Migraines – all you need to know

What causes migraines?

The cause exact cause of migraines is not clear. It was previously thought that migraines were caused by changes in blood flow in the brain but this may not be the only or main reason for migraines. It is also thought that migraines may be caused by changes in levels of chemicals in the brain.

There are a few triggers for migraines. There may be genetic factors as several members of the same family may experience migraines. Environmental factors may also play a role. Examples of environmental triggers include alcohol, stress, changes in wake-sleep patterns, physical exertion, sensory stimuli like sun glare, strong smells.

What are the symptoms of migraines?

The most common form is migraine without aura. The headache usually affects one side of the head or may start on one side and then become more generalized. The pain is described as throbbing or pulsating and can last between 4-72 hours if untreated. Other common symptoms include nausea, vomiting, not liking bright lights or loud noises. Less common symptoms include loss of appetite, blurred vision, impaired concentration, diarrhea, abdominal pain, sweating, nasal congestion.

Individuals who have migraine with aura have similar symptoms to individuals who have migraine without aura except that they describe a warning sign (aura) which occurs before the headache. The most common aura would be visual auras eg temporary loss of part of vision, bright spots, flashing lights, seeing various shapes. Other less common auras include altered sensation in an arm or leg, problems with speech, odd smells, food cravings.

Other less common types of migraines include menstrual migraines, abdominal migraine, ocular migraine, vestibular migraines.

Which demographic is most at risk?

 Migraines are more common in women. 80% of patients have their first episode of migraine before the age of 30.

15% of women with migraines only have attacks around the time of their periods.

Can migraines be prevented?

It can be useful to keep a migraine diary to record when and where each migraine attack started, what foods were eaten and activity at time of attack. This may reveal a pattern and help to identify and avoid triggers.

Other factors which can help prevent attacks of migraine include:

  • Having a regular sleep pattern
  • Having regular meals
  • Stress management
  • Regular exercise also promotes a healthy lifestyle, reduces stress and helps with healthy weight management. It is important to choose an exercise routine and intensity that is suited to your personal fitness as sudden intense exercise can trigger headaches.
  • Women who experience migraines that are triggered by oestrogens should avoid or reduce medication that contain oestrogens.

Treatment of migraines

During a migraine episode, medication to control pain; eg paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs eg ibuprofen); or medications called triptans can help ease the discomfort and pain associated with migraines. Medications to help with nausea and vomiting can also be helpful.

Patients who experience frequent and/or severe migraines may benefit from taking preventative medication on a regular basis to reduce the frequency and severity of attacks.

There is some evidence that botulinum toxin injections may reduce the number of attacks. These injections are also used for cosmetic purposes but for the treatment of migraines, the injections are given by a trained medical practitioner in specific sites.

Speak to you doctor about which medication is suitable for you as this may be dependent on several factors eg age, pregnancy, breast feeding, your medical history and if you are already taking other medication.

Headaches are often not due to a sinister or worrying cause. However, it is important to see your doctor if you experience headaches on a regular basis or if you experience a change in pattern of the headaches. If you experience any of these types of headaches, it is important to seek urgent medical attention:

  • Thunderclap headaches
  • Headaches with fever, stiff neck, confusion, seizures, altered vision, weakness, numbness or trouble speaking
  • Headache which occur after a head injury, especially if the headache gets worse
  • A headache that is worse after coughing, exertion, straining or a sudden movement
  • New onset of headache especially if you are above the age of 50 years.

Dr Tan is graduate of Queen’s University Belfast, UK and completed her General Practice training in Birmingham, UK. If you would like to book an appointment, please call: 6733 4440 or click here: https://www.imc-healthcare.com/appointments/

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