What is a migraine? Experts explain!

What is a migraine? A Mayo Clinic expert explains

Learning about migraine disorder can be intimidating. Amaal Starling, M.D., a neurologist at Mayo Clinic, walks you through the facts, the questions, and the answers to help you better understand this condition.

A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities.

For some people, a warning symptom known as an aura occurs before or with the headache. An aura can include visual disturbances, such as flashes of light or blind spots, or other disturbances, such as tingling on one side of the face or in an arm or leg and difficulty speaking.

Medications can help prevent some migraines and make them less painful. The right medicines, combined with self-help remedies and lifestyle changes, might help.

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Symptoms

Migraines, which affect children and teenagers as well as adults, can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages.

One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including:

·         Constipation

·         Mood changes, from depression to euphoria

·         Food cravings

·         Neck stiffness

·         Increased urination

·         Fluid retention

·         Frequent yawning

 

For some people, an aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They're usually visual but can also include other disturbances. Each symptom usually begins gradually, builds up over several minutes and can last up to 60 minutes.

Examples of migraine auras include:

·         Visual phenomena, such as seeing various shapes, bright spots or flashes of light

·         Vision loss

·         Pins and needles sensations in an arm or leg

·         Weakness or numbness in the face or one side of the body

·         Difficulty speaking

 

A migraine usually lasts from 4 to 72 hours if untreated. How often migraines occur varies from person to person. Migraines might occur rarely or strike several times a month.

During a migraine, you might have:

·         Pain usually on one side of your head, but often on both sides

·         Pain that throbs or pulses

·         Sensitivity to light, sound, and sometimes smell and touch

·         Nausea and vomiting

 

After a migraine attack, you might feel drained, confused and washed out for up to a day. Some people report feeling elated. Sudden head movement might bring on the pain again briefly.

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When to see a doctor

Migraines are often undiagnosed and untreated. If you regularly have signs and symptoms of migraine, keep a record of your attacks and how you treated them. Then make an appointment with your doctor to discuss your headaches.

Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.

See your doctor immediately or go to the emergency room if you have any of the following signs and symptoms, which could indicate a more serious medical problem:

·         An abrupt, severe headache like a thunderclap

·         Headache with fever, stiff neck, confusion, seizures, double vision, numbness or weakness in any part of the body, which could be a sign of a stroke

·         Headache after a head injury

·         A chronic headache that is worse after coughing, exertion, straining or a sudden movement

·         New headache pain after age 50

 

Causes

Though migraine causes aren't fully understood, genetics and environmental factors appear to play a role.

Changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway, might be involved. So might imbalances in brain chemicals — including serotonin, which helps regulate pain in your nervous system.

Researchers are studying the role of serotonin in migraines. Other neurotransmitters play a role in the pain of migraine, including calcitonin gene-related peptide (CGRP).

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Migraine triggers

There are a number of migraine triggers, including:

·         Hormonal changes in women. Fluctuations in estrogen, such as before or during menstrual periods, pregnancy and menopause, seem to trigger headaches in many women.

Hormonal medications, such as oral contraceptives, also can worsen migraines. Some women, however, find that their migraines occur less often when taking these medications.

·         Drinks. These include alcohol, especially wine, and too much caffeine, such as coffee.

·         Stress. Stress at work or home can cause migraines.

·         Sensory stimuli. Bright or flashing lights can induce migraines, as can loud sounds. Strong smells, such as perfume, paint thinner, secondhand smoke and others — trigger migraines in some people.

·         Sleep changes. Missing sleep or getting too much sleep can trigger migraines in some people.

·         Physical factors. Intense physical exertion, including sexual activity, might provoke migraines.

·         Weather changes. A change of weather or barometric pressure can prompt a migraine.

·         Medications. Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.

·         Foods. Aged cheeses and salty and processed foods might trigger migraines. So might skipping meals.

·         Food additives. These include the sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods.

 

Risk factors

Several factors make you more prone to having migraines, including:

·         Family history. If you have a family member with migraines, then you have a good chance of developing them too.

·         Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s, and gradually become less severe and less frequent in the following decades.

