The misunderstood mystery of the migraine
12th November 2013
migraineWhen somebody says they have a ‘migraine’, the chances are there will be those who almost dismiss their complaint as just some fancy word for headache and suggest the sufferer taking a painkiller. However, a headache and a migraine differ in many ways and the latter is a severely debilitating condition for the estimated one in four women and one in 12 men in the UK who are affected by them on a regular basis. This equates to around 15% of adults in the UK who are suffering. You may be surprised to learn that in fact migraine is the most common neurological condition, and the problem is actually more prevalent than epilepsy, asthma and diabetes. Migraine does not pick and choose who it targets; it can affect people regardless of age, race, culture or social class, although they are more commonly experienced by women (two thirds of sufferers are women) and attacks usually begin during teenage years. If you are still confused as to what constitutes a migraine as opposed to merely a headache, it would be advised to understand some of the signs and symptoms of migraine. There are actually five stages of migraine, although not everybody will experience all five. They are: 1. 'Prodromal' (pre-headache) stage. As well as physical symptoms such as ache and pains for hours or days prior to the migraine attack, some people may notice a change in mood, a drop in energy levels, appetite and behaviour change. 2. Aura. Some people experience a sensation, or aura, just before their migraine starts. They are neurological interruptions such as seeing flashes of light or blind spots, temporary blindness and seeing things almost like you are looking through a broken mirror. The aura stage usually lasts from anywhere between 15 minutes and an hour. 3. Headache stage. Normally a pulsating or throbbing pain that is on one particular side of the head. You will probably feel queasy and sick, followed by vomiting. There will be an increased sensitivity to bright light and loud sounds, which is why many people with migraine want to rest in a quiet, dark room. This stage can vary in length from four to 72 hours. 4. Resolution stage. Here the migraine is fading slowly but surely. If you do have a migraine, at this point you might find your headache comes to an abrupt end after you have vomited, and sleep can help to relieve the symptoms. 5. ‘Postdromal’ or recovery phase. There could be a feeling of exhaustion and weakness afterwards. The big question therefore is why do migraines occur? The answer is believed to be due to alterations to chemicals in the brain. The chemical in question is one called serotonin, which declines during a migraine. If serotonin levels are low, this can cause blood vessels in a certain area of your brain to spasm; suddenly contracting and becoming narrower. Low levels of serotonin can make the blood vessels in a part of your brain spasm (suddenly contract), which makes them narrower. The symptoms of the aura stage may follow soon after and then after the blood vessels have dilated (widened), this is believed to be responsible for the headache. What causes this drop in serotonin has not yet been fully established. It is worth remembering that severity and patterns of symptoms associated with migraines could differ from one person to the next. But the fact there usually is a pattern is important and you should be aware of this to plan how to manage your migraine. It is vital you consult a doctor to get a diagnosis as the fact remains that around half of all cases are left without a diagnosis or treatment. Like patients with Irritable Bowel Syndrome are often advised to do, you should ideally maintain a diary, documenting when your symptoms have begun, what activities you were doing at that particular time, or what you may have eaten prior to your symptoms beginning. For example, you could find that alcohol consumption leads to you experiencing excruciating headaches - and no, not through a hangover! If you are experiencing something that you suspect to be migraine or frequent and severe headaches, you must get your symptoms checked out by a doctor for an accurate diagnosis to start with, followed by appropriate treatment. Unfortunately, there is no cure for migraines but a variety of treatments may help to ease symptoms. You may have to be patient in trying to find what works best at easing your migraine symptoms and if you find that over-the-counter medicines are relatively ineffective, your doctor can help with other treatment options such as prescribing stronger painkillers, anti-sickness medicines, or anti-inflammatory medicines. If you still find you are not responding well to treatment, your doctor may refer you to a specialist migraine clinic for further analysis of the cause for your symptoms.