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Migraines affect one in seven adults in the UK. Women
are three times more likely to get them than men. You can get migraines
at any age but they are most common from your late teens up to the age
of 50.
There are a number of different types of migraine. The most common types
of migraine are migraine with aura (classic migraine) and migraine
without aura (common migraine). Aura is a term used to describe the
symptoms that come on just before your migraine. Less common types of
migraine are retinal, abdominal and menstrual migraines.
Severe migraine can be very distressing and disabling. It can affect
your daily life and can mean taking time off work or school.
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Symptoms of migraine
The main symptom of migraine is a severe headache, which can last for
anything between four hours and 72 hours. The headache usually occurs on
one side of your head and is a throbbing or pulsating pain. Activity
usually makes the pain worse, for example climbing stairs. You may also
feel sick or vomit during a migraine, and you may find you’re more
sensitive to bright lights and noise.
You can get a migraine at any time, though it’s more common to have a
migraine during the day than to be woken by one at night. Some people
have migraines once a year, whereas other people may have them as often
as several times a week. Most people have one or two migraines a month.
One of the things that make a migraine different from other types of
headache is that it has clear stages. Most people will have one or more
of the following stages.
Premonitory Stage. This is a sense that a migraine is about to start and
includes symptoms like tiredness, craving sweet foods, feeling thirsty
and mood changes. These feelings can last up to 24 hours.
Aura Stage. About one in three people have this stage, which may last up
to an hour. Symptoms include visual disturbances, such as flashing
lights or sensory symptoms, such as pins and needles.
Main Attack Stage. This is when the headache develops.
Resolution and Recovery Stage. This is when the migraine fades. This
usually happens slowly although a migraine can sometimes stop suddenly,
if you vomit for example.
Most people don’t need to see their GP when they get a migraine.
However, you should see your GP if:
your migraines become more frequent or get worse over time
you have a sudden very severe headache
you’re over 50 and you have never had a migraine before
you get aura symptoms lasting more than an hour
you have symptoms such as a fever or weight loss with the headache
you have a child under the age of 10 that develops a migraine
you get migraines with aura and are taking the combined oral
contraceptive pill (COCP)
Complications of migraine
Occasionally, a migraine can last for more than 72 hours and doesn’t go
away by itself. This type of migraine is known as status migrainosus.
It’s important to see your GP if your migraine lasts longer than 72
hours.
If you get frequent migraines on more than 15 days a month for an
average of three months out of the year, this is called chronic
migraine. When describing an illness, the term chronic refers to how
long a person has it, not to how serious a condition is. If you have
chronic migraine, you may need to take increasing amounts of medication
to help control your symptoms. Over time, this can lead to further
headaches, called medication-overuse headaches.
If you get migraines, you may be more likely to develop depression,
anxiety, and panic disorders. You may also be more likely to have a
stroke. If you’re taking the COCP and have frequent migraines or
migraines with aura, your risk of stroke will be increased. Speak to
your GP for more advice.
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Causes of migraine
It’s not fully understood what causes migraines, but it’s thought they
may be caused by a chemical called serotonin. Serotonin affects the
blood vessels in your brain. It’s not known exactly what causes the
serotonin levels to change.
Migraine is also linked to your genes. About half of all people who get
migraines have a close family member who also has them.
Some things can cause a migraine to start and these are called triggers.
You may find it useful to keep a diary to spot the triggers that cause
your migraines or make them worse.
Common triggers include:
stress
change in sleep patterns and tiredness
poor posture or tension in your neck and shoulders
certain food or drink – commonly chocolate, cheese, alcohol, caffeine
loud noises
bright or flickering lights
strong smells
strenuous exercise if you’re not used to it
skipping meals
not drinking enough fluid
Women may get migraines around the time of their periods, during the
menopause, or as a result of taking oral contraceptives or hormone
replacement therapy (HRT).
Other less common triggers may include high blood pressure, smoking,
toothache, eye strain or taking certain sleeping tablets.
Diagnosis of migraine
Your GP will ask you about your symptoms and examine you. He or she may
also ask you about your medical history.
There isn’t a specific test that can diagnose migraines. Try to keep a
diary of when you get migraines and possible triggers. This will help
your GP to see if there is a pattern to your symptoms.
Treatment of migraine
Although migraine can’t be cured, there are treatments that can help you
to control your symptoms and minimise the effect of migraine on your
daily life. Some treatments can help to prevent a migraine, whereas
others work to stop a migraine once it has started. You may need to try
a number of different treatments, such as medicines, before you find the
ones that work for you. It can help to keep a record of your symptoms
and how treatments affect your migraines.
Self-help
If you know what triggers your migraines, do your best to avoid these
triggers. For example, it may help to change your sleeping patterns or
eating habits. If you find that stress can trigger your migraine you may
find yoga and relaxation techniques helpful.
When you get a migraine it’s best to rest in a quiet, darkened room and
sleep if you can. You may want to try using a cold compress, such as an
ice pack or ice wrapped in a towel to ease your headache. Don’t apply
ice directly to your skin as it can damage your skin. A hot compress may
also help. You can also try applying pressure to the pulse points on the
side of your forehead or neck.
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Medicines
Different types of medicine are used to treat migraines, depending on
your symptoms and how severe your migraines get. You doctor will usually
suggest you take an over-the-counter painkiller, such as ibuprofen, with
an anti-sickness tablet. Because you need the painkillers to work
quickly once a migraine has started you can take soluble painkillers
which dissolve in water, or fast acting tablets. Always read the patient
information leaflet that comes with your medicine and if you have any
questions, ask your pharmacist for advice.
If this doesn’t work, your doctor may suggest taking medicines called
triptans. Triptans stop the effects of serotonin, which is thought to
cause migraines. They are more effective if you take them as soon as
your migraine starts. Triptans are available as tablets, dissolvable
wafers, nasal sprays or injections. Up to half of all people who take
triptans medicines find that their migraine symptoms come back within
the next 48 hours.
If you use any type of painkiller for your migraine too frequently, it
may become less effective and cause further headaches. You may get
medication-overuse headaches if you regularly use painkillers for 10 to
15 days a month, for more than three months to relieve your migraines.
If you’re worried you may have this type of headache, speak to your GP.
Complementary therapies
There is some research which shows that acupuncture and biofeedback may
help to ease the symptoms of migraine. If you decide to try either of
these therapies, check that your therapist belongs to a recognised
professional body.
Prevention of migraine
It’s important to learn to spot the signs and triggers of your migraine
to help prevent them. The easiest way of doing this is by keeping a
diary about your migraines.
Keeping active may also prevent migraines. The recommended healthy level
of physical activity is 150 minutes (two and a half hours) of moderate
exercise over a week in bouts of 10 minutes or more. You can do this by
carrying out 30 minutes on at least five days each week.
Some medicines such as antidepressants, antihistamines and beta-blockers
can help to reduce the number of migraines you have. Your GP may suggest
these if your migraines are severe or happen often, and if they are
affecting your daily life.
If you have chronic migraine (headaches on at least 15 days per month,
of which at least eight days are with migraine), and other medicines
haven’t worked, your GP may refer you to a neurologist (a doctor who
specialises in investigating, diagnosing and treating conditions of the
nervous system).
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