MIGRAINES

A MIGRAINE is usually an intense pounding headache that can last for hours or even days. The pounding or pulsing pain usually begins in the forehead, the side of the head, or around the eyes. It is often associated with nausea, vomiting, and extreme sensitivity to light and sound. For some persons, a warning symptom known as an aura occurs before or with the headache. An aura can include visual disturbances, such as flashes of light or blind spots, or other disturbances, such as tingling on one side of the face or in an arm or leg.

The pain of a migraine headache can be intense; it can get in the way of your daily activities. According to the WHO, “Half to three quarters of adults aged 18–65 years in the world have had headache in the last year, and among those individuals, 30% or more have reported migraine”. Headache disorders are a worldwide problem; they affect people of all ages and races. Not only are headaches painful, but they are also disabling; they enforce a burden on sufferers such as personal suffering, impaired quality of life and financial cost.

CAUSES

The exact cause of migraines is unknown, but they are thought to be the result of abnormal brain activity that briefly affects nerve signals, chemicals and blood vessels in the brain.

Risk Factors

• Family history: You are much more likely to have migraines if one or both of your parents had migraines.
• Sex: Women are more likely than men to have migraines.
• Age: Migraines can start at any age, but usually begin before age 40.

Triggers

• Food and drink: Certain food and drink may trigger your migraines. Dehydration and dieting/ skipping meals may also trigger migraines.
• Hormone changes: Women may experience migraines related to their menstrual cycles or to menopause. Women can also develop migraines when using hormonal birth control or hormone replacement therapy.
• Stress: Stress may trigger migraines. Stress includes feeling overwhelmed about a situation. Anxiety, excitement and any form of tension and shock may also start a migraine.
• Sleep: An abnormal sleep pattern, such as getting too much or too little sleep can initiate migraines.
• Senses: Loud sounds, bright lights (such as flashing lights or sunlight), or strong smells (such as paint or some perfumes) may trigger migraines.
• Illness: Infections, such as the cold or the flu, may produce migraines.
• Medicines: Certain medicines may trigger migraines. If you think your migraines might be related to your medicine, talk to your doctor. Your doctor may be able to prescribe a different medicine.

 
SYMPTOMS

Migraines usually include an intense throbbing pain on one side of the head or both sides. They may also include some of the symptoms below:

• Headache that worsens with physical activity
• Nausea or vomiting
• Blurred vision or blind spots
• Being bothered by light, noise, or odors
• Feeling tired and/or confused
• Feeling cold or sweaty
• Stiff or tender neck
• Lightheadedness
• Tender scalp

DIAGNOSIS

Your doctor can diagnose migraines by the symptoms you explain. If the diagnosis is not certain, your doctor might want to do blood tests or imaging tests, such as an MRI or CT scan of the brain. These tests can help to confirm that there are no other causes for the headache (such as tumors, infections or bleeding in the brain).

TREATMENT

Currently, there is no cure for migraines; however, there are a number of treatments available to help ease the symptoms. It may take some time to work out the best treatment for a person. Someone may need to try different types or combinations of medicines before they can find the most effective ones.

Medications used to relieve migraine pain work best when they are taken at the first sign of a migraine; that is as soon as signs and symptoms of a migraine begin. It is important to note that taking any form of painkiller frequently can sometimes make migraines worse. This is called a medication overuse headache or painkiller headache.

MEDICATIONS

Pain relievers

Some examples of these medications include Acetaminophen (Paracetamol, Tylenol), Ibuprofen (Advil, Motrin) and Aspirin. There are also some combination medications like Excedrin that combine caffeine, aspirin and acetaminophen. These medications may be helpful, but usually work best for mild migraine pain.

Triptans

These medicines are specific pain relievers for migraine headaches. They are thought to work by reversing the changes in the brain that may cause headaches. These are prescription drugs such as sumatriptan (Imitrex, Tosymra), rizatriptan (Maxalt) and eletriptan (Relpax). Triptans are available as tablets, injections and nasal sprays.

Anti- Sickness Medications

Anti- Sickness medications, also called Anti-emetics (eg. Gravol) can successfully treat migraines in some persons, especially when used in combination with some pain relievers. The side effects of these medications include drowsiness and diarrhea.
 
Tip#1:

During a migraine

When symptoms of a migraine start, try going into a quiet and dark room. Close your eyes and rest or take a nap. Placing a cool cloth or ice pack wrapped in a towel or cloth on your forehead or at the back of your neck, may help to ease the pain.

Tip#2:

URGENT!!

You should go to a hospital immediately if you or someone you are with experiences an intense headache with any of the other symptoms below:

• Headache with paralysis or weakness in one or both arms/legs (or one side of the face)
• Headache with slurred speech
• A sudden excruciating headache resulting in a severe pain unlike anything experienced before
• Headache along with a fever, stiff neck, mental confusion, seizures, double vision and a rash

These symptoms may be a sign of a more serious condition, such as a stroke or meningitis, and should be assessed by a doctor as soon as possible.

Tip#3:

Migraine diary
 
Keeping a migraine diary can help you and your doctor to determine some of your triggers. Keep a record of when you get migraines and document: what you were doing, where you were, what you were eating, whether you felt stressed or not, and any other symptoms you experienced. Knowing your triggers can help you better prevent migraines.

Tip#4:

Prevention

Develop a sleeping and eating routine. Try not to sleep too much or too little; set and follow a consistent sleep and wake schedule daily. Also, try to eat meals at the same time every day.

Drink plenty of fluids. Try to stay hydrated, preferably with water.

Exercise regularly. Regular aerobic exercise reduces tension and can help prevent a migraine. Regular exercise can also help you to lose weight or maintain a healthy body weight, as obesity is thought to be a cause of migraines.

Tip#5:

Acupuncture

Acupuncture is a part of traditional Chinese medicine. It involves inserting very thin needles into pressure points on the body. Studies have shown that acupuncture may be helpful for headache pain.

 
I hope these tips on Migraines were helpful; Remember, Your Health Is Invaluable.

Dr. J. Lawarna Matthew
 
Acknowledgements
The Migraine Trust
https://www.migrainetrust.org/
World Health Organization
https://www.who.int/news-room/fact-sheets/detail/headache-disorders
American Migraine Foundation
https://americanmigrainefoundation.org/living-with-migraine/migraine-essentials/ 
Visit any of the links above for more information.