Migraine

Migraine

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Migraines are like a very severe headache, with additional symptoms such as dizziness, nausea, and oversensitivity to light and sound. As they are a medical condition different to a normal headache, they need to be treated differently too. Women tend to experience migraines more than men do, and although the definite cause is not clear, it’s believed there is a genetic link as if you have a relative who suffers from them, you are more likely to as well. They can be immensely painful, and last from a few hours to a few days, which can have a huge impact on your life, impacting your ability to hold down a job or live life as normal. Some people also experience a visible aura during or just before a migraine attack, which can impair your vision significantly. From iMeds you can buy two types of medication to help manage the severity of migraine attacks: beta blockers and triptans. Regular over the counter painkillers such as paracetamol and ibuprofen don’t usually prove very effective against migraines.

Migraines are different and more severe than a headache, and can include other symptoms such as oversensitivity to light and sound, nausea and dizziness. This combination of symptoms can leave you bed bound whilst you’re having a migraine attack, but as soon as the attack is over the symptoms usually disappear. These attacks generally last 4-72 hours. If you experience them several times a month, you should speak to your doctor about preventative treatment. There are two main types of treatment: beta blockers which lower your heart rate, or triptans which reduce inflammation and constrict blood vessels in the brain so the attack isn’t so severe.

Migraines explained

A migraine is a type of very severe headache which comes with other side effects and symptoms. They are usually characterised by a throbbing on one side of the head, and are often excruciatingly painful. The combination of pain and other side effects may leave you wanting to lie in a dark room in silence until it's passed, which may be anything from a few hours to several days. Suffering from migraines is not an uncommon problem, and although they tend to lessen as you get older, it is an ongoing condition that can affect some people very severely. Alongside the pain of the headache, symptoms of a migraine include:

  • Nausea
  • Vomiting
  • Stomach pain
  • Sweating
  • Poor concentration
  • Feeling too hot or too cold
  • Diarrhoea
  • Lethargy and exhaustion
  • Sensitivity to light, sound smell

How do I know if I have a migraine or a headache?

A lot of headaches can be very painful and some may last for hours or even days. There are different types of headaches caused by different factors, but they are inherently different from migraine. Migraines are more painful, usually on one side of the head (although there may stretch across both sides, or across the forehead, but never across the back), and have other severe symptoms such as those listed above. Mild painkillers such as paracetamol will usually clear up a standard headache, but you should speak to your doctor if you have them persistently, paracetamol doesn't fix the problem, or you think may be something more serious going on. Your chance of suffering from a migraine is increased if a close family member suffers from them too.

What causes migraines?

No one is certain of the exact factors which cause someone to suffer from migraines, but it appears that you are more likely to have them if you are female, or you have a relative who also suffers from them. Some women who suffer from migraines report that they get more frequent or severe at the point in their menstrual cycle when the oestrogen levels drop. This is thought to be due to the sudden change of hormones, not due to having a low level of oestrogen. It is because of this that women who have previously suffered from migraines, or have a family member who suffers from migraines, should not be prescribed the combined (progestogen and oestrogen) contraceptive pill as the combined pill is known to exacerbate the drop in oestrogen levels, which can potentially make migraines worse. It doesn't mean they can't take any contraceptive pill though. They are likely to be prescribed the POP (progestogen only pill) instead.

If you know you suffer from migraines regularly, try to keep a diary of what has happened in the hours and days before an attack. This might help you to identify triggers which bring on a migrant attack. Trigger may include but not limited to:

  • Changes in your emotions such as stress, tension, grief, shock, depression, anxiety or excitement
  • Physical changes such as tiredness, poor sleep, poor posture, tension in your neck or shoulder, jet lag or low blood sugar levels, known as hypoglycaemia
  • Food related triggers such as dehydration, skipping meals, caffeine or alcohol consumption, or specific foods such as cheese
  • Environmental triggers such as bright lights, being around people who smoke, humidity, loud noises or flickering lights and screens
  • Some types of medication

What is a migraine with aura?

Migraines can be divided into two types: those with an aura and those without. Around one third of migraine sufferers experience aura before or during an attack. Symptoms of an aura include:

  • Seeing things that aren't there such as flashing lights
  • Blurring or loss of vision
  • Numbness
  • Dizziness
  • Vertigo
  • Having blindspots in your vision
  • Seeing zig zag lines

If you usually experience an aura with your migraine, you may very occasionally get the aura without a migraine. Whenever you are experiencing an aura you should not drive or operate machinery, especially if it affects your vision.

Who can get migraines?

Migraines are a long-lasting condition which don't usually affect people on a one-off basis, but anyone can suffer from an attack. However, there are certain factors which put some groups of people at a higher risk of getting them. If one of your close relatives suffers from migraines, you are more likely to as well as there is believed to be a genetic factor involved in what causes them. Migraine attacks usually begin adolescence, and tend to affect more women than men. It is thought that migraines are linked to hormonal balances in the body, as women tend to suffer them more when the oestrogen levels drop in their menstrual cycle. Women have also reported fewer or less painful migraines during the second and third trimester of pregnancy, and especially after the menopause. If you experience migraines very regularly (for example they affect you for more than a few days a month), you should speak to your doctor about medication to treat the problem. Migraine attacks may begin before adolescence, but when children suffer from them, they are usually shorter and the pain only lasts for less than an hour.

