What Is a Migraine?
Migraines are a recurring type of headache characterized by moderate to severe pain that is often throbbing or pulsing, usually on one side of the head.
They are often accompanied by other symptoms such as nausea, weakness, and increased sensitivity to light and sound [1, 2].
There are several types of migraines:
- Migraine without aura: This is the most common type of migraine, characterized by moderate-to-severe unilateral headache, nausea, and increased sensitivity to light and sound [2, 3].
- Migraine with aura: This type of migraine is accompanied by visual or sensorial illusions and hallucinations, sudden aura, and sometimes prolonged aura lasting more than 60 minutes [4].
- Rare migraine syndromes: These include basilar migraine, familial hemiplegic migraine, ophthalmoplegic migraine, retinal migraine, and confusional migraine [4].
- Secondary migraines: These are migraines triggered by a specific factor leading to migraine in patients with no history of migraine previously. These include post-traumatic migraine and cervical migraine [4].
- Frontal, temporal, occipital, and rhinogenic migraines: These are types of migraines characterized by their location of pain [5].
- Chronic migraine: This is defined as headaches on at least 15 days per month for at least 3 months, with the features of migraine on at least 8 days per month [6].
- Episodic migraine: This is characterized by headaches that occur on fewer than 15 days per month [6].
Each type of migraine has unique symptoms and triggers, and their treatment may vary.
What Is a Migraine with Visual Aura?
Migraine with visual aura is a type of migraine headache that is characterized by recurrent episodes of transient visual disturbances, often followed by headaches.
Visual auras are specific visual symptoms that occur before or during a migraine attack. These symptoms can include flashes of light, blind spots, zigzag lines, scotoma (temporary loss of vision in a specific area), and other visual phenomena.
The most specific visual symptom is the "fortification spectrum," which consists of glimmering jagged lines spreading from the center to the periphery [7,8,9,10].
What Causes Migraine with Visual Aura?
The exact mechanism of this delicate condition are not precisely understood, but research suggest that this phenomenon is linked to cortical spreading depression (CSD). For a more detailed answer, let's consult MediSearch.
Migraine Triggers
The triggers for migraine with aura can vary from person to person, but some common triggers include:
- Stress: Emotional or physical stress can trigger migraine with aura [11].
- Bright lights: Exposure to bright lights, such as sunlight or fluorescent lights, can trigger migraine with aura [11,12]
- Intense emotions: Strong emotions, such as anger, excitement, or sadness, can trigger migraine with aura [11].
- Lack of sleep or excessive sleep: Both not getting enough sleep and getting too much sleep can be triggers for migraine with aura [11].
- Hormonal changes: Fluctuations in hormones, such as those that occur during menstruation or menopause, can trigger migraine with aura [12].
- Certain foods and drinks: Some people find that certain foods or drinks, such as red wine, chocolate, or caffeine, can trigger migraine with aura [12].
- Strong smells: Strong odors, such as perfume or cigarette smoke, can trigger migraine with aura [12].
- Physical exertion: Strenuous exercise or physical exertion can trigger migraine with aura in some individuals [13].
- Weather changes: Changes in weather, such as changes in barometric pressure or temperature, can trigger migraine with aura [14].
- Visual stimuli: Certain visual stimuli, such as patterns or flickering lights, can trigger migraine with aura [1].
It's important to note that triggers can vary from person to person, and not everyone with migraine with aura will have the same triggers.
Identifying and avoiding individual triggers can help in managing and preventing migraine with aura attacks.
Treatment and prevention
The treatment of migraine can be split into two categories: acute treatment and preventive treatment.
Treatment
Acute Treatment
The acute treatment of migraine with visual aura typically involves the use of medications to relieve the symptoms and reduce the duration of the attack.
Triptans, such as sumatriptan, are commonly used and have been shown to be effective in treating migraine with aura [16,17].
Nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics may also be used for mild to moderate attacks.
In addition to medication, external trigeminal nerve stimulation (e-TNS) and transcranial magnetic stimulation (TMS) have shown promise as non-drug treatment options for acute migraine with aura [18, 19]. However, more research is needed to fully understand their effectiveness.
It's important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan.
Preventive Treatment
Beta Blockers
Beta blockers are a class of medications primarily used to treat cardiovascular conditions such as high blood pressure, heart failure, and certain heart rhythm disorders.
They work by blocking the effects of adrenaline on the heart and blood vessels, which helps to lower heart rate and blood pressure.
Beta blockers have been shown to be effective in preventing migraines. They work by blocking the effects of adrenaline on the heart and blood vessels, which helps to reduce the frequency and severity of migraines.
Propranolol is the most commonly used beta blocker for migraine prevention, but other beta blockers such as metoprolol and nadolol have also been found to be effective [20,21,22,23,24,25,26].
Antiepileptic Drugs
Antiepileptic drugs (AEDs) are medications used to treat epilepsy, a neurological disorder characterized by recurrent seizures.
AEDs work by reducing the excessive electrical activity in the brain that leads to seizures. They can help control seizures and prevent their occurrence [27,28,29].
AEDs have shown efficacy in preventing migraine with aura. Valproic acid and topiramate have been found to be effective in reducing the frequency of migraine attacks in clinical studies.
Other AEDs such as gabapentin, lamotrigine, levetiracetam, and zonisamide have also been investigated for their potential in migraine prevention. However, further research is needed to assess their safety and efficacy [30,31,32,33,34,35].
Gepants
In recent times, researchers have zeroed in on a specific neuropeptide as a key player in the migraine mechanism.
Calcitonin gene-related peptide (CGRP) is a neuropeptide that is encoded by the calcitonin gene. It is a 37-amino acid peptide that is primarily produced in sensory nerves, including those in the central and peripheral nervous systems.
CGRP plays a significant role in migraine pathophysiology and has been targeted for the development of migraine treatments [36,37,38,39,40,41,42].
Gepants are a class of therapeutic agents that are being developed for the treatment of migraine. They are calcitonin gene-related peptide (CGRP) receptor antagonists, which means they block the activity of CGRP, a neuropeptide that plays a major role in the pathophysiology of migraine.
Gepants inhibit CGRP release without causing vasoconstriction, unlike triptans, which are another class of drugs used for migraine treatment. Gepants are considered a promising alternative for patients who do not respond well to triptans or have contraindications to their use.
Have a follow-up question? You can ask it in the above window. For example, try asking: "What is the efficacy of rimegepant in treatment of migraine?"
Disclaimer
This article was not written by a medical professional and does not offer health advice. The purpose of this article is to demonstrate the usage of MediSearch, an AI-powered search engine, providing science-based answers to medical queries. Always consult a medical professional regarding your condition.