What is a migraine?

Migraine is an intense throbbing headache, usually occurring in just one half of the head. The headache is often accompanied by nausea, vomiting and sensitivity to light, sound or strong smells, and can last for several hours or even days. About 20% of people with migraine also experience an ‘aura’ (visual disturbances) before the headache begins.

Around 400,000 people in Ireland (10% of the population) are thought to suffer from migraines, and they are more common in women than men.

What are the symptoms of a migraine?

Some people may start to experience various symptoms even before a migraine begins, which can act as an early warning sign that an attack is about to begin. These early symptoms can include food cravings, change in mood and change in energy levels.

The aura sometimes associated with migraine will also be experienced before the actual headache phase. An aura may last for around 20-60 minutes and normally involves visual disturbances e.g., blind spots or seeing flashing lights and zig-zag patterns. Aura can also involve pins and needles, slurring of speech, muscle weakness, less of co-ordination and confusion.

Once the headache stage begins there may be:

  • Intense, throbbing headache – usually on one side of the head
  • Nausea and vomiting
  • Sensitivity to light, noise or smells
  • Stiff neck
  • Blurred vision

This is followed by a ‘resolution’ stage, as the attack gradually fades away, followed by a postdromal or recovery phase.

What causes migraine?

The exact cause of migraine remains unknown. However, it is thought that the headache occurs when blood vessels leading to the brain swell and become inflamed, causing intense, throbbing pain. This may be due to abnormal sensitivity of the blood vessels to various triggers, causing rapid changes in the artery size due to spasm.

It is also known that there is a reduction in the levels of a chemical called serotonin or 5HT in the brain during a migraine attack. This may cause some of the symptoms, such as aura – and also have an effect on the blood vessels in the brain.

What triggers migraine?

Many people with migraine will find that specific triggers may set off their attacks. These vary from person to person but may include:

  • Particular foods or drinks, including coffee, soy sauce, wine, chocolate, garlic, certain fruits, alcohol, dairy products and smoked meat
  • Lack of food or change in eating patterns
  • Extreme emotions such as depression, stress, anger, excitement
  • Travel/long journeys
  • Exercise
  • Medications, including contraceptive pill
  • Sudden changes in the temperature, strong odours, loud noise and bright light
  • Sleep deprivation or disturbance, or too much sleep
  • Head, neck or back injury
  • Hormonal changes in women – e.g., menstruation, pregnancy.

How can I prevent migraines?

Identifying and avoiding triggers of your migraines is the best means to decrease their frequency. However, some triggers will be out of your control – such as hormonal changes or changes in the weather. Concentrate on those triggers that are within your control.

It is also important to control stress – make sure you are keeping fit, sleeping and eating well. Some people find yoga, mediation and relaxation useful.

It is also advisable to keep to a regular routine with regards to eating, resting, exercising and sleeping – even at weekends or on holidays.

How is a migraine treated?

Sleep is one of the best ways to get through a migraine attack. Resting in a dark room is also often helpful. Some sufferers find that an ice bag reduces the pain – while others find that heat, whether as a hot towel or warm bath – is helpful.

Drug treatment includes painkillers – such as aspirin or paracetamol. Soluble painkillers are often useful for people with migraine, as stomach symptoms during an attack can often slow down absorption of ordinary tablets.

A group of drugs called triptans can be prescribed for migraine by your doctor. These help to resolve the headache in migraine if the drug is taken early on in the attack.

A preventive medication may be prescribed by your doctor if your attacks are regular (2-3 a month), particularly severe, or if they follow a regular pattern. These drugs must be taken for 6-12 months and while they may not prevent attacks altogether, the goal is to reduce the frequency of attacks.

It is worth discussing your treatment options with your doctor.

When should I call my doctor?

You may need to visit your doctor for advice and treatment when migraines keep you from functioning normally at work. It is advisable to contact your doctor if you have a severe headache together with vomiting, speech difficulty, loss of consciousness or numb face and tingling arm or leg.

Where can I get more information and advice?

For more information and advice about migraine, contact the Migraine Association of Ireland on Tel: 1850 200 378, Email: info@migraine.ie or website: www.migraine.ie

You can set up your own personal migraine tracking service, which you can update via your mobile phone by logging on to Migrainemonitor.ie, a free service from Irishhealth.com.

Reviewed: December 7, 2006