·         Sex. Women are three times more likely than men to have migraines.

·         Hormonal changes. For women who have migraines, headaches might begin just before or shortly after onset of menstruation. They might also change during pregnancy or menopause. Migraines generally improve after menopause.

 

Complications

Taking painkillers too often can trigger serious medication-overuse headaches. The risk seems to be highest with aspirin, acetaminophen and caffeine combinations. Overuse headaches may also occur if you take aspirin or ibuprofen (Advil, Motrin IB, others) for more than 14 days a month or triptans, sumatriptan (Imitrex, Tosymra) or rizatriptan (Maxalt, Maxalt-MLT) for more than nine days a month.

Medication-overuse headaches occur when medications stop relieving pain and begin to cause headaches. You then use more pain medication, which continues the cycle.

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By Mayo Clinic Staff

Snoring Explained

 

Snoring

Snoring occurs when something restricts your airflow during sleep. Loud or long-term snoring increases the risk of heart attack, stroke and other health problems. You may be able to stop snoring by losing weight and avoiding alcohol before bed. If snoring keeps you awake or disrupts your partner’s sleep, talk to your provider about treatments.

 

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What is snoring?

Snoring happens when air can’t flow easily through the mouth or nose. When the air is forced through an obstructed area, soft tissues in the mouth, nose and throat bump into each other and vibrate. The vibrations make a rattling, snorting or grumbling sound.

Snoring can interrupt sleep. Loud, long-term (chronic) snoring can be a sign of a serious disorder called obstructive sleep apnea. A wide range of surgical and nonsurgical treatments can stop or reduce snoring.

How common is snoring?

Snoring is very common. Anyone can snore at some point in their life. It’s more common in men over 50 who have overweight or obesity.

Who is more likely to snore?

Nearly everyone snores from time to time, including babies, children and adults. Some people are more likely to snore than others. Snoring risk factors include:

• Age: Snoring is more common as we age because muscle tone decreases, causing airways to constrict.
• Alcohol and sedatives: Alcoholic beverages and certain medications relax muscles, restricting airflow in the mouth, nose and throat.
• Anatomy: A long soft palate (the back of the roof of the mouth), enlarged adenoids, tonsils or a large tongue can make it hard for air to flow through the nose and mouth. A deviated septum (displaced cartilage in the nose) can block the flow of air.
• Gender: Snoring is more common in men.
• Family history: Snoring runs in families. If you have a parent who snores, you’re more likely to snore too.
• Overall health: Nasal stuffiness due to allergies and the common cold block airflow through the mouth and nose. Pregnant people are more likely to snore due to hormonal changes and weight gain.
• Weight: Snoring and sleep-related breathing disorders are more common in people who have overweight or obesity.

What causes snoring?

When you breathe, you push air through your nose, mouth and throat. If the airway is restricted, tissues — including the soft palate (the back of the roof of the mouth), tonsils, adenoids and tongue — vibrate against each other as you force air through. The vibrations make a rumbling, rattling noise. Several conditions and factors can block airflow. These include:

• Alcohol and other sedatives that relax muscles, restricting airflow.
• Bulky soft tissue, including enlarged adenoids, tonsils or tongue.
• Excess body fat, which puts pressure on the soft tissues and compresses the airway.
• Pregnancy hormones that cause inflammation in the nose.
• Low muscle tone and muscle weakness in the mouth, nose or throat.
• Nasal congestion and inflammation due to a cold, flu, allergies or irritants in the air.
• Structural differences in the mouth, nose or throat that decrease the size of the airway.

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What are the symptoms of snoring?

Snoring sounds range from quiet vibrations or whistles to very loud grumbling, snorting or rumbling. Some people might not realize they’re snoring when they sleep. People who snore may toss and turn at night, have a dry, sore throat when they wake up and feel tired during the day. Lack of sleep can cause headaches, difficulty focusing and moodiness. Besides snoring, some people gasp for air and stop breathing for a few seconds while they’re asleep. These are signs of sleep apnea, a disorder that leads to serious health problems if it isn’t treated.

How is snoring diagnosed?

