(Image: Christina K)
If you get them…
Although migraine is a result of abnormal brain activity, the causes are still unclear. Around 70 per cent of people who report migraines have a family history of the condition, but because of misdiagnosis, family history may remain hidden.
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Migraine attacks usually involve intense, one-sided throbbing head pain. They are also generally accompanied by other symptoms, ranging from nausea and sickness to sensitivity to light, sounds and smells. There may be nasal congestion, tears and sweating. Sometimes there is tingling in limbs, neck pain, even one-sided paralysis and slurred speech, so occasionally it looks almost like a stroke. And around 20 per cent of people who suffer from migraines get the strange visual or auditory hallucinations known as aura. Because the symptoms of migraine are so broad, it is often misunderstood and misdiagnosed.
So if you think you might suffer from migraine, seek professional advice and get a proper diagnosis. Find out what kind of lifestyle changes and medications are most appropriate for your symptoms. Do not just tough it out, as that can make things worse in the long run. Self-medication with over-the-counter painkillers can even prolong the pain. Taking painkillers can lead to rebound, where the symptoms return as the drugs wear off, leading to a cycle of often worsening symptoms.
Do try to keep a good routine, sleep well, stay hydrated and try to eat “clean”. If nothing else it might help you to identify patterns and triggers for your attacks. A migraine diary will help, and there are also online diaries and apps which can help find links you might not have considered.
Trigger trouble
One unique feature of migraine is the way it appears to be “triggered” by something environmental. Common triggers are said to include red wine, chocolate, flashing lights, hormonal changes, sleep disruption, and stress. Doctors advise patients to try to identify their own triggers by keeping a migraine diary, and to make changes to their lifestyle and diet. But recent studies show that the story is more complex than first thought.
For a start, the things that get reported as triggers may not always be to blame. In one recent study on people who believed their migraines were triggered by flashing lights, the researchers failed to trigger in the lab using all manner of annoying lighting and strobes. Instead, it could be that the trigger itself does not cause the attack, but that people are more susceptible to these stimuli once a migraine is under way, and are therefore more likely to notice them.
During the prodome stage of an attack (see diagram) people are more sensitive to stimuli such as light and noise, but don’t always realise that their attack has started. It’s possible that sleep may be disrupted by the attack, that things feel more stressful or that a stimulus like bright lighting becomes more troublesome. These things might then be blamed for the attack that was already in progress.FIG-mg30110701.jpg
Stress let-down, the feeling of relief after a period of stress, has also been found to be one of the most common triggers. People often report migraine at the weekend or after a big exam or work event. But even this might actually be due to change of routine – a lie-in, say, or a change in diet or caffeine intake.
Read more: “Not just a headache: How migraine changes your brain“
