Getting your head around migraines

Posted on 19 September 2012

Our expert Dr Manesh Pillay is a neurologist affiliated with Mediclinic Kloof in Pretoria.

How will I recognise a migraine?
It’s usually an intense, throbbing pain on one or sometimes both sides of the head that can last up to 72 hours. Most people with migraines feel the pain in the temples or behind one eye or ear, although any part of the head can be involved. Migraines are often coupled with nausea and vomiting, and sensitivity to light and sound. Some people experience visual disturbances (auras) such as seeing spots or flashing lights, or a temporary loss of vision.

What causes a migraine?
Most researchers think that migraine headaches are due to abnormal changes in levels of substances produced naturally in the brain. When the levels of these substances increase, they can cause inflammation. This inflammation then causes blood vessels in the brain to swell and press on nearby nerves, causing pain.

How can I tell if I have a migraine coming on?
About 60% of migraine patients experience early signs of an approaching migraine anything from two hours to two days before the pain hits. These signs may include mood changes, irritability, fatigue, food cravings, stiff muscles (especially in the neck), constipation or diarrhoea, and sensitivity to smells or noise.

Can medication relieve the symptoms?
Simple painkillers such as ibuprofen and paracetamol are usually recommended for the headache, and an anti-emetic for the nausea. Medication is usually more effective if used earlier in an attack. However, it’s important to note that the frequent use of medication may result in medication-overuse headaches, which means they become more severe and more frequent.

Could a migraine damage my brain or affect my mental ability?
There is no evidence that migraine has a long-term effect on the function of the brain or long-term neurological consequences for the patient. However, there is abundant evidence now that migraine sufferers with a history of aura have a high risk of stroke. Most of the time migraines aren’t a threat to your overall health, although the attacks can interfere considerably with your day-to-day quality of life.

If I drink a single glass of red wine, I’m sure to have a monster headache the next day. Why does this happen?
Contrary to conventional belief, red wine as such usually does not trigger a migraine attack. However, it seems that the tannins found in red wine cause the release of a neurotransmitter called serotonin. Excessive serotonin can cause headaches, also in people who suffer from migraines.

When should I become concerned about headaches?
You should talk to your doctor if:
• you have several headaches per month and each lasts for several hours or days
• your headaches disrupt your home, work, or school life
• you have a severe headache with a stiff neck
• your headache is coupled with confusion, loss of alertness or convulsions
• you develop severe headaches for the first time after the age of 50

Although migraine can change over the course of a person’s lifetime, it’s always wise to see your doctor if your migraine symptoms change – just to make sure the symptoms are still those of migraine and not of a life-threatening or disabling neurological disease.

Any questions? Want to know more about migraines? Post your comments here and we’ll do our best to have them answered. Or visit www.facebook.com/MediclinicSouthernAfrica

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.