Your provider will ask you (and perhaps your partner) several questions, including how often you snore, what it sounds like and how your diet and lifestyle affect your sleep. During an exam, your provider will check your blood pressure, listen to your heart and look in your mouth, nose and throat.

To evaluate your sleep patterns, your provider may order a sleep study (polysomnogram). You might be able to do a sleep study at home, or you may need to spend the night in a sleep center. A sleep study evaluates:

• Brain wave activity.
• Breathing patterns, including any periods when you stop breathing or gasp for air.
• Heart rate and oxygen levels.
• Movements during sleep, such as arm or leg movements or tossing and turning.
• Sleep cycles and snoring.

 

What are the nonsurgical treatments for snoring?

Your provider may recommend treatments to improve your posture or open your airways when you sleep. Remedies for snoring include:

• Lifestyle changes: Avoiding alcohol before bed, changing your sleep position and maintaining a weight that's healthy for you can reduce snoring.
• Medications: Cold and allergy medications relieve nasal congestion and help you breathe freely.
• Nasal strips: Flexible bands stick to the outside of your nose and keep nasal passages open.
• Oral appliances: Wearing an oral appliance when you sleep keeps your jaw in the proper position so air can flow. Your healthcare provider might call it a mouth device or mouth guard. A mouth guard used for other purposes, like sports, won’t resolve snoring.

What are the surgical treatments for snoring?

In some cases, snoring and sleep disordered breathing are treated with surgery to shrink or remove excess tissue or correct a structural problem. Many of these procedures are minimally invasive. Your provider uses small incisions, and you may be able to go home the same day. Surgery for snoring includes:

• Laser-assisted uvulapalatoplasty (LAUP): LAUP reduces tissue in the soft palate and improves airflow.
• Radiofrequency ablation: Also called Somnoplasty®, this technique uses radiofrequency energy to shrink excess tissue in the soft palate and tongue.
• Septoplasty: This procedure straightens a deviated septum in the nose. A septoplasty improves airflow through the nose by reshaping the cartilage and bone.
• Tonsillectomy and adenoidectomy: The surgeon removes excess tissue from the back of the throat (tonsillectomy) or the back of the nose (adenoidectomy).

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How can I stop snoring?

You might be able to prevent snoring by changing your lifestyle, diet and daily activities. To reduce snoring, you should:

• Ask your provider about medications to relieve nasal congestion.
• Avoid alcohol and other sedatives before bed.
• Maintain a weight that's healthy for you, stay active and get plenty of exercise.
• Raise the head of your bed a few inches to change the angle and improve airflow.
• Sleep on your side, not your back.
• Try a snore-reducing pillow that keeps your head and neck in the proper position when you sleep.

Occasional snoring due to a cold or flu is usually harmless. But very loud or frequent snoring can be a sign of sleep apnea, which is a serious disorder. Long-term snoring increases the risk of health problems.

 

Last reviewed by a Cleveland Clinic medical professional on 05/07/2021.

What is Parkinson’s Disease

 

Parkinson's disease is a progressive disorder that affects the nervous system and the parts of the body controlled by the nerves. Symptoms start slowly. The first symptom may be a barely noticeable tremor in just one hand. Tremors are common, but the disorder may also cause stiffness or slowing of movement.

In the initial stages of Parkinson's disease, your face may show little or no expression. Your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson's disease symptoms worsen as your condition progresses over time.

Although Parkinson's disease can't be cured, medications might significantly improve your symptoms. Occasionally, your health care provider may suggest surgery to regulate certain regions of your brain and improve your symptoms.

Parkinson's disease signs and symptoms can be different for everyone. Early signs may be mild and go unnoticed. Symptoms often begin on one side of the body and usually remain worse on that side, even after symptoms begin to affect the limbs on both sides.

Parkinson’s disease is cruel -but thousands no longer suffer it…

Symptoms

Parkinson's signs and symptoms may include:

·         Tremor. A tremor, or rhythmic shaking, usually begins in a limb, often your hand or fingers. You may rub your thumb and forefinger back and forth. This is known as a pill-rolling tremor. Your hand may tremble when it's at rest. The shaking may decrease when you are performing tasks.

