What is Migraine

migrainetrust.org: Migraine is a chronic health condition. Most people who suffer from migraines get headaches that can be severe. A migraine headache is usually an intense, throbbing pain on one, or sometimes both, sides of the head. Most people with migraine headache feel the pain in the temples or behind one eye or ear, although any part of the head can be involved. Besides pain, migraine also can cause nausea and vomiting and sensitivity to light and sound. Some people also may see spots or flashing lights or have a temporary loss of vision.

Migraine can occur any time of the day, though it often starts in the morning. The pain can last a few hours or up to 72 hours. Some people get migraines once or twice a week. Others, only once or twice a year. Most of the time, migraines are not a threat to your overall health. But migraine attacks can interfere considerably with your day-to-day quality of life.
We don’t know what causes migraine, but some things are more common in people who have them:

* Often, migraine affects people most severely between the ages of 15 and 55.
* Most people have a family history of migraine or of disabling headache.
* They are more common in women.
* Migraine often becomes less severe and less frequent with age.

Migraine pain and symptoms affect 18% of women and 8% of men. According to the Department of Health (2005) eight million people get migraine making it the most prevalent long term neurological condition. Migraine is the most common form of disabling headache that sends patients to see their doctors.

The exact cause of migraine is not fully understood. Most researchers think that migraine is due to abnormal changes in levels of substances that are naturally produced in the brain. When the levels of these substances increase, they can cause inflammation. This inflammation then causes blood vessels in the brain to swell and press on nearby nerves, causing pain.

Genes also have been linked to migraine. People who get migraines may have abnormal genes that control the functions of certain brain cells.

Experts do know that people with migraines react to a variety of factors and events, called triggers. These triggers can vary from person to person and don’t always lead to migraine. A combination of triggers—not a single thing or event—is more likely to set off an attack. A person’s response to triggers also can vary from migraine to migraine.

Frequently mentioned migraine trigger factors include:

Lack of or too much sleep
Skipped meals, getting hungry or not eating enough
Bright lights, loud noises, or strong odours
Hormone changes during the menstrual cycle
Stress and anxiety or relaxation after stress
Some weather changes
Alcohol
Caffeine (too much or withdrawal)
Changes of routine and travel

Keeping a migraine diary may help in identifying triggers. You can use our online diary to do this

The Migraine Trust recommends that migraine sufferers should obtain a diagnosis from their GP. A migraine diary can help a GP identify whether you have migraine and if so what type of migraine. The diary will also assist the GP in prescribing medication for your migraine.Thinks that should be covered in the diary are:

how often you have headaches
where the pain is
how long the headaches last
when the headaches happen, such as during your period
other symptoms, such as nausea or blind spots
any family history of migraine
all the medicines that you are taking for all your medical problems, even the over-the-counter medicines (better still, bring the medicines in their containers to the doctor)
all the medicines you have taken in the past that you can recall and, if possible, the doses you took and any side effects you had

The Migraine Trust has an online diary which will help you record this information. Your doctor may also do an exam and ask more questions about your health history. This could include past head injury and sinus or dental problems. Your doctor may be able to diagnose migraine just from the information you provide. You may get a blood test or other tests, such as CT scan or MRI, if your doctor thinks that something else is causing your headaches.

Sometimes, headache can be a symptom of another health condition than migraine.

You should talk to your doctor about your headaches if:

You have several headaches per month and each lasts for several hours or days
Your headaches disrupt your home, work, or school life
You have a severe headache with a stiff neck
You have a headache with confusion or loss of alertness
You have a headache with convulsions
You have a headache after a blow to the head
You used to be headache – free but now have a lot of headaches
You develop severe headaches for the first time over the age of fifty
You have symptoms that persist between attacks

Although migraine can change over the course of a person’s lifetime, it is always wise to see your GP if your migraine symptoms change, just to make sure the symptoms are still those of migraine.

Yes. Stress can trigger both migraine and tension-type headache. Anything can actually trigger a migraine e.g. lack of sleep, missing a meal etc. if these are combined with stress then a migraine can be triggered.

Making time for yourself and finding ways to deal with stress are important.

Some things you can do to help prevent or reduce stress include:

being active (at least 30 minutes most days of the week is best)
doing relaxation exercises
getting enough sleep

There are no objective tests for migraine. It is diagnosed on the basis of the history, or the pattern of symptoms over time. This is why keeping a migraine diary can be helpful. Your doctor may refer you for tests such as CT or MRI scans to rule out other conditions that may cause similar symptoms.

Migraine has no cure. But your migraines can be managed with your doctor’s help. Together, you will find ways to treat migraine symptoms when they happen, as well as ways to help make your migraines less frequent and severe. Your treatment plan may include some or all of these methods:

Medicine. There are two ways to approach the treatment of migraines with drugs: stopping a migraine in progress (called “abortive” or “acute” treatment) and prevention. Many people with migraine use both forms of treatment.

Acute treatment. Over-the-counter pain-relief drugs such as aspirin, acetaminophen, or NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen relieve mild migraine pain for some people, if taken early enough and at the right dose. If these drugs don’t work for you, your doctor might want you to try a prescription drug.

Most acute drugs for migraine work best when taken right away, when symptoms first begin. Always carry your migraine medicine with you in case of an attack. For people with extreme migraine pain, a powerful “rescue” drug might be prescribed, too. Because not everyone responds the same way to migraine medication, you will need to work with your doctor to find the treatment that works best for you.

Prevention. Some medicines used daily can help prevent attacks. Many of these drugs were designed to treat other health conditions, such as epilepsy and depression. These drugs may not prevent all migraines, but they can help a lot. Hormone therapy may help prevent attacks in women whose migraines seem to be linked to their menstrual cycle.

Ask your doctor about prevention drugs if:

your migraines do not respond to drugs for symptom relief
your migraines are disabling or cause you to miss work, family activities, or social events
you are using pain-relief drugs more than two times a week
you are having frequent attacks, more than two to four attacks a month

Lifestyle changes. Practicing these habits can reduce the number of migraine attacks:

Manage your exposure to triggers that you can control, such as hunger.
Get up and go to bed the same time every day.
Try not to skip meals.
Engage in regular physical activity.
Limit alcohol and caffeine intake.
Learn ways to reduce and cope with stress.

Alternative methods. Biofeedback has been shown to help some people with migraine. It involves learning how to monitor and control your body’s responses to stress, such as lowering heart rate and easing muscle tension. Other methods, such as acupuncture and relaxation, may help relieve stress. Counselling also can help if you think your migraines may be related to depression or anxiety. Talk with your doctor about these treatment methods.

( For more details refer Migraine trust website. The Migraine Trust is the health and medical research charity for migraine in the United Kingdom.)