12% of the world’s population are chronic migraine suffers (migraineurs). This means that there are more people who suffer from migraine than diabetes, asthma or epilepsy!
Migraine is an extremely debilitating illness with episodes lasting from 4-72 hours.
In most people migraines begin in young adulthood, coming and going in frequency over the following years, and often diminishing after the age of 50. There appears to be a genetic component, and evidence suggests that migraines may also develop after mild traumatic brain injury.
The pain experienced in a migraine is due to pericranial ( around the brain) muscle tenderness and can also be due to inflammation of the cranial blood vessels. The things that cause the muscles and blood vessels to become inflamed and painful are called TRIGGERS.
Many migraine triggers have been identified and include the following:
- Drinking red wine
- Skipping meals
- Excessive stimuli such as flashing lights and strong odours
- Weather changes
- Sleep deprivation
- Hormonal factors
Most migraineurs know what their particular triggers are and learn to steer clear of them.
Fluctuating oestrogen levels are a potent migraine trigger. This accounts for the reason that 18% of women suffer from migraine, and only 6% of men. Many women have onset of migraine at puberty, have severe attacks during menstruation (menstrual migraine) and worsening during menopause. Oral contraceptives and hormone replacement therapy can worsen migraine.
Often a change in the body signals that a migraine is beginning, such as mood changes or a loss of appetite. In about 25% of patients an “aura” heralds an attack.
What is an aura? It is a temporary disturbance in the brain that can affect speech, vision, balance and muscle coordination. Visual disturbance is the most common, but regular sufferers know exactly what THEIR aura is and will know that a migraine is on its way.
Migraine is more than a headache: there are almost inevitably other symptoms that accompany an attack such as nausea and vomiting, sensitivity to light and sound, and the inability to concentrate. Most people will need to lie in a dark quiet room until the attack subsides.
The treatment of migraine depends on the severity of the pain.
Prevention is better than cure, so avoid triggers, especially stress.
Mild pain can be treated with readily available anti-inflammatory pain killers. Medication to treat nausea can be added if required.
If more severe, migraine specific medication can also be taken. Some are available over the counter, but the most effective is a class of drugs called triptans.
Triptans require a prescription from your doctor. They are not analgesic as such but work on the peptides that cause vascular pain. To be effective Triptans MUST be taken at the onset of an attack.The sooner they are taken the more effective they are.
They will not work if the headache is muscular in origin, or if the severity of the pain is extremely high.
The diagnosis of migraine is clinical based on symptoms and a physical examination. If possible evaluation is best done whilst the patient is actually experiencing an attack.
SINUS HEADACHE OR MIGRAINE? Too often people come into the pharmacy complaining of migraine when in actual fact they are experiencing a sinus headache. Although an accurate diagnosis is best done by your doctor a person suffering from a sinus headache will also have some of the symptoms of a sinus infection: a yellow or green nasal discharge, swollen lymph nodes, and fever. The classic signs of a true migraine, nausea and light sensitivity, will be absent.
Article supported by Mylan Pharmaceuticals.