What are migraines?

Migraine headache is a recognised medical condition affecting about 1 in 10 people. Migraine is a chronic neurological disease characterized by recurrent moderate to severe headaches often in association with a spasm of the blood vessels leading to the brain and a number of autonomic nervous system symptoms. The pain is severe and throbbing, usually on one side of the head and typically lasts 2 to 72 hours. Other symptoms can include nausea and vomiting, sensitivity to light, sound, smell and touch. Up to one-third of people with migraine headaches report an aura: a transient visual, sensory, language, or motor disturbance which signals that the headache will soon occur.

Migraines can be experienced from as little as once or twice a year, or as often as two or three times a week. When you have a migraine, it may be so painful that you are not able to do your usual activities. Within the population, three times as many women (15 per cent) as men (5 per cent) suffer from migraine, and doctors believe that hormones play a large role. Diet, sleep, the menstrual cycle and other factors may also trigger migraines. There is no cure, but treatment includes medication and other therapies to reduce attacks.  It is important to discuss your treatment with your doctor.

What are the symptoms of migraines?

A migraine headache has different symptoms from other types of headache. Doctors have also identified two types of migraine, migraine without aura, and migraine with aura.

Both types of migraine:

  • are associated with a severe throbbing or ‘pounding’ pain, usually only on one side of the head, although the affected side may change between, or even during attacks
  • usually last from four hours up to three days
  • are generally accompanied by nausea and vomiting and a sensitivity to bright lights or noise.
  • can be aggravated by physical activity
  • are often so painful and distressing that normal everyday activities become impossible during an attack
  • can experience sensitivity to smell and touch
  • can leave a person feeling drained and exhausted afterward

Migraines with aura are preceded by an aura, which presents as altered vision, speech, sensation or more rarely, altered movement. The visual symptoms of aura usually develop five minutes to an hour in advance of pain and may include flashes of light and colour (as though looking through a prism), blurred vision or blind spots, zigzag or jagged lines. Disturbances of speech can sometimes occur because of changes in brain activity before a migraine. Some people also develop ‘pins and needles’ in a hand or arm, or on one side of their face. Symptoms can mimic a stroke and understandably can be quite frightening the first few times they occur.

What triggers migraine?

No one really knows what causes migraine but it is believed to be a neurovascular disorder due to a mixture of environmental and genetic factors. About two-thirds of cases run in families.

Attacks are almost certainly triggered by a combination of factors, such as:

  • diet – cheese, chocolate, citrus fruits, MSG, alcohol (especially red wine)
  • missing meals
  • sleep – too little or too much
  • menstrual cycle
  • head and neck problems can predispose some people to migraine and may respond to non-medicine treatment e.g. physiotherapy or chiropractic
  • physiochemical – excessive heat, light, noise or certain chemicals
  • emotional causes – stress, excitement or fatigue
  • relaxation (weekend migraines) – often triggered by a period of stress and overwork followed by relaxation

Treatment of migraines

There is no cure for migraine and prevention is difficult, but treatments can help reduce the number of attacks. Speak to a doctor to discuss the most appropriate treatment for you.  Migraines vary greatly from person to person and so does the treatment. The treatment options available to migraine sufferers include:

  • avoiding the trigger factors – keeping a headache diary can help since migraines are often triggered by a combination of factors,
  • medication – including pain-relieving medication, drugs to alter pressure on blood vessels and medication taken on a daily basis to reduce the number of attacks
  • non-medication therapies – including acupuncture, biofeedback, goggles, hypnotherapy, exclusion diets, relaxation, yoga, meditation, herbal or homeopathic remedies.

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