• Dr. Anshu Sachdev

MIGRAINES – THE EXASPERATING MENACE



WHAT IS A MIGRAINE?

A migraine is defined as a moderate or severe headache felt as a throbbing pain on one side of the head. It is a common health condition, affecting around one in every 5 women and one in every 15 men. They usually begin in early childhood.


There are several types of migraines, including:


· Migraine with aura – where there are specific warning signs just before the migraine begins, such as seeing flashing lights.


· Migraine without aura – the most common type, where the migraine occurs without the specific warning signs.


· Migraine aura without headache – also known as silent migraine, this is where an aura or other migraine symptoms are experienced but a headache doesn’t develop.

Some people have migraines frequently, upto several times a week. Other people may only have a migraine occasionally. It’s possible for years to pass between migraine attacks.


SYMPTOMS OF MIGRAINES

The main symptom of a migraine is usually an intense headache on one side of the head.


The pain is usually a moderate or severe throbbing sensation that gets worse when you move and prevents you from carrying out normal activities. In some cases, the pain can occur on both sides of your head and may affect your face or neck.


Additional symptoms

Other symptoms commonly associated with a migraine include:

· Nausea

· Vomiting

· Increased sensitivity to light and sound – which is why many people with a migraine want to rest in a quiet, dark room

· Sweating

· Poor concentration,

· Feeling very hot or very cold

· Abdominal pain

· Diarrhea


Not everyone with a migraine experiences these additional symptoms and some people may experience them without having a headache. The symptoms of a migraine usually last between four hours and three days, although you may feel very tired for up to a week afterwards.


STAGES OF A MIGRAINE

Migraines often develop in distinct stages, although not everyone goes through all of these:


1. Prodromal (pre-headache stage) – changes in mood, energy levels, behavior and appetite that can occur several hours or days before an attack.

2. Aura – usually visual problems, such as flashes of light or blind spots, which can last for 5 minutes to an hour.

3. Headache stageusually a pulsating or throbbing pain on one extra side of the head, often accompanied by nausea, vomiting, and/or extreme sensitivity to bright light and loud sounds, which can last for 4 to 72 hours.

4. Resolution stage – when the headache and other symptoms gradually fade away, although you may feel tired for a few days afterwards.


CAUSES OF MIGRAINES

The exact cause of migraines is unknown, but they’re thought to be the result of abnormal brain activity temporarily affecting nerve signals, chemicals and blood vessels in the brain. It is unclear what causes this change in brain activity, but it’s possible that your genes make you more likely to experience migraines as a result of a specific trigger.


MIGRAINE TRIGGERS

Many possible migraine triggers have been suggested, including hormonal, emotional, physical, dietary, environmental and medicinal factors.


These triggers are very individual but it may help to try to observe and notice a pattern. It can also sometimes be difficult to tell if something is really a trigger or if what you're experiencing is an early symptom of a migraine attack.


1. Hormonal changes

Some women experience migraines around the time of their period, possibly because of changes in the levels of hormones such as Oestrogen around this time.

These types of migraines usually occur between two days before the start of your period to three days after. Some women only experience migraines around this time, which is known as pure menstrual migraine. However, most women experience them at other times too and this is called menstrual related migraine.

Many women find their migraines improve after the menopause, although the menopause can trigger migraines or make them worse in some women.


2. Emotional triggers:

· Stress

· Anxiety

· Tension

· Shock

· Depression

· Excitement


3. Physical triggers:

· Exhaustion

· Poor quality sleep

· Poor posture

· Neck or shoulder tension

· Jet lag

· Low blood sugar (Hypoglycaemia)

· Strenuous exercise, if you're not used to it


4. Dietary triggers:

· Missed, delayed or irregular meals

· Dehydration

· Alcohol

· Caffeine products, such as tea and coffee

· Specific foods such as chocolate and citrus fruit

· Foods containing the substance tyramine, which include cured meats, yeast extracts, pickled herrings, smoked fish such as smoked salmon and certain cheeses such as cheddar, Stilton and Camembert. Foods that have been stored at room temperature, rather than being refrigerated or frozen can also have rising levels of tyramine.


5. Environmental triggers:

· Bright lights

· Flickering screens, such as a television or computer screen

· Smoking (or smoky rooms)

· Loud noises

· Changes in climate, such as changes in humidity or very cold temperatures

· Strong smells

· Stuffy atmosphere


6. Medication:

· Some types of sleeping tablets

· Combined contraceptive pill

· hormone replacement therapy (HRT), which is sometimes used to relieve symptoms associated with the menopause


Migraine headaches can be severe, debilitating, and uncomfortable. Many treatment options are available, so be patient finding the one or combination that’s best for you. Keep track of your headaches and symptoms in order to identify migraine triggers. Knowing how to prevent migraines can often be the first step in managing them.

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