Most of us are familiar with or have experienced throbbing aches in our temples, either one or both sides. Is it just another headache, Right? or No?
Let us know more….
MIGRAINE – WHAT IS IT I SHOULD KNOW
Headache disorders are among the most common disorders affecting people worldwide. Migraine is one of the most common syndromes of headache.
What is migraine?
A migraine is a severe, painful headache that is often preceded or accompanied by specific symptoms such as flashes of light, blind spots, tingling in the arms and legs, nausea, vomiting, and increased sensitivity to light and sound. The pain can be excruciating and can last for hours to days.
Migraine is more common in females. It is mostly observed 3-4 times per month (low-frequency episodic migraine)—the most common type. The other variety is high frequency episodic migraine where the migraine attacks anywhere between 10- 14 times a month.
What causes migraine attack?
Some people who suffer from migraines can identify triggers or factors that cause the headaches, but many cannot.
Potential migraine triggers include:
- Allergies and allergic reactions
- Bright lights, loud noises and certain odours or perfumes
- Physical or emotional stress
- Changes in sleep patterns or irregular sleep
- Smoking or exposure to smoke
- Skipping meals or fasting
- Alcohol
- Menstrual cycle fluctuations, birth control pills, hormone fluctuations during menopause onset
- Tension headaches
- Foods containing tyramine (red wine, stale cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs and salami)
- Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products and fermented or pickled foods.
What are the Signs and symptoms?
Symptoms of migraine can occur a while before the headache, immediately before the headache, during the headache and after the headache. Although not all migraines are the same, typical symptoms include:
- Moderate to severe pain, usually confined to one side of the head, but switching in successive migraines
- Pulsing and throbbing head ache
- Increasing pain during physical activity
- Inability to perform regular activities due to pain
- Nausea
- Vomiting
- Increased sensitivity to light and sound.
Some will have unusual feelings and perceptions called AURA; these are referred to as MIGRAINE WITH AURA. Most patients do not have aura; these are called MIGRAINE WITHOUT AURA. This is the most common subtype seen in Indians.
Auras are disturbances that a person may experience and include:
- confusing thoughts or experiences
- the perception of strange lights, sparkling or flashing lights
- lines in the visual field
- blind spots
- pins and needles in an arm or leg
- stiffness in the shoulders, neck or limbs
- unpleasant smells
Are there any other types of migraine?
There are various other types of migraine
- Retinal migraine—recurrent attacks and frequently involving only one eye – associated with blurring of vision, or seeing blind spots
- Menstrual migraine– many women feel headaches during their menstrual cycle—associated with headaches few days after starting/ finishing their cycle and at no other time.
- Abdominal migraine—seen in children with abdominal pain for one hour to as long as 72 hours associated with nausea, vomiting and loss of appetite.
How do we diagnose migraine?
There is no specific test which can diagnose migraine. Diagnosis will depend upon your doctor taking your medical history and ruling out other causes of the headaches. Maintaining a diary of your symptoms along with your lifestyle pattern sometimes helps to identify the triggers. If other medical conditions coexist alongside your migraine, this is important in terms of treatment as some medications cannot be taken together. A confirmed diagnosis and treatment help to reduce the pain and its frequency.
It requires a comprehensive examination by a physician/ neurologist and ophthalmologist to rule out any other co-existing condition.
What is the treatment?
Some lifestyle modifications might help reduce migraine frequency.
These are
- Getting enough sleep
- Reducing stress
- Drinking plenty of water
- Avoiding certain foods
- Regular physical exercise.
- Migraine treatment (abortive therapies) and prevention (prophylactic therapies) focus on avoiding triggers, controlling symptoms and taking medicines.
- Behavioural therapy can help reduce the frequency of stress-induced migraine.
Do I need to see a doctor on an emergency basis?
The signs and symptoms of migraine can sometimes be confused with those of a stroke.
Meet your doctor if
- Your headache is very severe
- You have problems with movement, balance, vision or speech, and these symptoms are different or new from those you have experienced before with your migraines
- You have a fever with your headache
- You have a stiff neck with your headache
- “The headache starts suddenly like a thunderclap”, especially if you are over 50 years of age.