Migraine matters

Posted on 2 May 2013

Dr Peter Haug, a neurologist at Mediclinic Milnerton in Cape Town, explains what a migraine is and when you should seek medical attention.

What is a migraine and how does it feel?
The intensity of a migraine is determined by a number of factors and can range from mild headaches to debilitating episodes. There are two types: the common migraine and the classic migraine. Common and classic symptoms include one-sided, throbbing pain, accompanied by facial aching, a sensitivity to light, smells and sounds and nausea. Classic migraine sufferers experience an ‘aura’ that lasts a few seconds or minutes, which includes seeing zigzag, wavy or coloured lines or shapes in one visual field. Less common symptoms include dizziness or one-sided weakness. Migraine headaches are often experienced with muscle tension headaches, which can take several days or weeks to improve.

Who is most likely to get them?
Migraines frequently run in families – there’s a 60% chance of suffering from migraines if another one of your first-degree relatives have them too. They’re five to six times more common in women, probably due to hormonal changes, especially in the premenstrual phase of your cycle. Hormonal imbalances experienced during puberty, early pregnancy and perimenopause can also influence the number and intensity of migraines.

What triggers a migraine?
There is no underlying brain pathology but research has shown that it’s a brain-cell dysfunction on an ionic channel level. Typical triggers (other than hormonal imbalances) include sleep deprivation, a change in sleeping patterns, the intake of alcohol and excessive exercise. There is also a long list of potential dietary triggers, including MSG.

What treatment is available?
Migraine headaches can potentially be stopped by the prompt intake of medication, and symptoms are frequently better after lying down and sleeping. Usually, migraines respond to anti-inflammatories, which should be taken as early as possible at the onset of pain. Anti-nausea medication can boost the effect of migraine medication. Most over-the-counter migraine kits can be effective concoctions, but shouldn’t be taken in repeated doses or long term. Patients with frequent or debilitating migraines can benefit from the daily intake of a low-dose oral antidepressant at night, or a low-dose anti-epileptic that blocks certain ion channels and acts as a nerve stabiliser, also at night. The chronic daily intake of painkillers for muscle tension headaches following migraine attacks must be avoided.

When should I seek medical attention?
If you suffer from frequent and debilitating migraine attacks. Also, any unusual or severe aura symptoms need to be investigated for a possible structural brain defect.

Look out for our next post that deals with tension headaches.

If you have questions on this post, or any other medical matter, please visit us on Facebook.

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.