·         Slowed movement (bradykinesia). Over time, Parkinson's disease may slow your movement, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk. It may be difficult to get out of a chair. You may drag or shuffle your feet as you try to walk.

·         Rigid muscles. Muscle stiffness may occur in any part of your body. The stiff muscles can be painful and limit your range of motion.

·         Impaired posture and balance. Your posture may become stooped. Or you may fall or have balance problems because of Parkinson's disease.

·         Loss of automatic movements. You may have a decreased ability to perform unconscious movements, including blinking, smiling, or swinging your arms when you walk.

·         Speech changes. You may speak softly, quickly, slur or hesitate before talking. Your speech may be more of a monotone rather than have the usual speech patterns.

·         Writing changes. It may become hard to write, and your writing may appear small.

Causes

In Parkinson's disease, certain nerve cells (neurons) in the brain gradually break down or die. Many of the symptoms are due to a loss of neurons that produce a chemical messenger in your brain called dopamine. When dopamine levels decrease, it causes atypical brain activity, leading to impaired movement and other symptoms of Parkinson's disease.

The cause of Parkinson's disease is unknown, but several factors play a role, including:

·         Genes. Researchers have identified specific genetic changes that can cause Parkinson's disease. But these are uncommon except in rare cases with many family members affected by Parkinson's disease.

However, certain gene variations increase the risk of Parkinson's disease but with a relatively small risk of Parkinson's disease for each of these genetic markers.

·         Environmental triggers. Exposure to certain toxins or environmental factors may increase the risk of later Parkinson's disease, but the risk is small.

 

Parkinson’s disease is cruel -but thousands no longer suffer it…

 

Researchers have also noted that many changes occur in the brains of people with Parkinson's disease, although it's not clear why these changes occur. These changes include:

·         The presence of Lewy bodies. Clumps of specific substances within brain cells are microscopic markers of Parkinson's disease. These are called Lewy bodies, and researchers believe these Lewy bodies hold an important clue to the cause of Parkinson's disease.

·         Alpha-synuclein found within Lewy bodies. Although many substances are found within Lewy bodies, scientists believe an important one is the natural and widespread protein called alpha-synuclein (a-synuclein). It's found in all Lewy bodies in a clumped form that cells can't break down. This is currently an important focus among Parkinson's disease researchers.

Risk factors

Risk factors for Parkinson's disease include:

·         Age. Young adults rarely experience Parkinson's disease. It ordinarily begins in middle or late life, and the risk increases with age. People usually develop the disease around age 60 or older. If a young person does have Parkinson's disease, genetic counseling might be helpful in making family planning decisions. Work, social situations and medication side effects are also different from those of an older person with Parkinson's disease and require special considerations.

·         Heredity. Having a close relative with Parkinson's disease increases the chances that you'll develop the disease. However, your risks are still small unless you have many relatives in your family with Parkinson's disease.

·         Sex. Men are more likely to develop Parkinson's disease than women.

·         Exposure to toxins. Ongoing exposure to herbicides and pesticides may slightly increase your risk of Parkinson's disease.

·         Blood pressure changes. You may feel dizzy or lightheaded when you stand due to sudden drop in blood pressure.

·         Smell dysfunction.  You may have difficulty identifying certain odors or the difference between odors.

·         Fatigue. Many people with this disease lose energy and experience fatigue, especially later in the day. 

Prevention

Because the cause of Parkinson's is unknown, there are no proven ways to prevent the disease.

Some research has shown that regular aerobic exercise might reduce the risk of Parkinson's disease.

Some other research has shown that people who consume caffeine — which is found in coffee, tea and cola — get Parkinson's disease less often than those who don't drink it. Green tea is also related to a reduced risk of developing Parkinson's disease. However, it is still not known whether caffeine protects against getting Parkinson's or is related in some other way. Currently there is not enough evidence to suggest that drinking caffeinated beverages protects against Parkinson's.

By Mayo Clinic Staff

 

Parkinson’s disease is cruel -but thousands no longer suffer it…