Migraine

Each year about 1 in 10 people in the UK has a migraine. Migraine is more common a women, and people usually have their first attack before the age of 30. First attacks can occur in children as young as 2 years old but their onset is rare in people over the age of 50. Migraine headaches recur at varying intervals. Some people have attacks several times a month; others have fewer than one a year. Most people find that migraine attacks occur less frequently and become less severe as they get older.


There are two major types of migraine: migraine with aura and migraine without aura. Aura is the term used for group of symptoms, including visual disturbances, that develop before the onset of the main headache. Migraine with aura accounts for about 1 in 5 of all migraine cases. Some people have attacks of both types of migraine.

What are the causes?

The underlying cause of migraine is unknown, but increased blood flow as a result of widening of the blood vessels in the brain is known to occur during a migraine. A bout 8 in 10 people who have migraine have a close relative with the disorder. Stress and depression may be trigger factors, as may the relief of stress, such as relaxing after a difficult day. Other potential triggers include missed meals, lack of sleep, and certain foods, such as cheese or chocolate. Many women find that their migraines tend to occur around the time of menstruation.

What are the symptoms?

Migraine headaches, either with or without aura, are sometimes preceded by a group of symptoms that are collectively known as a prodrome. These prodrome symptoms tend to appear about an hour before the main symptoms begin. The prodrome often includes:

- Anxiety or mood changes.
- Altered sense of taste and smell.
- Either an excess or a lack of energy.

People who have a migraine with aura experience a number of further symptoms before the migraine, including:

- Visual disturbances, such as blurred vision and bright flashes.
- Pins and needles, numbness, or a sensation of weakness on the face or on one side of the body.

The main symptoms, common to both types of migraine, then develop. These symptoms include:

- Hadache that is severe, throbbing, made worse by movement, and usually felt on one side of the head, over one eye, or around one temple.
- Nausea or vomiting.
- Dislike of bright light or loud noises.

A migraine may last for anything from a few hours to a few days but eventually clear up. After a migraine, you may feel tired and unable to concentrate.

What might be done?

Your doctor will usually be able to diagnose a migraine from your symptoms. Rarely, test such as MRI or CT scanning of the brain may be carried out to rule out more serious causes such as a brain tumour.

Once migraine has been diagnosed, your doctor may prescribe drugs that reduce the duration of the attacks, help to treat the symptoms, or prevent further migraine occurring. For example, he or she may prescribe an anti-migraine drug, such as a triptan drug that, if taken in the early stages of an attack, will usually prevent the migraine from developing further. Ergotamine, an other anti-migraine drug, may also be given to help to relieve an attack but should not be taken for long periods of time.

If a full-blown migraine develops, painkillers or non-steroidal anti-inflammatory drugs may help to relieve the pain. If you also experience nausea and vomiting, anti-emetic drugs may provide relief.

Self-help measures may be useful in preventing further migraines. If you experience severe migraines or you have more than four attacks a month, your doctor may prescribe a drug such as propranolol to take every day to prevent attacks.


PREVENTING A MIGRAINE

Many factors are known to trigger a migraine. You need to identify the ones that affect you. Avoiding these factors may reduce the frequency and severity of attacks.

- Keep a diary for a few weeks to help to pinpoint trigger factors.
- Avoid any food that brings on an attack. Common dietary triggers of migraine include red wine, chocolate, and cheese (especially matured cheese).
- Eat regularly, because missing a meal may trigger an attack.
- Follow a regular sleep pattern if possible, because changing it may trigger an attack.
- If stress is a trigger, try relaxation exercises.