Everything you need to know about migraines

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By Liz Connor

Ever experienced a pain in your head so bad that you can't talk, think
or see properly?

Migraines are believed to affect around eight million people in the UK
and they can be extremely debilitating, in many cases damaging a
person's quality of life and causing 18 million sick days from work each
year.

Contrary to popular belief, a migraine is not just 'a bad headache'.
It's an extremely painful collection of neurological symptoms, including
a headache often characterised by a severe throbbing pain on one side of
the head.

As well as pain, migraines are also associated with nausea, dizziness,
sensitivity to light and noise, and changes in eyesight.

"Attacks vary in length and frequency from person to person, and in
between attacks, there are no symptoms at all - which can make it very
difficult to plan and prepare yourself for the next one," says GP Dr
Lizzie Kershaw-Yates, one of the medical team at The Online Clinic
(theonlineclinic.co.uk).

She explains that there are are three different types of migraine, which
vary in their characteristics:

Migraine without aura: "This is a throbbing headache at the front or at
the side of the head, usually on one side. It can include moderate to
severe pain, with nausea and vomiting, sensitivity to bright light and
can be worsened by head movements."

Migraine with aura: "This has all the same features of a migraine
without aura but there is also a warning sign at the start of the
headache. This could be visual - such as seeing flashing lights, or
experiencing a partial loss of vision - or it could be a sensation, such
as numbness, struggling with speech or a smell."

Migraine with aura, without headache: "This type of migraine has the
same features of a migraine with an aura, but without the onset of a
headache."

How common are migraines?

"Migraines are one of the most common health conditions in the world,"
Dr Kershaw-Yates says. "It affects more women than men. On average, one
in five women suffer from them, and one in 12 men."

They usually begin in the teenage years, but can potentially start at
any age. "Over half of migraine sufferers have one or more attacks a
month, and more than one in 10 have one or more attacks a week," adds
Kershaw-Yates.

What's causing my migraines?

People with migraines are believed to have a very sensitive nervous
system which, for some reason, responds in a particular way,
particularly when it comes to change. "Migraines mean that someone's
brain is responding abnormally to normal signal and sensory information,
such as pain, light or sound," explains Kershaw-Yates. "The narrowing
and opening of the blood vessels can also play a part in causing a
migraine."

You should watch out for any external triggers which might be causing
your migraines. These aren't necessarily the same for everyone, but can
include foods such as chocolate, cheese, red wine or citrus fruits,
psychological factors such as stress, anxiety, depression or tiredness,
along with high altitude, humidity, noise or flickering lights. Food and
drinks which contain caffeine or food additives, sleep (either too much
or too little), drugs and dehydration can also be migraine triggers.

"The amount of factors which can cause migraines is huge, so it's
difficult to say exactly what causes them," says Kershaw-Yates. "One
thing that can help pinpoint your triggers is to keep a migraine diary.
Write down when it started, ended and what your symptoms were, along
with as many details about your daily life as you can, including
medication, exercise, diet and sleep." This can help you and your doctor
work out what might be triggering your attacks.

How are migraines diagnosed?

"No tests can confirm you suffer from migraines - you can only be
diagnosed by a doctor based on your symptoms," says Kershaw-Yates. "If
they are in any doubt, you might be referred to a migraine clinic or a
neurology department, which specialise in the diagnosis and treatment of
migraine." It's important to get properly diagnosed, if you think you
may be experiencing migraines, to ensure you get the right advice and
treatment.

How are they treated?

You can either treat a migraine when you start to feel the symptoms
coming on, or have treatment to prevent it from happening in the first
place.

"Once a migraine begins, you can take painkillers, anti-sickness
medicine, or a medicine called triptans which stimulate the production
of a chemical in the brain (serotonin)," says Kershaw-Yates.

"To prevent your migraine attacks, there are a variety of medicines
which can be tried. The different treatments include beta-blockers,
anticonvulsants, antidepressants, and even Botox."

You should always seek professional medical advice if you're thinking
about trying a new treatment method for your migraines, as most of them
include side-effects. Plus, some over-the-counter painkillers might not
always be the most suitable way of treating your migraine.

Should I contact my doctor?

Dr Kershaw-Yates says that you should speak to your doctor if your
migraines are severe or frequent, or if they are getting in the way of
your day-to-day life. "If you experience excruciating pain, paralysis
down one side of the body or face, speech difficulties, double vision,
or a rash - make sure you seek immediate medical attention ASAP, as this
may be a sign of something more serious," she adds.

Also, if you're struggling to manage your migraines, do go back and see
your GP again, or seek a specialist referral - there might be a lot more
that can be done to help.

Catherine Devane