Migraine is a common neurological disorder characterised by debilitating head pain and an assortment of additional symptoms which can include nausea, vomiting, photophobia, noise intolerance and occasionally visual sensory disturbances. Migraine is the most frequent type of headache in children.
Migraine is a multifactorial condition with predisposing genetic variants and environmental factors. It affects approximately    12 % of studied Caucasian populations with affected individuals being predominantly female. True migraine is consistently
present with aura, which provides warning of the upcoming attack. Migraines may begin at any age; they are most common between age 10 and 30 and may vanish after age 50 or, in women, after menopause.
Migraine attacks are characterised by throbbing, recurring headaches, typically affecting only one side of the head. Onset is sudden, and pain is usually severe. Visual, auditory, neurological, or gastrointestinal symptoms may appear 10 to 30 minut
es before head pain or may accompany the headache. Duration may be from a few hours to several days.
Research supports a relationship between mitochondrial dysfunction and migraine, as abnormal mitochondrial function leads to into high intracellular penetration of Ca2+, excessive production of free radicals, and deficient oxidative phosphorylation, which ultimately causes energy failure in neurons and astrocytes, thus triggering migraine mechanisms, in
cluding spreading depression. Mitochondrial abnormalities have been shown in migraine sufferers , including direct observation in muscle biopsy of ragged red and cytochrome-c oxidase-negative fibres , as well as other cellular abnormalities. Specific genetic mutations have been identified responsible for migraine susceptibility.
Also, abnormal serotonin metabolism has been implicated in the pathogenesis of this disease. Serotonin causes blood vessels to the brain and scalp to constrict and then dilate, irritating surrounding nerves and resulting in pulsating or pounding pain with blood flow.

Risk factors:
“Triggers” are specific factors that may increase the risk of migraine attacks. Triggers do not cause migraine, but are thought to activate the process in susceptible migraine sufferers. It is recommended to keep a ‘headache diary’ to identify their        triggers.
Dietary triggers: Skipping meals / fasting, sensitivity to specific foods
Medications: Overuse of pain medication or missed doses of usual medications may trigger
Changes in sleep patterns: Napping, oversleeping, too little sleep
Hormonal fluctuations: menstrual cycles, contraceptive pill, HRT, peri-menopause, ovulation
Environmental: Weather and temperature changes, bright lights, odours / pollution, or factors such as air travel or high altitude
Stress: Periods of high stress, accumulated stress, reacting easily to stress, repressed emotions
Stress letdown: Weekends, vacations, ending a stressful task or project
Physical: Over exertion, injuries, visual triggers (eye strain, bright lights, computer screens)
• Becoming over-tired or fatigued

Signs and Symptoms:
Common signs and symptoms of migraine include the following:
• Aura preceding headache: irritability, restlessness, hearing or vision disturbances, numbness, weakness, or tingling sensations may precede head pain or may be present with headache
• Severe, throbbing, usually unilateral headache
• Headache accompanied by increased sensitivity to light and noise
• Headache persists for hours and if untreated may last days
• Pounding pain worsens with movement or bending
• Nausea, vomiting
• Near-syncope (almost fainting), vertigo
• Feet and hands may be cold and cyanosed (blue)
• Scalp arteries may be prominent