Migraines: How to spot the signs and deal with them

Migraine is the most common neurological condition, affecting about one in four women and one in 12 men in the UK, though attacks usually get less frequent with age

Miriam Stoppard

Posted On Monday, July 20, 2009   


Migraine is far more than just a headache. As a rough guide, if you have two or more of the following symptoms and they stop you doing normal daily activities, it's probably a migraine:

  • Visual disturbances like blind spots, distorted vision or flashing lights - these often happen first
  • A severe, throbbing headache, often on one side of the head above the eyebrow
  • Nausea and/or vomiting and/or diarrhoea
  • Increased sensitivity to light, sounds or smells
  • Stiff neck and shoulders
  • Stiffness, tingling or numbness in limbs
  • Difficulty concentrating or even speaking
  • Paralysis or unconsciousness, though this is very rare.
  • Attacks can last anywhere from four hours to three days and, while many people get warning signs, it can come on suddenly.

Treatment tactics

Over-the-counter options
Besides the usual headache pills like aspirin, ibuprofen and paracetamol, there's sumatriptan (Imigran recovery), a specially-designed migraine remedy that used to be only available on prescription.

Codeine, a strong painkiller, is also available in small doses but can cause constipation and, if taken frequently, can cause rebound headaches as well as being addictive.

Prescription drugs
If over-the-counter drugs don't work for you, or your attacks get more frequent, see your GP for prescription drugs. The most common are triptans, designed specifically for migraine, which aim to control serotonin levels.

Besides pills, there are some drug options in injection or suppository form. You can also get anti-sickness drugs and, if you have more than four attacks a month, you may need preventive drugs such as beta blockers.

To rule out other conditions, see your GP if you suddenly get migraines for the first time over the age of 50 or the aura symptoms are always on the same side of the body with every attack.

Botox

US doctors using Botox as a cosmetic treatment found some patients reported migraines had stopped.

Botox isn't licensed for migraines in the UK but is offered at some private clinics. However, if you go down this route, check that the doctor is experienced in using Botox specifically to treat migraines.

Spot the triggers

It's thought that migraine is caused by changes to a brain chemical called serotonin. However, this can be triggered by many factors. Known triggers include:

  • Specific foods such as cheese, chocolate, coffee, red wine or sherry
  • Long gaps between food or being dehydrated
  • Emotional changes - stress, excitement, depression or even the end of a stressful time
  • Physical change - too little or too much sleep, physical or mental overexertion, travelling or a new job
  • Bright lights, certain noises or smells
  • Hormonal changes - for example, a period, oral contraception, pregnancy or the menopause

6 ways to manage symptoms

(1) Keep a migraine diary - Include activities, food and mood. This could help you spot the most common triggers or combination of triggers. For me a main one was excitement - for instance, if I was having a party. I also had a bad attack once when I was in a desert and dehydrated.

(2) Get to recognise warning signs - Not everyone has these but, the earlier you take your medication, the more effective it will be.

(3) Have medication with you at all times - Even though I don't really get them any more, I have it, just in case. Stock up before you go on holiday.

(4) Drink plenty of water, eat regularly, try to have a regular sleep pattern and limit caffeine and alcohol.

(5) De-stress - If stress is a trigger, regular relaxation techniques like yoga or putting your feet up for half an hour a day can help keep it under control. Some people find complementary therapies, such as acupuncture, helpful.

(6) See your dentist - the problem could be a misaligned jaw or grinding your teeth at night.

Deal with doubters

Explain your symptoms to your colleagues and boss, including what you have to do to manage them.

If you're a conscientious worker the rest of the time, this will give weight to what you say.

Source: Daily Mirror

Pic: Julia Freeman-Woolpert



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