are questionable since migraines, tension headaches and cluster headaches have sources that can be identified.
Bias against chronic headache patients, excessive use of pain killers and lack of understanding of the neurophysiology of headaches compromise the success of treatments.
Migraine can be classified into:
(1) Classic migraine, also called migraine with aura
(2) Common migraine, also called migraine without aura
Classic migraine or migraine with aura (mwa) refers to headaches preceded by a neurological phase. This neurological phase (aura) usually begins suddenly and lasts 15 to 30 minutes; then it is followed with the headache phase that usually lasts up to several hours. The headaches can be moderate to intense. Sometimes the patients may have the neurological phase but do not have the headache phase. The neurological events can include aura, vertigo, nausea, loss of consciousness, paralysis, ataxia (loss of ability of muscle control), aphasia (partial loss of speech control), diplopia (double vision) and behavior disturbances.
Common migraine or migraine without aura is the most common type of migraine, consisting of about 75% to 80% of all migraines. Common migraine headaches are not preceded by a neurological phase of aura, but there are signs that last hours or a day before the migraine develops. Usually the patients may have signs of behavioral and psychological disturbances, yawning, muscle pains, dietary craving, and fatigue. The headaches develop gradually, last longer and are more debilitating than the migraine with aura.
Causes of Migraine
The causes of migraine can be classified as primary causes and inducing causes.
The primary cause is the pressure exerted on the nerves and the inducing causes include: stress, anxiety, menses, oral contraceptives, bright light, drop of barometric pressure, lack of sleep, hunger, over exertion, head injury, food allergies, e.g. foods or drink that contain nitrites, glutamates, aspartic acid, caffein, and tyrosine and other lesser inducing causes include: high fever, too much sleep, high altitude, glycerin nitrate, histamine, reserpine, estrogen, stopping cortisone usage, cold food, reading, eyesight problem, odors, fragrance, organic solvents, and fluorescent lights.
Treatments of Migraine
Tui Na Treatments
Note: PFO (Patent foramen ovale) is a abnormal passage or a hole in the heart wall separating the two atria (upper chambers) of the heart. The hole let part of the stale blood (before picking up oxygen in the lungs) to go into left atria (upper chamber) and to go into the left venticle and pump into the body and the brain. When the brain does not get enough oxygen, the histamine kicks in and expands the blood vessels which may put pressure on the nerves. The overly expanded blood vessels may leak out liquid and put more pressure on the nerves and creates serious headaches.
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Last update: Sept 28, 2013; 10 P.m. LAH