EDP column by Professor Ketan Dhatariya
“I have recently been suffering from splitting headaches and vomiting. I see flashing lights and find a quiet dark room is the only way to reduce the pain. Are these ‘migraines’ and what can I do?”
Migraine is the most common cause of recurrent disabling headache in the population – occurring in 8% of men and 25% of women. Most people have their first attack before the age of 30, and it is uncommon to have migraines start after the age of 40.
It is a cluster of symptoms that include intermittent headaches that go away completely between attacks. The headaches may also be associated with an ‘prodrome’. This is a sensation that warns the individual that an attack is about to take place. This may be a change of mood or of appetite.
In a quarter of cases, the prodrome may be followed by an ‘aura’ that is an usually visual, motor or sensory sensation that can occur before the onset of the headache or be a part of the symptoms experienced with the headache.
The headache itself is often only on one side and throbbing in nature. People are often sick and the light often hurts their eyes. Loud noises can also make the headache worse, and so sufferers find relief in lying down in darkened, quite rooms.
These may be a few seconds or several hours prior to the headache starting. They may occur several times a week or only a few times per year. Women may find that they are associated with their periods.
No one knows what causes migraine and there are several theories as to whether it is a problem with the blood supply to the brain or the nerve tissue itself that is the source of the pain.
People who have migraine have been found to be at twice the risk of someone who does not have migraine to have a stroke. Being on the oral contraceptive pill makes this risk even higher. Occasionally, migraines are also associated with depression.
Treatment involves avoiding things that precipitate the headaches – such as smoking and the oral contraceptive. In an acute attack some people find simple pain killers such as paracetamol or ibuprofen helpful, or a painkiller with codeine in it. The pharmacist may advice the use of products that also have an anti-sickness medication in it to act in combination with the pain killers. If these measures do not help then there are medications that your doctor can give you.
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