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DISEASE AWARENESS PAGE FOR R3 STEM CELL – MIGRAINES
A migraine is a headache disorder that typically affects one side of the head and sometimes neck. It is characterised by recurrent headaches, with each bout about lasting between two and 72 hours. The headaches have moderate to severe intensity and may be accompanied by other symptoms like vomiting, increased sensitivity to light, sound and smell.
The headaches in migraines are believed to be caused by neurovascular structures in the brain. Some theories propose that the disorder begins in the brain tissue and then spreads to the bold vessels. Some other researches suggest that migraines are caused by neurons in the brain. The specific cause of migraines is still unknown, but the discussion revolves around the fact that it may be caused by blood vessels and neurons.
One explanation proposes that the excitability in the cerebral cortex is increased, and that causes an abnormal control of pain in neurons in the brainstem. These neurons are a part of the trigeminal nucleus, which is the largest of the cranial nerves. It extends through the pons, medulla, and midbrain and goes further into the upper part of the spinal cord. The wide distribution of this cranial nerve could explain why migraine headaches feel the way they do.
Another factor that has been linked to the way migraines develop is the levels of serotonin in the body. Serotonin is popularly known as the “feel good” hormone and is responsible for several positive and happy feelings we experience as human beings. It is also linked to modulating pain, memory, reward, learning and several other processes in the body. The theory is that low levels of serotonin lead to the development and prevalence of migraine headaches.
Some other theories have linked migraines to a phenomenon called “cortical spreading depression”. What happens in this is a burst of neuronal activity, and that is followed by a period of lack of activity. This “burst” and “inactivity” is seen in people who experience migraines. The theory is that after the activity, the blood flow to the cerebral cortex is affected for a couple of hours. This then triggers the nerves that sense pain in the head and neck
Except for the fact that pain in migraines is of varying durations and that they occur on one side of the brain, not much else is known about it. Here too, there are theories to try and explain how the pain is experienced. Some suspect structures in the central nervous system, such as the brainstem and diencephalon, while others suspect structures the peripheral nervous system (sensory nerves around blood vessels in the head and neck).
There are four phases to a migraine headache. They all differ in duration and prevalence. Some people experience all the phases in varying durations while others only experience some of them. The stages are:
The prodrome stage: This stage is experienced by 6 out of every ten people who suffer migraines. Its onset can last for anywhere between two hours to two days, and it is followed by the aura phase. The prodrome stage is characterised by a series of experiences, including altered mood, depression or euphoria, fatigue, food craving, diarrhoea, sensitivity to smells and even muscle stiffness.
The aura: The aura can occur before or during the migraine headache, and it is a neurological problem that appears gradually, over several minutes. It generally subsides within an hour and presents symptoms that are visual (in 90% of cases) and motor. With the visual disturbances in the aura phase, the individual may see bright lights, zig-zag lines, or a complete loss of sight in a part of the visual field.
The pain (headache) phase: The headache is usually on one side of the head, and it begins mildly and becomes more severe the longer it lasts. The pain is usually throbbing or pulsing and aggravated with physical activity. In about 4 out of every ten migraine cases, the headache is experienced on both sides of the head and neck (bilateral). This bilateral pain is most common in individuals who don’t experience the aura phase.
The postdrome: The postdrome is the period after the headache. The symptoms include feelings of general weakness, confusion, and even soreness in the area of the head where the migraine occurred.
The causes of migraines are numerous. It has been linked to some genetic factors, and so people whose parents suffer migraines are more likely to get them.
Migraines can also be triggered by several factors, including:
Migraines are ranked as the third most common diseases in the world, and it is estimated that about 1 in 7 people get migraines worldwide. Furthermore, about 2 in 100 people suffer from chronic migraines.
