Migraine

Migraine is a common condition in which a person gets repeated attacks of moderate to severe headache, often with nausea and discomfort from light and sound. It is a long-term tendency of the brain, not a sign of a tumour or other structural disease, and it can be managed well with the right care. Migraine is more common in women and often runs in families.

Symptoms

• Throbbing or pulsating headache, often on one side of the head but sometimes on both sides
• Pain that worsens with routine activity, such as walking or climbing stairs
• Nausea or vomiting
• Discomfort with bright light, loud sound or strong smells
• Attacks lasting from a few hours up to two or three days
• In some people, an aura before the headache: flashing lights, zigzag lines, blind spots or tingling on one side, usually lasting less than an hour
• Tiredness, low mood or poor concentration before or after an attack

Causes

The exact cause is not fully understood. Migraine is thought to involve changes in nerve activity and chemical signals in the brain, together with the blood vessels around it. People with migraine have a sensitive nervous system, and attacks are often set off by triggers such as:

• Stress, or relaxing after a period of stress
• Lack of sleep or oversleeping
• Skipped meals, fasting or not drinking enough water
• Hormonal changes around periods
• Bright sunlight, heat, strong smells or loud noise
• Certain foods, tea, coffee or alcohol (this varies from person to person)
• Long hours of screen use

Diagnosis

Migraine is diagnosed mainly from the pattern of symptoms and a normal neurological examination. There is no blood test for migraine. A brain scan is not routinely needed, but a CT or MRI may be advised if there are unusual features, a sudden change in the pattern or abnormal signs on examination, to rule out other causes.

Treatment

Migraine is treated with medicines and lifestyle measures. Surgery is not a treatment for typical migraine.

During an attack: pain relievers and specific migraine medicines work best when taken early. Medicines for nausea may be added. Resting in a dark, quiet room helps.

Prevention: if attacks are frequent or disabling, a doctor may prescribe daily preventive medicines for some months. Regular sleep, regular meals, enough water, exercise, yoga or relaxation, and avoiding personal triggers all reduce attacks. Pain relievers should not be taken on more than a few days a week, as this can lead to medication-overuse headache.

A neurosurgical evaluation is useful when headaches have unusual features, to make sure there is no underlying problem such as a tumour, bleed or abnormal blood vessel.

When to Seek Urgent Care

• A sudden, very severe headache that peaks within seconds to a minute
• Weakness on one side of the body, or an aura lasting more than an hour
• Headache with fever, stiff neck or confusion
• Loss of vision, double vision or difficulty speaking
• Headache after a head injury
• An attack lasting more than three days
• A clear change from your usual pattern, or a new headache after the age of 50

If you notice any of these, go to the nearest emergency immediately.

If migraine is affecting your daily life or your headaches have changed, consult Dr. Prashant Sharma for a careful evaluation.

Related Conditions

• Nerve Pain (Neuropathic Pain)
• Paralysis (Weakness of Limbs)
• Unconsciousness (Loss of Consciousness)
• Vertigo
• All Neurological Treatment ›