Migraine is a chronic disorder characterized by recurrent moderate to severe headaches often in association with a number of autonomic nervous systemsymptoms. The word derives from the Greekἡμικρανία (hemikrania), “pain on one side of the head”, from ἡμι- (hemi-), “half”, and κρανίον (kranion), “skull”.
Typically the headache is unilateral (affecting one half of the head) and pulsating in nature, lasting from 2 to 72 hours. Associated symptoms may includenausea, vomiting, photophobia (increased sensitivity to light), phonophobia (increased sensitivity to sound) and the pain is generally aggravated by physical activity. Up to one-third of people with migraine headaches perceive an aura: a transient visual, sensory, language, or motor disturbance which signals that the headache will soon occur. Occasionally an aura can occur with little or no headache following it.
Migraines are believed to be due to a mixture of environmental and genetic factors. About two-thirds of cases run in families. Fluctuating hormone levels may also play a role: migraine affects slightly more boys than girls before puberty, but about two to three times more women than men.
Initial recommended management is with simple analgesics such as ibuprofen and acetaminophen for the headache, an antiemetic for the nausea, and the avoidance of triggers. Specific agents such as triptans or ergotamines may be used by those for whom simple analgesics are not effective. Globally, more than 10% of the population is affected by migraine at some point in life.
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