One of the major risk factors of migraines is genetics. Individuals with a family history of migraines are several times more likely to suffer the condition than others. Other risk factors include:
The typical symptom associated with migraines is recurrent headaches that have varying durations. They also include autonomic symptoms. All the stages of migraines described earlier are also symptoms that individuals with the condition experience. Sometimes, not all the stages are experienced. About 15% to 30% of cases, an aura (see above for more information) is associated with the migraine.
Migraine headaches last for different durations and have been known to last from between two hours to 72 hours. A migraine headache that lasts longer than 72 hours in one occurrence is known as status migrainosus.
In addition to headaches, other symptoms of migraines are increased sensitivity to light, sound and smell.
There are also conditions associated with migraines. These have been observed in individuals who present with migraines, and they include Depression, Bipolar disorder, anxiety, and obsessive-compulsive disorder. Additionally, these disorders are up to five times more common in people who have migraines without aura. They are three to ten times more common in people that have migraines with aura.
Migraines can be diagnosed based on their presentation alone. For this, history and assessment of symptoms are enough. These symptoms include the stages of the migraine, and well as headaches that fit the stages. The diagnosis of migraines also includes ruling out other similar conditions.
There is no cure for migraines, and so, the treatment is focused on relieving the symptoms of the condition and preventing future attacks. For symptom relief, several medications are usually prescribed, including pain relievers, triptan drugs, and ergotamine drugs. There are also drugs prescribed to prevent the reoccurrence of migraines in individuals who experience it frequently.
Other things that can be done for symptom relief include
Treating migraines also involves making lifestyle changes. For example, reducing the levels of stress experienced can help reduce the pain and the frequency of occurrence. Stress management strategies like exercise, relaxation techniques, monitoring vital signs can also help keep a lid on the impact of migraine.
Here are answers to many of the frequently asked questions we receive.
Arthritis can be classified into several types. Osteoarthritis is caused by the normal aging process of the body, or could be a result of injury.
Rheumatoid arthritis, the most common type of arthritis, happens due to autoimmune problems, wherein the body’s own immune system attacks healthy cells of the body. Infectious arthritis is caused by an infection to the joint. Patients with psoriasis may be affected by Psoriatic arthritis. Finally, excessive uric acid in the body can cause Gout, an arthritis that often starts at the toe.
Rheumatoid arthritis is an inflammatory form of arthritis. This disease causes chronic inflammation of the joints and can lead to deterioration of a variety of systems in the body. Rheumatoid arthritis occurs when the immune system attacks the lining of the membrane around the joints known as the synovium, which causes inflammation that thickens the synovium and ultimately deforms the cartilage and bone of the joints.
How common is it and who is at risk?
An estimated one percent of the entire world population suffers from rheumatoid arthritis. As the case with osteoarthritis, women are more likely to develop rheumatoid arthritis. Other groups at risk are people middle-aged or older as well as those suffering from obesity. Rheumatoid arthritis risk is inheritable, which may be accelerated by smoking or unknown environmental exposures.
Signs of the disease include swollen, tender joints that may feel stiff, particularly in the mornings. Fever, fatigue, and loss of activity are also common symptoms. Rheumatoid arthritis tends to manifest initially in the smaller joints like those in the fingers and toes. Symptoms are exhibited in joints of other body parts as the disease spreads.
Diagnosis begins with a physical test checking for redness, warmth, and swelling as well as the state of reflexes in the affected joints. Multiple blood tests are conducted as people with rheumatoid arthritis usually have elevated erythrocyte sedimentation rates and C-reactive protein levels. Additionally, X-rays, MRIs, and ultrasounds are conducted to track the spread of the disease.
While no cure exists as of now, research has revealed that the symptoms may be controlled by early application of disease modifying anti-rheumatic drugs (DMARDs). Steroids or nonsteroidal anti-inflammatory drugs may be prescribed depending on the case. Exercises to retain joint flexibility also provide some relief. If medications fail to slow down the disease, doctors may recommend surgery to repair or replace joints or swollen tendons.
