Migraines

[nicko18]

I'm trying to figure out a bit more with regards to migraines with associated aura's.

One example i came across was a lady who had the zig zag visual patterns, tingling and weakness of the left arm and hand, as well as getting lost driving a familiar route home. Then left sided head pain always followed.

I've read some theories stating that a spasming of blood vessels on one side of the cerebrum can cause these signs, but there's one thing i cant understand. Certainly if a reduced blood flow to the right hemisphere causes the neurologic signs, why does the subsequent increased flow and stretch cause head pain on the same side as the neurologic signs?

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[vcatz]

Wolf's Headache is a decent reference. There are also a number of great review articles you can find by searching PubMed. The main theory regarding migraine, especially with aura, is called cortical spreading depression. Again there are a number of great papers on this in the medical literature.

 

[MarchMover]

Migraine is one of these weird phenomena that we don't really understand yet because we still don't really understand the brain....

The zig-zag or "fortification spectra" as we like to call that visual aura, is what we refer to as a positive phenomenon. Purely vascular events usually create negative phenomena, such as a scotoma, or hole in the visual field. So, trying to use vasospasm and ischemia as an explanation for this aura falls short of the meat, which is that the brain is producing something abnormal during these aura.

Couple this with the knowledge that while about 1-2% of the population at large will have an abnormal EEG without associated findings, up to 9% of migraineurs have abnormal EEGs. There is something functionally abnormal with the way these brains behave.

I would recommend Oliver Sack's "Migraine" as a nice read, it's not a textbook, and not his usual quasi-medical effort. It's well annotated and includes a lot on the mechanism.