Migraines

Migraines affect more than 30 million people in the United States alone, and can prove to be debilitating and even dangerous in some circumstances, although for most people they present no general threat to overall health. Their effects can last for several hours, and even stretch to a day or more in some patients. Their frequency also varies widely between patients, with some sufferers experiencing an attack several times a month, and others going a year or more without a problem.

Migraine affects both women and men, although women are more likely to be sufferers, and it is commoner in younger people, with attacks becoming less frequent and severe as the sufferer gets older.

Symptoms

Although a common symptom of migraine is severe headache, it must not be thought that every bad headache is a migraine attack, because the pain comes from different causes. A typical headache comes about from the narrowing of blood vessels in the brain (vasoconstriction), whereas migraine pain is caused by vasodilation, which is the widening of blood vessels.

One common feature of migraine is “aura”, which usually means visual disturbance. About 25% of patients report that they typically experience an aura as a warning sign of an impending migraine. The nature of visual auras varies considerably between patients. In my own case, I become aware of a quivering at the edge of my field of vision, followed by an inability to focus on a particular object, such a word on a screen or a printed page. This sensation increases in severity, and in some cases may be the only symptom I experience. However, a dull headache usually follows, and nausea on rare occasions.

Visual auras can be of various kinds, with typical features being flashing lights, blurred vision, blind spots, hallucinations, or even total loss of vision. It is the sudden onset of an aura that can make a migraine dangerous, especially if the patient is driving a vehicle or operating machinery at the time.

However, other types of aura are possible, and these include “pins and needles”, usually in the hand or arm, speech problems, food cravings, and funny smells.

A migraine headache tends to be intense and throbbing, and is sometimes felt on only one side of the head. It is made worse by movement, and the sufferer will probably want to be allowed to stay still until the pain goes away.

Nausea is a common symptom, and actual vomiting is possible. The feeling of nausea may be the most long-lasting symptom.

There are several kinds of migraine that are relatively rare and which can produce a variety of symptoms. For example, hemiplegic migraine can be confused with stroke, because it leads to paralysis of one side of the body, accompanied by severe speech difficulty. However, the patient recovers quickly, which is not the case with stroke. With an ocular migraine, severe pain is felt around the eye socket. A basilar artery migraine affects an artery at the base of the brain and can lead to giddiness, double vision, and even total loss of consciousness.

Triggers

With any disease, prevention is always better than cure, and a migraine attack is a condition that, in many cases, can be anticipated and prevented.

Migraines are typically instigated by “triggers”, some of which are controllable and others of which are not. One reason why women are particularly susceptible to migraines is that the onset of menstruation can be one such uncontrollable trigger. However, that is unlikely to be the only trigger, and the likelihood of an attack can be lessened by avoiding as many as possible of the controllable ones.

Another uncontrollable trigger is the weather. How the weather acts as a trigger will vary between patients; it could be a sudden drop in atmospheric pressure, or wind from a certain direction, for example. Again, weather conditions are unlikely to be the only trigger, and a sufferer who keeps a careful eye on weather forecasts can take warning to avoid adding any of the controllable triggers that, in combination with the weather factor, could lead to a migraine.

Controllable triggers are typically cigarette smoke, bright lights (especially flickering ones), red wine, chocolate, some cheeses, and aspartame (which is an additive often found in soft drinks and flavoured water).

Treatment

Treatment for migraine can be as simple as lying down in a darkened room until the symptoms have passed, but strong painkillers such as Ibuprofen can also be effective.

Medication can also be used as a preventative, but this should be done under medical direction. Prescribed drugs may be beta-blockers, antidepressants or anticonvulsants.

A wide range of complementary therapies have also been found helpful for many patients, either to treat acute attacks or as preventative measures (usually as ways of reducing tension). These include acupuncture, aromatherapy, massage, shiatsu and yoga.