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Migraines

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Headaches aren’t uncommon. In fact, almost everyone will experience at least one headache in their lifetime, and many will deal with them off and on throughout their lives. However, some headaches are worse than others. These may be migraines.

There are several theories on the mechanism of a migraine. It is a complex disorder that is caused by the interaction of nerve impulses and the release of chemicals that irritate some parts of the brain. These parts include the cerebral cortex and the trigeminal nerve, which is the largest cranial nerve.

The majority of all headaches are not migraines. Simply put, they are pain signals within your head. These headaches are most often associated with and made worse by fatigue, sleep deprivation, certain allergens, or stress. They’re usually successfully treated with medications or rest.

 

Symptoms

People with migraines may experience:

• sensitivity to light or noise

• dizziness

• eye pain

• nausea or vomiting

• vision blurring

• visual aura, such as seeing “floaters” or bright spots

• irritability

• headache itself

Risk factors

Both migraines and tension headaches affect women more than men. In fact, 3 out of 4 people who get migraines are women. This may be because of hormonal fluctuations brought on by menstruation or menopause.

Though obesity isn’t a direct trigger of migraines, being significantly overweight can increase the risk for a regular headache progressing into a migraine.

Signals

Your body may give you warning signs a day or two before a migraine occurs. These subtle changes include:

• constipation

• depression

• diarrhea

• hyperactivity

• irritability

• neck stiffness

• Such symptoms typically don’t occur before a tension headache.

 

Triggers

For migraines, the most common include:

• alcohol use

• bright lights (photophobia)

• consumption of sweets or processed foods

• changes in sleep patterns, including lack of sleep

• exposure to odors, such as strong perfume or cigarette smoke

• loud noises (phonophobia)

• skipping meals

• in females, hormone changes

Diagnosis

There's no specific test to diagnose migraines. For an accurate diagnosis to be made, a GP must identify a pattern of recurring headaches along with the associated symptoms. Migraines can be unpredictable, sometimes occurring without the other symptoms. Obtaining an accurate diagnosis can sometimes take time.

On your first visit, a GP may carry out a physical examination and check your vision, co-ordination, reflexes and sensations.

They may ask if your headaches are:

• on 1 side of the head

• a pulsating pain

• severe enough to prevent you carrying out daily activities

• made worse by physical activity or moving about

• accompanied by feeling and being sick

• accompanied by sensitivity to light and noise

Migraine diary

To help with the diagnosis, it can be useful to keep a diary of your migraine attacks for a few weeks. Note down details including:

• the date

• time

• what you were doing when the migraine began

• how long the attack lasted

• what symptoms you experienced

• what medicines you took (if any)

Regularly taking frequent doses of painkillers is an important reason why migraines can become difficult to treat. Doing so can cause a medication overuse headache.

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Migraine management

Migraine management is essential because of the debilitating effects. Current Pain and Headache Reports estimates that people who have chronic migraines miss an average of five work days in a three-month period. People who get regular migraines were also found to make less income than people who don’t.

Some treatment options include:

• antidepressants

• other prescription drugs, for both prevention and acute treatment

• birth control pills (for women)

• daily exercise

• dietary changes

• getting adequate sleep

• meditation

• yoga

Talk to your doctor. They can help you explore ways to treat your migraines.

 

Prevention

There are a number of ways you can reduce your chances of experiencing migraines.

1. Identifying and avoiding triggers .Keeping a migraine diary can help you identify possible triggers and monitor how well any medicine you're taking is working. In your migraine diary, try to record:

• the date of the attack

• the time of day the attack began

• any warning signs

• your symptoms (including the presence or absence of aura)

• what medicine you took

• when the attack ended

1. Medicines and supplements. Medicines are also available to help prevent migraines. These medicines are usually used if you have tried avoiding possible triggers but you're still experiencing migraines.

2. Acupuncture.

3. Preventing menstrual-related migraines.

4. Non-hormonal treatments.

• non-steroidal anti-inflammatory drugs (NSAIDs)

• triptans – medicines that reverse the widening of blood vessels, which is thought to be a contributory factor in migraines.

1. Hormonal treatments

• combined hormonal contraceptives, such as the combined contraceptive pill, patch or vaginal ring

• progesterone-only contraceptives, such as progesterone-only pills, implants or injections

• oestrogen patches or gels, which can be used from 3 days before the start of your period and continued for 7 days.

*Hormonal contraceptives are not usually used to prevent menstrual-related migraines in women who experience aura symptoms because this can increase your risk of having a stroke.

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