Rheumatoid arthritis is an inflammatory form of arthritis. This disease causes chronic inflammation of the joints and can lead to deterioration of a variety of systems in the body. Rheumatoid arthritis occurs when the immune system attacks the lining of the membrane around the joints known as the synovium, which causes inflammation that thickens the synovium and ultimately deforms the cartilage and bone of the joints.
How common is it and who is at risk?
An estimated one percent of the entire world population suffers from rheumatoid arthritis. As the case with osteoarthritis, women are more likely to develop rheumatoid arthritis. Other groups at risk are people middle-aged or older as well as those suffering from obesity. Rheumatoid arthritis risk is inheritable, which may be accelerated by smoking or unknown environmental exposures.
Signs of the disease include swollen, tender joints that may feel stiff, particularly in the mornings. Fever, fatigue, and loss of activity are also common symptoms. Rheumatoid arthritis tends to manifest initially in the smaller joints like those in the fingers and toes. Symptoms are exhibited in joints of other body parts as the disease spreads.
Diagnosis begins with a physical test checking for redness, warmth, and swelling as well as the state of reflexes in the affected joints. Multiple blood tests are conducted as people with rheumatoid arthritis usually have elevated erythrocyte sedimentation rates and C-reactive protein levels. Additionally, X-rays, MRIs, and ultrasounds are conducted to track the spread of the disease.
While no cure exists as of now, research has revealed that the symptoms may be controlled by early application of disease modifying anti-rheumatic drugs (DMARDs). Steroids or nonsteroidal anti-inflammatory drugs may be prescribed depending on the case. Exercises to retain joint flexibility also provide some relief. If medications fail to slow down the disease, doctors may recommend surgery to repair or replace joints or swollen tendons.
Juvenile Idiopathic Arthritis (JIA) is the most prevalent form of arthritis within kids. It is characterized by persistent pain, swelling, and stiffness in the joints. The disease occurs when the body’s own tissues are attacked by its cells. In some cases, it can create more serious complications such as growth problems and eye inflammation.
It is the most common form of arthritis diagnosed in children under the age of sixteen. Certain gene mutations can make the body more vulnerable to the external environment, which can result in Juvenile Idiopathic Arthritis occurring. Although reasons are unknown, girls are more susceptible to Juvenile Idiopathic Arthritis than boys.
Commonplace symptoms include joint pain or a limp caused by the pain, swelling of joints and stiffness of the joints that results in clumsiness by the child. In some cases, the disease can manifest as high fever and rashes.
Diagnosis for Juvenile Idiopathic Arthritis is difficult as the pain and swelling in the joints could be attributed to a number of diseases. Quite a few blood tests are conducted to determine the status of markers like erythrocyte sedimentation rate, C-reactive protein levels, and quantity of anti-nuclear bodies, among others. However, many children with Juvenile Idiopathic Arthritis show no abnormalities in these tests.
The treatment for Juvenile Idiopathic Arthritis is geared towards making sure the child can maintain a regular level of physical activity. This can include different types of medication like nonsteroidal anti-inflammatory drugs to reduce pain and swelling or disease modifying anti-rheumatic drugs in more severe cases. Biologic agents may be recommended to help prevent joint damage. Physical therapy can also help the child maintain a full range of motion with or without joint supports or splints based on the situation. Surgery is the most extreme option used to improve the position of the affected joint.
Aminoff, Roger P. Simon, David A. Greenberg, Michael J. (2009). Clinical neurology (7 ed.). New York, N.Y: Lange Medical Books/McGraw-Hill. pp. 85–88. ISBN 9780071664332.
Vos, T; Flaxman, AD; Naghavi, M; Lozano, R; Michaud, C; Ezzati, M; Shibuya, K; Salomon, JA; et al. (Dec 15, 2012). “Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010”. Lancet. 380 (9859): 2163–96. doi:10.1016/S0140-6736(12)61729-2. PMC 6350784. PMID 23245607
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