Migraines are very severe headaches, similar to cluster headaches, often accompanied by flashing or zigzag lights in front of the eyes, nausea and vomiting. The pain can move during the attack, and can change from a constant pain to throbbing. Rarely, sufferers can feel tingling or pins and needles, sometimes there is abdominal pain with or without diarrhoea, and some patients need to urinate urgently.
There is a form of migraine called a hemiplegic migraine, which can be intensely scary for the patient and their loved ones, as it presents very similarly to a stroke. Weakness on one side of the body, slurred speech, vision problems and cognitive issues are all signs of this type of migraine. If it is a stroke the patient needs the fastest possible medical treatment, while the hemiplegic migraine lifts its grip on the affected side of the body after a period of time which can be as much as twenty-four hours or as little as one hour, although the pain can continue for some days. If in doubt, a sufferer must always have stroke ruled out before it is assumed that they are merely suffering a migraine.
Many migraine patients report ocular disturbances such as seeing an aura, up to fifteen minutes before the pain begins. This can be a useful warning, allowing the sufferer to take pain medication and get to a quiet dark place to cope with the problem.
The cause of migraines is believed to be from low levels of serotonin in the brain. The lack of serotonin can cause some of the blood vessels in the brain to spasm suddenly, causing the pain. Many women find that migraines appear at certain points of their menstrual cycle and it is believed that there are hormonal causes for migraines too.
Stress, ill-health, depression, anxiety, excitement, poor sleep, low blood sugar and travelling in cramped positions have all been named as triggers for migraines, while many people find that foodstuffs such as cheese, chocolate and red wine are to blame.
Migraines are quite hard to diagnose and much of the doctor's information will come from the patient. To this end, sufferers are encouraged to keep a migraine journal, detailing stressful events, foods eaten and when the migraines have struck. Most migraine sufferers have a chronic problem, which means that the condition keeps recurring over time, and some can get very adept at managing the symptoms, while others are afflicted with little or no warning.
In some cases painkillers can help, but not always. Triptans are the next step up from painkillers. These drugs work by contracting the blood vessels back to their regular form, thus reducing the pain. Anti-inflammatory and anti-nausea medications can also be prescribed, with each sufferer responding differently to treatment.
If none of the above works, a doctor may well refer the patient to a specialist migraine clinic where the doctors and nurses will try to rule out rare forms of migraine and other conditions that present with the same symptoms.
In extreme cases surgery may be merited. The surgeon will cauterize the blood vessels that are causing the pain, in order to prevent them being able to dilate and cause pain in future.
- Migraine sufferers have a slightly raised chance of suffering an ischemic stroke or mental issues
- Pregnant women must be very careful about which medications they use to control their pain. If in any doubt consult a doctor before taking anything that may impact on the babies health.
- Some sufferers take beta blockers regularly to ward off migraine attacks, but these are not suitable for asthmatics, pregnant women and those suffering a number of other conditions.