A migraine is not “just a headache.” It is a complex neurological condition, which affects the whole body and may result in many symptoms including a headache with a throbbing pain, nausea, vomiting and sensitivity to light. It can be easily mistaken or overlooked for other health conditions and can affect people in different ways.
The definite cause of a migraine is not known. However, genetics and environmental factors are believed to play a role, apart from changes in brain activity and certain brain chemical imbalances.
It is believed that there are ‘triggers’ that bring on a migraine, although finding out an individual’s specific trigger is not always easy.
Some common triggers include:
- Lack of food or infrequent meals
- Changing sleep pattern
- Extreme heat or cold
- Hormonal changes during periods and menopause
- Bright light (glare) or loud noise
- Over-exertion or fatigue
- Alcohol, especially red wine
- Strong smell of chemicals, like those found in petrol, perfumes, etc.
- Foods like aged-cheese, coffee, nuts, chocolate, tomatoes, etc.
- Food additives and preservatives like monosodium glutamate (MSG), aspartame, etc.
- Emotions – anger, excitement or grief
Several factors increase the risk of having migraines, including:
- Age. A migraine can begin at any age, but it often starts during adolescence and tends to peak during 30’s and gradually becomes less frequent and less severe in the following decades.
- Family history. If there is a family member with a migraine, then you may have a high probability of developing them too.
- Sex. Women are three times more prone to suffer from migraines.
Migraines often begin in adolescence or early adulthood. They usually progress through various stages:
- Recovery stage
Though, everyone may not experience all the phases.
Prodrome or warning stage
1 or 2 days before a migraine, a person may notice subtle changes that may warn of an upcoming migraine, like:
- Mood changes
- Food cravings
- Neck stiffness
- Increased thirst and urination
Aura may occur before or during migraines. These usually include vision disturbances such as flashes of light or wavy vision. However, sometimes it can also include sensory, motor or verbal disturbances. Each of these symptoms begins gradually and lasts for about 20 to 60 minutes. Examples of migraine aura include:
- Visual disturbances like seeing different shapes or bright spots
- Weakness or numbness in the face or one side of the body
- Hearing noises or music
- Sensations of pins and needles in arms and legs
- Difficulty in speaking
- Uncontrollable movements or jerking
- Sometimes, a migraine may be associated with limb weakness
A migraine headache usually lasts from 4 to 72 hours if left untreated. The frequency of headaches varies from person to person. You may experience:
- Severe pain on one or both sides of the head
- Throbbing or pulsing pain
- Nausea and vomiting
- Sensitivity to light, sounds, smells and sometimes touch
- Blurred vision
The stage occurs after a migraine attack. In this stage, the pain eases or disappears, but you may feel drained and washed out. For about 24 hours, you may also suffer from:
- Sensitivity to light and sound
You may take a few days to fully recover. Though some lucky folks can recover surprisingly quickly.
A doctor expert in treating headaches (neurologist) may diagnose migraines depending on your medical history, symptoms, physical and neurological examination.
The doctor may also recommend some more tests to rule out other possible causes for pain like:
- Blood tests: To tests for any infections.
- Magnetic resonance imaging (MRI): MRI scans can help to diagnose tumours, bleeding in the brain, strokes and any other brain or nervous system (neurological) conditions.
- Computerised tomography (CT) scan. This also helps doctors diagnose tumours, brain damage, bleeding in the brain or other medical problems that may cause headaches.
Many medications are available to treat migraines. Medicines used for its treatment fall into two broad categories:
Pain-relieving medication: Also, known as acute or abortive treatment, these drugs are taken during migraine attacks and are they help in treating the symptoms. These can include:
- Ergotamine and caffeine combination drugs
- Anti-nausea drugs
Preventive medicines. These types of drugs are taken on a regular basis, often daily, to reduce the frequency or severity of migraines. These can includes
- Cardiovascular drugs
- Anti-seizure medication
- Botox injections may be injected into the muscles of neck and forehead
- Nonsteroidal anti-inflammatory drugs
Lifestyle and home remedies
Few self-care measures can help in reducing the migraine pain like:
- Rest and relax: Try to rest in a dark and quiet room when you feel a headache is going to start. Apply a cold pack on the back of your neck and apply gentle pressure to painful areas on your scalp.
- Muscle relaxation exercises: Relaxation methods like progressive muscle relaxation, yoga, or meditation can also help in relieving the pain.
Until recently, experts recommended avoiding common triggers of a migraine. Some triggers can’t be avoided. But some of these lifestyle changes and coping strategies may help in reducing the number and severity of your condition:
- Make a diary: Write down what you ate, drank or did before an attack. Identifying the triggers means you can take steps to avoid them.
- Eat and drink regularly: Dieting or fasting may trigger an attack. Having your meals at regular times each day may reduce the chances of a migraine.
- Follow a sleep routine: Try going to bed and awakening at the same time each day. Get enough sleep but avoid oversleeping.
- Exercise: Go jogging or join a gym. Keeping your body fit and healthy is a great way to reduce migraines.
- Reduce stress: Regular workout, yoga, deep breathing exercises and meditation can be good stress relievers.
- Avoid overstimulation of senses: Avoid using bright lights. Have your sunglasses handy on sunny days. Stay away from fragranced oils and soaps.
- Psychological support: Cognitive behavioural therapy and coping skills can help individuals in handling migraine attacks.
When to consult a doctor?
Migraines are often left untreated and undiagnosed. If you regularly experience symptoms of migraine attacks, try to keep a record of your headaches and how you got relief. Then take an appointment with your physician to discuss your condition.
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- Migraine. http://www.pfizer.ca/sites/g/files/g10017036/f/201410/Migraine.pdf. Accessed on 13th Dec 2016.