Managing Migraines

Lacking a miracle cure, your best bet is control

  People often mistake a headache for migraine. However, migraine is more      than just a headache. The Migraine Action Association, a UK-based specialist patient programme that aims to help migraineurs (or migraine sufferers) self-manage their condition, offers a general rule of thumb. If a headache comes with other associated symptoms and prevents you from continuing with normal daily activities, it could be a migraine.

Aside from the obvious headache, two or more of the following symptoms before or during an attack, known as aura, would indicate that you are suffering from migraine:

•   Pre-headache neurological disturbances lasting 15 to 60 minutes

•   Blind spots, flashing lights or visual zigzag patterns

•   Confusion, inability to concentrate, problems with articulation or coordination

•   Tingling sensation, pins and needles or numbness on the affected side

 These symptoms are most often identified with migraine but only about 10-15% of sufferers experience them.

Although some people experience aura symptoms only, the migraine attack normally follows after a short interval. Similarly, migraine without aura or common migraine, could be heralded by some or all of these symptoms:

•   Intense throbbing headache, often on one side of the head only

•   Nausea and/or vomiting and/or diarrhoea

•   Increased sensitivity to light (photophobia), sounds (phonophobia) or smells (olfactophobia)

Migraine attacks normally last between 4 and 72 hours, and sufferers are usually symptom-free between attacks.

What causes migraine?

Migraine is believed to be caused by the release of a chemical called serotonin or 5HT into the bloodstream, resulting in changes in the neurotransmitters and blood vessels in the brain. Exactly what causes this is still a subject for research and debate. However, certain factors have been identified to trigger attacks in susceptible people:

 •   Stress or sometimes the relief of stress

•   Lack of food or infrequent meals

•   Foods containing monosodium glutamate, caffeine and tyramine

•   Certain foods like chocolate, citrus fruits, cheese

•   Alcohol, especially red wine

•   Overtiredness or changes in sleep patterns

•   Hormonal factors

•   Extreme emotions

•   Physical activity

•   Extreme environmental or climatic factors

•   High blood pressure

•   Toothache or pain in the eye, sinuses or neck

•   Anxiety or depression

•   Travel or change of routine

•   Sexual arousal

•   Extremely hot baths

Treating migraine

Many people treat migraine with over-the-counter painkillers (e.g. aspirin, paracetamol, ibuprofen). These can be very effective, especially if taken early in the attack.

If these don’t work, your doctor can prescribe stronger painkillers like 5HT agonists or triptans, which act directly to correct the serotonin imbalance in the brain during a migraine attack. These are available via prescription only and may not be suitable for all patients.

Recourse may also be had from alternative remedies, physiotherapy and hypnosis–all of which have been proven to work for some people.

Migraine is a complex and individual condition. It is important to consult a physician and persevere until you find the right treatment or combination of treatments and diet/lifestyle changes that work for you.

Although the condition cannot be cured, migraine can be managed. Many migraineurs now live completely normal lives, free from attacks because they have learned to control their condition •