MIGRAINES [ THE BRAIN’S EQUILIBRIUM ]

THE DAMAGE caused by headaches is eye-popping. About 45 million Americans suffer them regularly, and about half of the sufferers find the pain severe and sometimes disabling. The result: lost time from work, play, the day to day stuff of life. Counting only the 30 million who suffer migraine headaches one of the 150 described categories of headaches American victims lose 157 million work days each year.

ALL IN YOUR HEAD?

Victims often describe the pain as throbbing or pounding. Other related symptoms include sensitivity to light, sound, and odor. Some experience nausea, abdominal pain, or vomiting, and some sufferers report seeing auras or streaks of light shortly before the pain begins. Young victims may also complain of blurred vision, fever, dizziness, and upset stomach. A few children get migraines about once a month accompanied by vomiting; such headaches are sometimes referred to as abdominal migraines. About 5 percent of children younger than 15 report having had migraines, compared with 15 percent who experienced tension headaches.

ANATOMY OF A MIGRAINE

Headaches occur when nerve cells that are pain sensitive, for reasons that are still not clearly understood, begin sending pain signals to the brain. These nociceptor cells often act in response to stress, tension, hormonal changes, or the dilation of blood vessels.

Some researchers theorize that chronic headache sufferers lack normal levels of pain-blocking neurotransmitters called endorphins, a Greek word that means “the morphine within.” This deficiency means that their pain signals are more likely to cause severe discomfort than those in people who have higher endorphin levels.

Migraines are particularly devastating because of their severity and recurrence. They begin with impulses in hyperactive nerve cells. These impulses tell blood vessels in the head to constrict, and then to dilate. The process releases serotonin, prostaglandins, and other chemicals that inflame nerve cells surrounding the blood vessels in the brain. Specifically targeted are the trigeminal cranial nerve and its connections to the upper spinal cord and brain stem. The result: pain. Researchers long believed migraines arose from the narrowing and expanding of blood vessels on the surface of the brain; now, the most common theory traces migraines to hereditary abnormalities of the brain itself.