Migraine: Symptoms and Treatment

A migraine is a severe, painful headache that can be preceded or accompanied by sensory warning signs such as flashes of light, blind spots, tingling in the arms and legs, nausea, vomiting, and increased sensitivity to light and sound.
The excruciating pain that migraines bring can last for hours or even days
. Migraine is a common problem affecting 36 million Africans, about 12% of the population.

What are migraine headaches?

The exact cause of migraine headaches is unknown; it is thought to be due to abnormal brain activity causing a temporary alteration in the nerve signals, chemicals and blood flow in the brain.

Migraine headaches can be very debilitating affecting 1 in 4 households in Africa. They are more common in women than men, and 3% of people have chronic migraines where they experience symptoms for half the month for six months

What triggers migraine headaches?

Some people who suffer from migraines can clearly identify triggers or factors that cause the headaches, but many cannot. Potential migraine triggers include:

• Allergies and allergic reactions
• Bright lights, loud noises, flickering lights, smoky rooms, temperature changes, strong smells and certain odors or perfumes
• Physical or emotional stress, tension, anxiety, depression, excitement
• Physical triggers such as tiredness, jet lag, exercise
• Changes in sleep patterns or irregular sleep
• Smoking or exposure to smoke
• Skipping meals or fasting causing low blood sugar
• Alcohol
• Hormonal triggers such as menstrual cycle fluctuations, birth control pills, menopause
• Tension headaches
• Foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs and salami)
• Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products and fermented or pickled foods
• Medication such as sleeping tablets, the contraceptive pill, hormone replacement therapy.

                     

Signs and Symptoms of Migraines

Symptoms of migraine can occur a while before the headache, immediately before the headache, during the headache and after the headache. Although not all migraines are the same, typical symptoms include: :

• Moderate to severe pain, usually confined to one side of the head during an attack, but can occur on either side of the head
• The pain is usually a severe, throbbing, pulsing pain
• Increasing pain during physical activity
• Inability to perform regular activities due to pain
• Feeling sick and physically being sick
• Increased sensitivity to light and sound, relieved by lying quietly in a darkened room
• Some people experience other symptoms such as sweating, temperature changes, tummy ache and diarrhea.

Migraines with aura

Many people experience migraines with auras or warning signs just before or during the head pain, but many do not. Auras are perceptual disturbances such as:

• Confusing thoughts or experiences
• The perception of strange lights, sparkling or flashing lights
• Zigzag lines in the visual field
• Blind spots or blank patches in the vision
• Pins and needles in an arm or leg
• Difficulty speaking
• Stiffness in the shoulders, neck or limbs
• Unpleasant smells.

If any migraine sufferer experiences unusual or worrying features that they do not normally have, then they should seek medical help rather than blaming the migraine.

Symptoms such as unusual severe headache, visual disturbance, and loss of sensation or power, difficulties with speech are all important features, which, if unusual for the sufferer, should not be ignored. 
When migraines with aura affect vision, the patient may see things that are not there, such as transparent strings of objects, not see parts of the object in front of them, or even feel as if part of their field of vision appears, disappears and then comes back again.
It is common for patients to describe the visual disturbance as similar to the sensation one has after being photographed with a very bright camera flash, especially if one walks into a darker room straight away.
For many migraine sufferers, the auras act as a warning, telling them that the headache is soon to come.
The Migraine Trust says that in adults auras usually occur before the headache, but in children they may happen at the same time.
Migraine sufferers also may have premonitions know as a prodrome that can occur several hours or a day or so before the headache. These premonitions may consist of feelings of elation or intense energy, cravings for sweets, thirst, drowsiness, irritability, or depression.

Treatment and prevention

There is currently no cure for migraine, so treatment is aimed at preventing a full-blown attack, and alleviating symptoms if they come.

Different people respond to different treatments.

Some lifestyle alterations might help reduce migraine frequency, says Mayo Clinic doctor, Robert Sheeler MD. These include:

• Getting enough sleep
• Reducing stress
• Drinking plenty of water
• Avoiding certain foods
• Regular physical exercise.

Migraine treatment (abortive therapies) and prevention (prophylactic therapies) focus on avoiding triggers, controlling symptoms and taking medicines.

Medication

Analgesia:

• Over-the-counter medications such as naproxen, ibuprofen, acetaminophen (paracetamol), and other analgesics like Excedrin (aspirin with caffeine) are often the first abortive therapies to eliminate the headache or substantially reduce pain
• Painkillers should be taken early rather than allowing the headache to develop.

Go straight to hospital if:

• Your headache is very severe
• You have problems with movement, balance, vision or speech, and these symptoms are different or new from those you have experienced before with your migraines
• You have a fever with your headache
• You have a stiff neck with your headache
• "The headache starts suddenly like a thunderclap," especially if you are at least 50 years of age.