7 things you need to know about migraines
Migraines are the sixth most disabling condition in the world. Understanding how the disorder affects you can help you treat – or even prevent – an attack.
1. What is a migraine?
A migraine is a primary headache disorder. Symptoms include headache, sickness and photophobia (an aversion to light). According to The Migraine Trust, experts don’t yet know why people develop the condition. However, they do know that it has a genetic component. Someone with migraines is likely to have a parent or sibling who gets them too.
When a migraine hits, it can be very difficult to carry on with work or family life. In fact, in the Global Burden of Disease study done by the World Health Organization, it is listed as the sixth most disabling condition. Often pain, sickness and exhaustion lead sufferers to retreat to a dark room to wait for the attack to pass. This can take hours or even days.
2. How common are migraines?
In the UK, more than 20% of adults get migraines, and there are 190,000 attacks daily. It’s no surprise that migraines have a massive impact on the workforce. A report by the Work Foundation found that migraines are costing the UK economy £8.8 billion each year. Often it’s just not possible to carry on while in the throes of an attack.
3. Different migraine symptoms
“There are various ways to classify migraines,” says Benenden Hospital’s consultant neurologist, Dr Muhammad Chowdhury. “But there are some main types, like common migraine and migraine with aura.”
Up to 90% of people who get migraines have common migraine, also called migraine without aura.
Warning symptoms include:
- Tiredness
- Craving food
- Stiff neck
This leads on to:
- Headaches
- Sickness
- Photophobia (an aversion to light)
- Sensitivity to sound
Once these symptoms have passed, they can leave behind a sort of migraine hangover with symptoms like tiredness and hunger. Without treatment, on average a migraine without aura will last between four and 72 hours.
For people who get migraine with aura, an attack can start with neurological symptoms such as:
- Visual disturbances
- An unusual taste or smell
- Feelings of dizziness
- Weakness on one side
This tends to last for less than an hour and can then be followed by the same symptoms as common migraine. It’s also possible to have an ocular migraine, which is when the aura is not followed by other symptoms.
Other types include vestibular migraines, which cause unsteadiness and slurred speech. Hemiplegic migraines can mimic the symptoms of a stroke, such as temporary paralysis on one side of the body.
4. Who gets migraines?
According to the World Health Organization, women are twice as likely to get migraines as men.
“I suspect that’s because of hormonal factors,” says Dr Chowdhury. “Migraines usually begin in the teenage years. In women, they usually occur after puberty, although occasionally they start later on.”
Some women have menstrual migraines, which they’ll get just before or during the first days of their period, like clockwork. Menstrual migraines are probably triggered by the change in hormones during the menstrual cycle.
5. What causes migraines?
It’s a good idea for anyone who has migraines to consider what brings on an attack. A migraine trigger is something that’s harmless to most people, such as bright sunlight, but could set off an attack in someone with this disorder.
Triggers can vary from person to person, so there’s no definitive list of what to avoid. However, common triggers can include:
- Some foods and drinks, such as alcohol, caffeine and processed meats
- Smells
- Fluorescent lighting
- Stress
Sometimes a single trigger in isolation may bring on a migraine. But it also may take several triggers at once to lead to an attack. For example, someone who gets migraines may drink coffee without experiencing any problems. But a migraine could develop from drinking a strong cup of coffee after a bad night’s sleep spent worrying.
6. Prevention
Tracking triggers is the easiest way to try to prevent migraines. “We always encourage patients to carry out a three-month migraine diary to see if there are any triggers,” says Dr Chowdhury.
A migraine diary can reveal lifestyle patterns that may be leading to attacks. Making lifestyle changes such as getting better sleep, eating well and staying hydrated, for example, can be effective.
If migraines are still frequent, specialists can try preventative medications or treatments. A new preventative drug called Aimovig has recently been approved for use in Europe and is awaiting NHS recommendation.
7. Migraine treatment
For anyone who hasn’t found a way to prevent migraines, available treatment is important. Medication works best when taken early in an attack. That means having painkillers or migraine medication, such as triptans, within easy reach. Triptans are drugs that mimic the effect of serotonin, a mood-stabilising neurotransmitter. They block pain receptors and narrow blood vessels in the head, and may be used if painkillers aren’t effective.
Remember, if it’s tricky to get an NHS appointment, you can use your Benenden Health membership to speak to our 24/7 GP Helpline.
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