How often do you get migraines?

Migraines can vary in frequency in severity very widely dependent on the individual. Although it is very rare to only have one migraine your whole life, some can have them only a few times a year and they may pass in a few hours, whereas for some people migraines occur several times a week and can leave the sufferer bed bound. The average person who suffers from migraines usually gets around one a month. In between your migraine attacks you'll be totally free of any symptoms, and the pain which is at one moment leaving you wanting to hide under a duvet can seem to have disappeared entirely. Although adults tend to find they get less severe as you get older, this isn't a hard and fast rule and they can be extremely painful and distressing nonetheless.

What is meant by the stages of a migraine?

Migraines are typically divided into four stages, but not everyone experiences all of them all the time. Understanding the stages can help you to know when an attack is on the way, so you know when to take medication to prevent the pain. These four stages are:

  • Prodrome phase (also known as the premonitory or warning phase)
  • Aura phase (which only applied to those who experience migraine with aura)
  • Pain or attack phase
  • Postdrome or recovery phase

The prodrome phase

The prodrome phase can occur a while before the aura or attack begins, although you might not always experience one. It happens a few days to a few hours in advance and is characterised by changes in mood, appetite, or bodily function. If you experience migraines regularly you may learn what's your prodrome phase feels like. Symptoms vary person to person, but can include:

  • Depression
  • Euphoria
  • Irritability
  • Food cravings
  • Increased thirst
  • Pain in your neck
  • Fatigue and exhaustion
  • Diarrhoea

The aura phase

Not everyone experiences this phase, as not everyone gets and aura before they have a migraine. If you do experience an aura with your migraine, it usually happens 5 to 60 minutes before the pain begins, and is a certain sign that an attack is on the way. If you're taking preventative measures in the form of medication to ease the pain of migraines, this is when you should take it so it can begin working as an attack starts.

The pain or attack phase

This is the most severe stage, and where things get really bad. As a migraine is different from a regular headache, it is generally accompanied by nausea, vomiting, sensitivity to light and sound, and pain is exacerbated with movement. Most of the time, the pain in my tennis for someone signs ahead, but to me occasionally be on both sides all across the front of the forehead. Migraines don’t usually occur on the back of the head. The pain tends to come on gradually and can be very severe at its most intense. The pain phase tends to last 4 to 72 hours.

The postdrome phase

As with everything about a migraine attack, recovery can vary from person-to-person. Some people feel totally euphoric and elated once attacks are over, whereas some feel depressed and ill. For a few days after the migraine you may feel like you can't think clearly, and experience a sort of bleary hangover type pain in the part of your brain where the attack took place. This should settle after a few days.

How do migraines affect your life?

Suffering from migraines is a huge problem that affects thousands of people across the UK. According to a report from the Guardian in 2016, 25 million days of work are lost a year due to people suffering from migraines, costs in the country £2.3 billion. Normal over-the-counter painkillers do not clear up a migraine like they do a headache. They are much more severe and can leave you bed bound, in extreme pain and unable to function properly if they are severe. When you are experiencing the aura or pain phase, you shouldn’t drive or operate heavy machinery. As migraines can last for several days, this can mean you’re taking a lot of sick days off work.

Do I have a migraine or something else?

You should not try to diagnose a migraine yourself, even if you seem to have all the symptoms. If someone does not have a history of migraines, and seems to have all the symptoms of one, you should contact a doctor to be on the safe side: the symptoms of suffering a migraine are quite similar to those of having a stroke. Symptoms of having a stroke include:

  • Weakness or numbness of the limbs which means the person cannot lift their arms
  • Loss of vision or blurred vision
  • Confusion
  • Losing tension and control on one side of the face, so it appears to drop
  • Slurred speech
  • Extreme severe pain in the brain
  • Paralysis on one side of the body

The symptoms of a stroke are also the symptoms of the mini strokes, which is also known as a TIA (transient ischaemic attack). A mini-stroke is not as serious as a stroke, and it will probably pass within a few minutes of hours, but you still see a doctor as soon as possible. A mini stroke is usually indicative of a problem with blood supply to the brain, which puts you at an increased risk of suffering a full stroke.

What treatment can I get for migraines?

Although migraines affect a huge amount of people, there is not a whole lot of research into how to treat them. For a long time doctors dismissed them as a psychosomatic disorder exacerbated by people who couldn't manage stress well.

If you suffer migraines regularly, keep a diary of the things you were doing, eating, and feeling in the days and hours leading to the migraine attack. If you notice common themes this may be able to help you identify your triggers. Once you figure out what they are, avoiding your triggers is the surest way to prevent migraine attack. However, this isn’t possible for everyone. Often, doctors are on willing to prescribe standard painkillers to help cope with migraines as they are not as effective as they are traditional headaches. The volume of painkillers you'd require to treat migraines could lead to liver damage, or tolerance and dependency on medication. There are two main groups of medication which are prescribed treat migraines, both of which you can buy from iMeds. The first of these is Propranolol, a type of beta blocker. Beta blockers work by slowly the intensity with which your heart beats, so blood flows slower around your body. You can also buy triptans to ease migraines, which work by affecting the brain’s level of serotonin, reducing inflammation and restricting blood vessels. You should check with your doctor that migraines are the source of your pain and that there is no underlying condition causing them.