What is a migraine?
A migraine is characterised by severe headaches, nausea, and altered perceptions. The headaches are usually on one side of the head, or behind one eye or temple. Sometimes they affect both sides. They typically last between 2 and 72 hours.
People suffering a migraine will seek to retreat in a dark, quiet room.
The severity, duration and frequency of migraines can vary. Some people experience just a few in a lifetime, others several a week. The average sufferer experiences one to three migraines per month. The head pain varies greatly in intensity, and can be very severe.
Between 12-28% of people will have a migraine at some time in their life. About two thirds of migraines run in families. Three times as many women suffer from migraines as men. However, prior to puberty migraines equally affect boys and girls. Fewer children (pre-puberty) and older people (especially post-menopause women) suffer migraines. After age 40, about 25% of women experience a migraine at least once a year, compared with fewer than 10% of men. After menopause, attacks in women are far fewer, so that in the over 70s approximately equal numbers of males and females are sufferers (at about 5%).
Some people feel refreshed or euphoric after a migraine attack, whereas others feel depressed or malaise.
Causes of migraines
The cause of migraines is not well understood, but seems to involve the widening and narrowing of blood vessels in the brain, along with pain neurons in parts of the brain somehow going out-of-control.
Symptoms of migraines
- Nausea (90% of sufferers).
- Vomiting (30% of sufferers).
- Sensitivity to light.
- Sensitivity to smell.
- Sensitivity to loud noises.
- Blurred vision.
- Poor concentration and mood, confusion.
- Vertigo, feeling lightheaded, faint.
- Pallor (pale skin).
- Stiffness and tenderness of the neck.
- Prominence of a vein or artery in the temple.
- Swelling on the scalp or face, scalp tenderness.
- Nasal stuffiness.
- Excessive urination (polyuria).
Migraine podrome phase
A few hours or days before a migraine attack, the majority (about 60%) of sufferers have a podrome phase. They may notice altered mood, irritability, depression or euphoria, sensitivity to smells or noise, visual disturbances, altered sense of taste and smell, fatigue, yawning, excessive sleepiness, craving for certain food (e.g. chocolate), stiff muscles (especially in the neck), constipation or diarrhoea, or increased urination. With experience the patient is warned that a migraine attack is coming.
An aura is a transient visual, sensory, language, or motor disturbance. It can occur as as a strange light, an unpleasant smell or confusing thoughts or experiences. People can experience flashes of white or black, or occasionally multi-coloured lights; zig zag lines, or cloudy or blurred vision. Others experience feelings of pins and needles, tingling, numbness, or hypersensitivity.
Most people who experience auras have the same type of aura every time, though it is not unusual for migraine sufferers to experience more than one type of aura during a migraine.
About 15 to 35% of people who suffer from migraines experience an aura before the migraine occurs. The time between the appearance of the aura and the onset of a migraine may be between a few seconds and up to an hour. Sometimes there is no migraine after they experience an aura.
The aura can stay with a migraine sufferer for the duration of the migraine. This can leave the person disoriented or confused.
Keep a diary to look for associations between headaches and suspected triggers. One trigger in isolation may not cause a migraine. For example, a small block of dark chocolate will not cause a migraine, but half a slab may if it was eaten on a hot humid day, after an argument and having had little sleep.
- Stress, emotional upset.
- Gluten. Migraine sufferers have a much higher incidence of celiac disease than the general population. A gluten-free diet may reduce or eliminate migraines.
- MSG (monosodium glutamate). Widely used in processed foods, fast food, many restaurants and take-aways.
- Tyramine. An amine found in cheese, rotting meat, and mistletoe. It is produced from the breakdown of the amino acid tyrosine.
- Alcohol. Red wine may have an additional component in it that acts as a trigger.
- Caffeine withdrawal.
- Hunger, missing meals or low blood-sugar level.
- Menstrual cycle.
- Weather changes.
- Physical activity, straining. (However, exercise is recommended as a preventative.)
- Hormonal contraception.