Dealing with migraine

By Dr Brigid Monda

A migraine is a terrible headache with pain that often begins in a specific area of the head then spreads and intensifies over one to two hours before it gradually fades off. The insides of your head become a torture chamber and feel like someone is persistently knocking at a door. Since there is no one to answer it, the knocking persists. Some forms of migraine come with nausea, vomiting, and sensitivity to light and sound. Moving around worsens the pain.

No one really knows what causes migraines or why women between the ages of 35 and 45 — a period when many are at the height of their professional careers, family responsibilities, and social life — have the most frequent attacks and which, occur three times more than men. But since migraines also tend to run in families, there is a notion that some people are born with a predisposition to them.

Doctors think migraines are caused by an abnormal function of the brain’s blood vessels — when they get overly narrowed and then widen abnormally. It is this widening that is responsible for the pain.

Migraines can be classified into two major groups: classic migraine and common migraine. The differentiating factor is an "aura" — or simply a warning. Persons suffering from classic migraines are able to predict that they will get migraine. An "aura" could present as flashing lights, zigzagging lines, a temporary loss of sight or hearing, ringing in ears or dizziness, slurred speech, confusion, weakness of an arm or leg or a tingling of face or hands.

No aura

The common migraine does not quite have an aura. Sufferers will only feel tired, depressed, restless or talkative two or three days before the headache begins. It may also come with abdominal pain and diarrhoea, more frequent passing of urine, nausea and vomiting. The duration of both types of migraines may be as short as a few hours to as long as one to two pain-racked days. They strike most often once a month but can be as often as several times a week or as rarely as once every few years.

Some things can trigger a migraine or make it worse. They include too much or too little sleep, bright lights or hormone fluctuations like when a woman is ovulating, just before her menses or during the rest period after a 21-day pack of the contraceptive pill. Those related to hormone fluctuations are also called ‘oestrogen withdrawal headaches’ and are caused by a fall in the levels of oestrogen in the blood. Hunger, fasting, certain foods, drinks, smells, tobacco smoke, light glare or dazzle, weather changes, certain drugs and psychological stress can also trigger a migraine. A migraine may also begin after a stressed person is finally able to relax and the "relaxing" becomes relaxation hell.

Take precaution

Migraines have no cure. The good news, however, is that with the right treatment, they can be controlled. There are various treatments available to either prevent migraines or relieve the symptoms. All you need to do is to find the right combination of medications that work for you.

But a recurring intense headache may be the sign of more than just a migraine so you must always see a doctor especially since people who suffer from classic migraines have an increased chance of suffering a stroke.

See your doctor if you have any problems that may be related to the medicine you are taking, if the headache worsens progressively or lasts more than 24 hours despite treatment; if you develop a high temperature, faint or develop weakness or paralysis that lingers long after a headache stops, numbness, double vision, difficulty with speech, or neck pain or stiffness with the headache, experience any change in the frequency, intensity or severity of a migraine; if you develop a headache after being hit on the head or when a person experiences the "worst headache of his or her life".