Migraine

What is migraine?

Migraine is a type of headache.

It is a neurological disorder characterised by moderate to severe head pain that can be made worse by movement and is often accompanied by nausea, vomiting, noise and light sensitivity and a disruption of daily activities.

Over a billion people worldwide get migraine and is estimated to affect 15-23% of the UK population which is equivalent to approximately 10 million people.

Further information is available at The Migraine Trust - Understand migraine

What are the characteristics of migraine?

  • The exact cause of migraine is unknown, but it is thought to be the result of abnormal brain activity that temporarily affects nerve signals, chemicals and blood vessels in the brain.
  • Migraine attacks can last for between four hours and three days.
  • Some symptoms may start about 24 hours before you get head pain, and end about 24 hours after you stop having head pain.
  • Migraine can often be more frequent and severe in women at times of hormone changes such as puberty, menstruation and perimenopause.
  • Periods of stress can make it worse, and it can be problematic for shift workers due to disruption of routine.
  • Migraine commonly runs in families with two thirds of migraine sufferers having a family history of migraine.

What are the symptoms of migraine?

The main symptom of a migraine is usually an intense headache on one side of the head; however, the pain can occur on both sides of your head and may affect your face or neck. The pain can worse when you move and may prevent you from carrying out normal activities.

Other symptoms include:

  • nausea
  • vomiting
  • sensitivity to light
  • sensitivity to sound
  • sensitivity to smell
  • skin sensitivity.

Less common symptoms are:

  • temporary partial loss of vision
  • dizziness
  • speech disturbances
  • muscle weakness
  • teariness, red swollen eyes, runny nose.

What are the potential triggers for migraine?

The brain of a person with migraine is believed to have a lower sensitivity to stimuli know as triggers. It can be difficult to tell if something is a trigger or if what you're experiencing is an early symptom of a migraine attack. There might not always be a trigger for your headache.

Examples of common triggers are listed below:

  • Missing meals
  • Tiredness or oversleeping
  • Changes in routine e.g., shift work
  • Stress, or when stress stops
  • Hormonal changes e.g., menstruation
  • Environmental factors e.g., lighting, heat, noise.
  • Dehydration
  • Alcohol

More information on potential triggers of migraine can be found at The Migraine Trust - Migraine attack triggers

How is migraine diagnosed?

There's no specific test to diagnose migraines. Diagnosis is usually made by your health care professional taking a thorough history of your symptoms - your story gives the clues to what your headache is. To help with the diagnosis, it can be useful to keep a diary of your migraine attacks for a few weeks. More details on keeping a migraine diary and a template can be found here The Migraine Trust - Keeping a headache diary

Your health care professional might do a physical examination and check your vision, co-ordination, reflexes and sensations. These will help rule out some other possible underlying causes of your symptoms. Often further investigations are not necessary.

Often, taking too many painkillers is a reason migraine can become difficult to treat or chronic in nature - this is called medication overuse headache and further information is available at The Migraine Trust - Medication overuse headache. Ensure you record the type of painkillers and how often you take them

How is migraine treated?

It can take time to determine the best treatment and you might need to try different types or combinations of medicines before you find the most effective ones.

For a lot of people over-the-counter painkillers such as paracetamol, aspirin or ibuprofen, can help to reduce their symptoms.

Some people may need anti-sickness and/or triptan medication to treat their migraine. Some of these medications can be prescribed by your local pharmacist, others require a GP to prescribe them – your health professional will assess which medication you may need prior to prescribing this.

Preventative medication, which is taken regularly, may also be prescribed if you get migraine frequently or if migraine has a disabling effect on your life.
If you do not respond well to treatment or if your migraine attacks are not being well managed, your healthcare professional may refer you on to a specialist headache clinic.

More information on the medications prescribed to people with migraine can be found at The Migraine Trust - Treatment Options

How can you manage your migraine?

As well as treating your migraine with medication it is important to think about aspects of your lifestyle which could be affecting the condition.

Maintain a healthy lifestyle by:

  • getting regular exercise, sleep and meals
  • ensuring you stay well hydrated
  • limiting your intake of caffeine
  • limiting your intake of alcohol.

Self-help support for people with migraine is available at a variety of places as listed below - your local pharmacist, GP and headache specialist can help signpost you to these too.

 

Published: 13/11/2023 12:26