Migraine Headaches with Aura

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Almost everyone has experienced some type of headache, but migraine headaches with aura, also known as classic migraines, are a very specific type involving more than just pain.

The word migraine, derived from the Greek hemikrania, which means "half of the head," refers to a throbbing pain in one side of the head that's often accompanied by a stiff and tender neck, extreme sensitivity to light and noise, difficulty concentrating and nausea.

Despite the name's origin, the pain may also travel throughout the entire head at times. The symptoms can last as little as four hours or as long as three days, and are often followed by a postdrome (aftereffect) phase during which patients feel exhausted and mentally inept.

Classic migraines also involve what health-care practitioners call an aura, which is a pre-migraine period lasting between 15 and 60 minutes that involves zigzag lines or shimmering stars in the field of vision. Some patients with the condition also report having blind spots and tunnel vision (an inability to see to either side), and in rare instances report speech disturbances, confusion and odd sensations such as tingling, numbness or weakness in the arms or legs. Within an hour, the symptoms associated with the aura usually subside and the migraine headache pain develops.

All types of migraine headaches affect women more than men, by a ratio of about three to one. Genetics also plays a role, and the American Council for Headache Education reports that about 90% of people who get migraines have a family history of the condition.

Approximately 20% of people who have migraines will experience auras. Why some people get them and others don't is still largely a mystery. In fact, researchers don't even understand the exact cause of migraines in general. Currently, they're focusing on the relationship between migraines and blood flow in the brain, electrical imbalances in cells and hormonal changes in the central nervous system in the hopes of uncovering the mechanism that causes the condition.

They already know, however, that a variety of things are correlated with migraines, including emotional stress, intense physical exertion, changes in the weather, environmental pollutants, certain medications, changes in sleep patterns and foods such as dairy products, red wine and chocolate.

Research also shows that people who get migraines, both with and without auras, have less frequent and less intense headaches after receiving proper care. If you get migraines with aura, your healthcare practitioner will investigate their nature by taking a detailed history of your condition and possibly performing a physical and neurological examination to rule out any organic causes, such as tumors.

Once he or she determines the factors that are contributing to your migraines, adequate care can begin.

Anatomy

Besides the pain, perhaps the most frustrating aspect of migraine headaches with aura, also known as classic migraines, is that there are very few answers regarding their anatomical origin.

What researchers do know is that the brain isn't sensitive to pain, so the pain associated with migraine headaches must come from somewhere else. Possible locations include the attaching structures at the base of the brain, such as the muscles and ligaments; the meninges, which are the tissues covering the brain and the spine; and the muscles and blood vessels around the scalp, face and neck.

Although researchers once believed that migraines were purely associated with the dilation (opening) and constriction (closing) of blood vessels in the head, they now believe that there is a neurogenic component as well -- meaning that they think an abnormal release of chemicals in the brain is partly responsible for migraine headaches.

One study, for example, found that the trigeminal nerve, which runs from the brain and branches into the face and jaw, releases vasoactive peptides (proteins) that cause an inflammation in surrounding blood vessels. This inflammation, in turn, irritates nerves in the tissue covering the brain, which causes migraine pain.

Researchers are also studying the role of a chemical called serotonin. One study found that the central nervous system's (the brain and spinal cord's) pain-inhibiting system may be dysfunctional in people who get migraines, allowing things that normally don't cause discomfort to be painful. Serotonin is a chemical that assists in inhibiting pain, as it reduces the release of vasoactive peptides. When it's lacking, people are more sensitive to pain, so some researchers believe that people who get migraines have abnormally low levels of serotonin.

Other factors that correlate with migraines include fluctuations in the female hormones estrogen and progesterone and drops in the body's magnesium levels. Magnesium is an important component of nerve cell function, and a lack of magnesium can cause the nerves in the brain to misfire, which could explain the auras associated with migraines.

Still, while all these theories provide a better understanding of migraines in general, none may fully explain a particular case. Some people get migraines after experiencing altered sleeping patterns, food allergies or stress, and it's hard to predict in advance what will trigger the condition for any one person.

That's why it's important to seek help if you have migraine headaches with aura. Your chiropractor can perform a detailed exam to help you determine and avoid what's triggering your condition, as well as provide chiropractic care to decrease the frequency and intensity of your headaches.

Chiropractic Care

If you have migraine headaches with aura, also known as classic migraines, your chiropractor can perform a detailed physical and neurological exam and take a history of your condition to help determine what factors might be contributing to their onset. Once this is complete, he or she can use a variety of techniques to help reduce your headaches' frequency and severity.

One particularly effective technique is spinal manipulative therapy (SMT), also known as adjustment. To perform an adjustment, your chiropractor will apply a quick, strategic thrust with his or her hands or a device called an activator. Studies have found that chiropractic adjustments can significantly reduce people's migraine symptoms, possibly by altering the central nervous system's pain sensitivity. Adjustments may also help during the aura stage of classic migraines by diminishing the constriction of blood vessels and by relaxing tight muscles surrounding the cervical spine, which is the portion of the spine in your neck.

To further reduce the muscle tension that can contribute to classic migraines, your chiropractor may use trigger point therapy, which involves the application of pressure to areas of tight, contracted muscle fibers. These areas, called trigger points or knots, can irritate nerves and cause pain in other body parts such as the head. After applying pressure for about 10 seconds with his or her thumb, your chiropractor will release the pressure and allow an influx of fresh blood to wash out the body's irritating waste products, such as lactic acid, and bring in oxygen, which relieves pain and releases the trigger point.

A transcutaneous electrical nerve stimulation (TENS) machine can also help to reduce pain, and your chiropractor may use one to reduce the pain associated with your migraines. TENS machines send mild electrical impulses through the skin into nerve fibers beneath, and researchers think they work by stimulating nerves surrounding those that are transmitting pain. Similar to how rubbing a wounded body part reduces pain, stimulating a painful area with a TENS machine may help drown out pain signals.

For people with severe migraine pain, some chiropractors may also make a medical referral. For people with infrequent but severe migraines, a medical doctor may recommend a pain-relieving drug such as acetaminophen. For people with more frequent migraines, a medical doctor may recommend an abortive or prophylactic medication. Abortive medications promote the release of serotonin, a chemical that promotes good feelings and decreases sensitivity to pain. Prophylactic medications work as antidepressants and also help to lower blood pressure.

Finally, most people who have migraines can reduce their intensity and frequency by making lifestyle changes. Increasing activity levels and performing more aerobic and stretching exercises can help you relieve tension and relax stiff muscles. Relaxation exercises, such as those people perform in yoga classes, can also be helpful.

Migraine Headaches with Aura

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