On Tuesday, we reported on LA news reporter Serene Branson’s “neurologic event” of garbled speech on live TV after the Grammy Awards. Many speculated that she may have suffered a stroke or transient ischemic attack on air. We can now report that this was not the case. Branson’s physician, Dr. Neil Martin, chief of neurosurgery at the Ronald Reagan UCLA Medical Center, told the LA Times that she had experienced a complex migraine.
What is a Migraine Headache?
A migraine headache is a severe headache, usually described as throbbing, or pulsing. It most commonly occurs on one side of the head, and is felt to be coming from behind the eye, temple or ear. It can last anywhere from four to seventy-two hours, and interferes with daily activity. It is frequently associated with nausea and vomiting, and sensitivity to light and sound. About one in five migraine sufferers have what has been called classic migraine (now called migraine with aura). These patients can tell that their headache is coming by experiencing an aura 10 to 30 minutes before the onset of the headache. An aura is an unusual sensory perception which can be visual, olfactory or non-visual. Visual auras are most common and are described as seeing wavy or zigzag lines or flashing lights. Non-visual auras include motor weakness, speech or language abnormalities, dizziness, vertigo, and tingling or numbness of the face, tongue, or extremities.
A “complex migraine” is one in which there are neurological symptoms such as weakness, loss of vision, or difficulty speaking in addition to the headache. In fact, a complex migraine may be mistaken for a stroke. Unlike a stroke, the neurologic symptoms of a complex migraine are almost always temporary.
Migraines affect 30 million people in the US, beginning at age 10 and decreasing after age 50.
It used to be thought that migraines were caused by dilation (opening) of blood vessels in the head, but more recent research shows that migraines may be related to genes that control the activity of some brain cells. Even though the cause be not be known, certain things have been found to trigger migraine headaches. These include stress, hormonal changes, certain foods (alcohol, caffeine, cheese, chocolate), sleep deprivation, and sensory stimuli such as bright lights or sun glare.
Treatment is either symptomatic- over the counter pain relievers or prescription medications such as Imitrex, designed to stop an migraine in progress, or preventive- avoidance of known triggers, and certain medications (beta blockers, antidepressives, anti-seizure medications) taken on a daily basis to prevent migraines from starting.
For more information about migraines, click here to go to the Resounding Health Casebook on the topic.