Continuing our very popular series Medical Matters, Dr Ciaran Roarty this week addresses the issue of migraine and to deal with it.
Migraine is a condition in which a person experiences recurrent headaches which often are accompanied by nausea or vomiting. Patients usually are symptom-free between these attacks.
Doctors often talk about a migraine with aura (an accompanying warning sign) and migraine without aura. An aura can be visual eg flashes of light, or numbness or pins and needles of the hands or arms or face, or an odd smell, and usually, lasts for a few minutes before a headache comes.
Patients will describe a throbbing severe pain that may have started on the front or side of the head and which may spread all over. Movement often exacerbates a headache which can last from 4 to 72hrs.
Common symptoms accompanying migraine include not wanting to be near bright lights or noise, and feeling or getting sick. Other symptoms include reduced appetite, poor concentration, change in vision, congested nose, diarrhoea, abdominal pain, paleness and sweating
Other less common types of migraine include:
Abdominal migraine – seen in children and often a forerunner of common migraine in adulthood. This tummy pain lasts for a few hours and often there is no or only a mild headache.
Eye migraines – usually a temporary loss of all or part of your eyesight in one eye (usually the same eye each time) and may or may not be accompanied by a headache. The eye is perfectly normal and eyesight returns. It is vital that you attend a doctor with a sudden loss of vision, especially the first time as other serious causes must first be outruled before eye migraine can be diagnosed.
Menstrual migraine – associated with periods and can be either premenstrual or around periods AND other times of the month.
There are other rarer forms of migraine also.
There is no test to confirm migraine and doctors will usually diagnose it from the history of your complaint, your symptoms and clinical examination – which is normal. Migraine headaches typically come and go. If your symptoms are not typical or are suggestive of less common forms of migraine your doctor may look for other tests.
We do not fully understand what causes migraine. It was thought to be due to blood vessels going into spasm and then relaxing but it is now thought to be more complicated with chemicals in the brain also being involved.
Migraine is not inherited but as it often occurs in members of the one family there likely is some genetic component in its cause.
Some people find that they can recognise things that my trigger their migraine,
For example certain foods such as cheese, chocolates, red wine and citrus fruits or even just, eating irregularly may be triggers. For others a smoky environment, bright lights, computer screens or flickering lights may set them off. Some people find depression, anxiety, tiredness and stress are their triggers while others report medicines such as some sleeping tablets can initiate their migraine. Your doctor may sometimes ask you to keep a migraine diary to help identify triggers for your migraine.
Paracetamol and aspirin (not in children under 16) are often used to treat migraine but must be taken early. Anti- inflamatory medication such as ibuprofen or others which need a prescription are also used. Your doctor may prescribe anti-sickness medication and other types of migraine medication called Triptans to treat your migraine. If you have frequent and bad attacks of migraine your doctor may discuss taking medication regularly to prevent or reduce the severity of your migraine attacks.
The above information is intended as advice only and should you have any concerns contact your own Doctor.
Dr Ciaran Roarty MB BCh BAO MICGP DRCOG is a full-time GP at Scally McDaid Medical Practice , Scally Place, Letterkenny, Tel 0749164111