Migraines, Social Security Disability, and Applying for Benefits

Although the neurological syndrome called "Migraine" is most commonly thought of as a severe, pulsating, painful headache, there are many symptoms which happen during an attack. Other symptoms may include vomiting, nausea, sensitivity to sound, sensitivity to light, pain in various parts of the body and perceptual disturbances called "aura". Aura manifests as either an unpleasant smell or strange lights and is also present in some forms of epilepsy; nearly one-third of migraine sufferers report aura. Some migraines are with aura and some are without.

Migraine usually last from four to seventy-two hours and is extremely common in the United States. Around six percent of men and eighteen percent of women report experiencing migraine. It is thought that migraine disorder can be genetic, though some types may be due to hormone organ disease, injury or hormonal changes. Many female sufferers mysteriously lose their migraines during pregnancy.

Migraines are classified into categories that involve no pain, mild pain, moderate pain and severe pain that can prevent daily activities. When a migraine headache symptom is without aura, diagnosis can only be made if there have been five attacks that last four to seventy-two hours, accompanied by either a pulsating, throbbing quality, moderate or severe pain, aggravation that interrupts physical activity and unilateral location. Two of these symptoms must be present. Also, one other symptom must be present from the following four: nausea, vomiting, sensitivity to sound or sensitivity to light.

When a migraine is with aura it must also be accompanied by visual disturbances such as flickering lights or spots, sensory symptoms such as numbness and pins and needles or speech disturbance. At least one of the symptoms must be present for a diagnosis. In addition, it must also have a least two of these symptoms: visual and/or sensory symptoms affecting just one side of the body, at least one aura symptom lasting over five minutes and symptoms lasting from five to sixty minutes.

There are many different causes or 'triggers' that lead to migraine. Allergic reactions, smoking, skipping meals, certain foods, alcohol, birth control pills, caffeine, the menstrual cycle, stress, bright lights, loud sounds, strong odors, and even certain weather changes can all affect or trigger migraine. At times it may even appear for no apparent reason.

There are different types of migraines, from basilar, familial and abdominal to acephalgic, and menstrual. They signs and symptoms can vary greatly among patients, but there are generally four stages. The first stage is called prodrome and it includes depression or euphoria, sleepiness, food cravings, yawning, fatigue, increased urination, stiff neck muscles and either constipation or diarrhea. These symptoms are usually seen hours or days before the headache comes along. The aura stage, if it is present, generally happens right before the headache stage. Aura can consist of visual impairments, such as cloudy vision, tunnel vision or strange lights and patterns. It can also be accompanied by pins-and-needles, numbness and other odd sensory symptoms, as well as a sensitivity to touch and unpleasant smells.

Next is the pain stage. Generally, a migraine is unilateral and throbbing, and can be moderate to severe. Although it can settle on one side, it may also switch back and forth. The pain stage usually lasts from four to seventy-two hours. During this stage nausea is present in nearly 90 percent of patients.

The last stage of migraine is usually the 'postdrome' stage which leaves sufferers feeling irritable, tired and drained. Some feel depressed, others feel euphoric. A long nap helps many relieve this stage.

There are many theory's on what causes migraine, such as the depolarization theory, vascular theory, serotonin theory, neural theory and unifying theory, though the cause is not completely understood. It is estimated that 12-18 percent of people will experience migraine at some point in their life.

There are many different treatments for migraine. Trigger avoidance is one form of treatment and may require lifestyle changes, such as diet modification. There are also many drugs for symptomatic control and also, preventative drugs. These treatments are not fool-proof, some work and some don't. Non-steroidal anti-inflammatory drugs are usually the first line of treatment. Paracetamol (ibuprofen), aspirin, serotonin agonists, triptans, narcotic pain relievers and other prescription drugs may be used for treatment. Prophylactics are used for management and prevention. Many people have also found that bodywork, massage, acupuncture and a variety of other alternative treatments help with migraine.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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