Migraine
A migraine is a severe throbbing headache that comes on suddenly and can last a few hours to days. It is a very common health condition that is not completely understood although there can be a history of migraine in some families.
The commonest type of migraine is called a migraine without aura. This is usually described as a moderate or severe throbbing pain that usually affects one side of the head around the temples. The headaches are usually accompanied by other symptoms that vary for each person but include things like vomiting or feeling sick or being sensitive to light or sound, often eased by lying down in a dark quiet room. This type of migraine often begins in the morning and lasts from 4 to 72 hours although it usually peaks up to 12 hours after starting.
A migraines associated with an aura has warning signals that come on just before the migraine is about to happen. Examples of these include flashing lights, numbness, and tingling, dizziness, or muscle weakness. It is also possible to have a silent migraine, where there is no headache but instead just the auras and other migraine symptoms.
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What are migraine triggers?
Migraines can be triggered by certain stressors and situations and so a symptom diary will help you to identify any triggers that may cause your migraines and help you find ways to manage them. Examples of these include stress, menstruation, dehydration, tiredness, certain foods or drinks such as cheese, chocolate, and alcohol, the menopause, and shift work.
How can migraines be treated?
There is no specific cure for a migraine but they can be managed in a number of ways. Simple painkillers are a good place to start, such as paracetamol or ibuprofen. Codeine-based medications are usually best avoided unless discussed with your doctor first.
Triptans are medicines often used in migraine treatment that are started at the first onset of the migraine and work by blocking the pain pathways in the brain. It is also wise to treat any other symptoms linked to a migraine, so anti-sickness medications can also be used separately or together with painkillers, to reduce vomiting or the feeling of being sick (nausea).
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When should I see my doctor?
If your migraines are occurring more frequently (more than 5 days a month) or more severely than you would expect, then discuss this with your doctor. If your migraines are occurring frequently, it might be best for you to try a prevention strategy and a trial of medication to help prevent them from occurring.
You should see your doctor if you experience headaches that come on suddenly and are the worst you have ever experienced.
If there are any changes such as slurred speech, confusion, weakness, and numbness, or if your headaches occur with fever, nausea, vomiting, or stiff neck and confusion, it would be best to treat this as an emergency and call 999 for a more urgent review.
How can I prevent migraines?
By identifying your triggers, you will best be able to understand how to avoid your migraine attacks. If your migraines are occurring more frequently, preventative medicines (where you take tablets every day) can be considered. Examples of these medications include topiramate, propranolol or amitriptyline.
If your migraines are brought about by stress then finding ways to reduce your stress levels can be important, for example through relaxation and meditative techniques. If your migraines occur before your period, it would be worthwhile exploring with your doctor hormonal and non-hormonal medicinal options.
Some specialists may be trained to give Botulinum toxin type A for chronic migraines, which is an injection that paralyses the scalp muscles. For reasons that are currently unclear, these have been shown to be helpful in some people suffering from migraines, as has acupuncture – a non-medicinal treatment.
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