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What is migraine?
Migraine is a chronic condition that causes attacks of headaches. It also causes other symptoms such as feeling sick (nausea) or being sick (vomiting) are also common between migraine attacks, the symptoms vanish completely.
Who gets migraine?
Migraine is one of the most common. About 1 in 4 women and about 1 in 12 men develop migraine at some point in their lives. It is mostly common in the initial years of adulthood or as a child. Some people have frequent migraine attacks lasting several days a week. Dr Shabrez Tariq, MD says “Some have attacks only now and then. Some attacks may go for years between them. In some people, the migraine attacks stop in later adult life. However, in some cases the attacks continue (persist) throughout life.”
What are the types and symptoms of migraine?
There are two main types of migraine attack:
Common migraine: This is the most common type of migraine. Symptoms include the following:
- Usually the headache is on one side of the head, normally at the front or side occasionally it is on both sides of the head and frequently it starts on one side, and then radiating all over the head. The pain is moderate to severe and is generally described as throbbing or pulsating movements of the head which may make it worse. It often begins in the morning but may begin at period of the day or night. Occasionally, it gradually gets worse and peaks after 2 and up to 12 hours, then slowly eases off.
- Other Migraine symptoms:
o Feeling sick (nausea)
o Being sick (vomiting)
o Not liking bright lights or loud noises, so that you may just want to lie in a dark room
- Some other Migraine symptoms:
o Being off food
o Blurred vision
o Poor concentration
o Stuffy nose
o Hunger
o Diarrhoea
o Tummy (abdominal) pain
o Passing lots of urine
o Going pale
o Sweating
o Scalp tenderness
o Sensations of heat or cold
Classic migraine: About 1 in 4 people with migraine have classic migraine. These symptoms are the same as those described above in common migraine, but also include a warning sign (an aura) before the headache begins.
Visual aura is the most common type of aura. Its includes a temporary loss of part of vision, flashes of light, objects may seem to rotate, shake, or boil. Numbness and pins and needles are the second most common type of aura. Numbness usually starts in the hand, travels up the arm, then involves the face, lips, and tongue. The leg is sometimes involved. Problems with speech are the third most common type of aura. Other types of aura include an odd smell, food cravings, a feeling of well-being, other odd sensations.
One of the above auras may develop, or other may occur one after each other. Each of the aura usually lasts just a few minutes before going but can last up to 60 minutes. The aura usually goes before the headache starts. The headache usually develops within 60 minutes of the end of the aura, but it may develop often straight afterwards.
Diagnosing Migraines, Do I need any tests?
Usually diagnosed by the typical symptoms, there is no test to confirm migraine. A doctor like Dr Tariq can usually be confident that you have migraine if you have typical symptoms and by an examination which does not reveal any abnormality.
Causes of migraine?
The causes for migraine are not clear. Earlier it was believed blood vessels in parts of the brain become narrower (go into spasm) which accounted for the aura. The blood vessels were then thought to open wide (dilate) soon afterwards, which accounted for the headache. It is now thought that some chemicals in the brain increase in activity and parts of the brain may then send out confusing signals which cause the symptoms.
Migraine treatment
Medication: Paracetamol or aspirin works well for many migraine attacks. Take a dose as early as possible after symptoms begin. If you take painkillers early enough, they often reduce the severity of the headache, or stop it completely. A lot of people do not take a painkiller until a headache becomes really bad. This is often too late for the painkiller to work well.
Anti-inflammatory painkillers probably work better than paracetamol. They include ibuprofen and aspirin.
Injections: For treating chronic migraines and headaches, injections like the Occipital nerve block and Sphenopalatine ganglion block have proven to be effective. BOTOX® injections are the first and only FDA-approved preventive treatment proven to reduce migraine and headache days every month.
Migraine treatment & Headache treatment options available at DPMC
- BOTOX injection
- Occipital nerve block
- Sphenopalatine ganglion block