Perspective

Not just another headache

The scene

Over these last two decades of her life, Ms MG has been experiencing a severe ‘’life threatening’’ (according to her) pounding headache, usually confined to one side of the head; gives a flashing and blinding sensation, makes her vomit occasionally and actually made her pass out on a particular occasion while waiting for a bus. She is said to have seen doctors and ‘’all manner of tests done but nothing was seen’’. Her mom got really bothered and at the last count she’s accompanied her to the 8th ‘’Baba’’ and as usual the head was washed in ‘’agbo’’ (herbal concoction); all these to no avail!

What is Migraine?

A migraine is usually a moderate or severe headache felt as a throbbing pain on one side of the head. Migraine is a common health condition, actually commoner in women. It affects around one in every five women and around one in every 15 men. It usually begins in early adulthood. Causes The exact cause of migraines is unknown, but they’re thought to be the result of abnormal brain activity temporarily affecting nerve signals, chemicals and blood vessels in the brain. It’s not clear what causes this change in brain activity.

Risk factors

Several factors make one more prone to having migraines, including: • Family history. If you have a family member with migraines, then you have a good chance of developing them too. • Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during the 30s, and gradually become less severe and less frequent in the following decades. • Sex. Women are three times more likely to have migraines. Headaches tend to affect boys more than girls during childhood, but by the time of puberty and beyond, more girls are affected.

Hormonal changes. If you are a woman who has migraines, you may find that your headaches begin just before or shortly after onset of menstruation.

Migraine triggers

Many possible migraine triggers have been suggested, including hormonal, emotional, physical, dietary, environmental and medicinal factors. These triggers are very individual but it may help to keep a diary to see if you can identify a consistent trigger. It can also sometimes be difficult to tell if something is really a trigger or if what you’re experiencing is an early symptom of a migraine attack.

Hormonal changes

Some women experience migraines around the time of their period, possibly because of changes in the levels of hormones such as oestrogen around this time. This type of migraine usually occur between two days before the start of the period to three days after. Emotional triggers: Stress, Anxiety, Tension, Shock ,Depression, Excitement Physical triggers: Tiredness, Poor quality sleep, Shift work, Poor posture, Neck or Shoulder tension, Jet lag, Low blood sugar (hypoglycaemia) ,Strenuous exercise, if you’re not used to it Dietary triggers: Missed, Delayed or Irregular meals, Dehydration, Alcohol, Tyramine (a food additive), Caffeine products, such as tea and coffee, Specific foods such as Chocolate, Citrus fruit and Cheese

Environmental triggers:

• bright lights

• flickering screens, such as a television or computer screen

• smoking (or smoky rooms)

• loud noises

• changes in climate, such as changes in humidity or very cold temperatures

• strong smells

• a stuffy atmosphere

Medications:

• some types of sleeping tablets

• the combined contraceptive pill

• hormone replacement therapy (HRT), which is sometimes used to relieve symptoms associated with the menopause

What gives it away

In adults, a migraine attack is divided into four or five stages that lead on from each other:

• Warning phase; This describes certain physical and mental changes such as tiredness, craving sweet foods, mood changes, feeling thirsty and a stiff neck. These feelings can last from 1 to 24 hours.

• Aura (not always present); may include seeing dark or bright colored spots, zigzag lines and having tingling sensation

• The headache or main attack stage; severe and pounding, nausea, vomiting

• Resolution; Most attacks slowly fade away, but some stop suddenly after the sufferer is sick, or cries a lot. Sleep seems to help many sufferers, who find that even an hour or two can be enough to end an attack.

• Recovery or postdrome stage; This is the final stage of an attack, and it can take hours or days for a ‘hangover’ type feeling to disappear. How to confirm it is Migraine The diagnosis of a migraine is mainly based on symptoms and not Neuroimaging tests which are usually not necessary for diagnosis.

Treatment

Please visit your doctor

Prevention Until recently, it was recommended that common migraine triggers should be avoided. Some triggers can’t be avoided, and avoidance isn’t always effective. But some of these lifestyle changes and coping strategies may help reduce the number and severity of migraines:

• Learn to cope. Recent research shows that a strategy called learning to cope (LTC) may help prevent migraines. In this practice, you are gradually exposed to headache triggers to help desensitize you to them.

• Create a consistent daily schedule. Establish a daily routine with regular sleep patterns and regular meals. In addition, try to control stress.

• Exercise regularly. Graded regular aerobic exercise reduces tension and can help prevent migraines. • Reduce estrogen medications if you are a lady.

• Transcutaneous supraorbital nerve stimulation (t-SNS). This device was recently approved as a preventive therapy for migraines. Those that used the device experienced fewer migraines.

Take Home

The diagnosis of a Migraine should be trusted only and only to a doctor and not to a relative or neighbour “who had a similar experience in the past”. It could feel like a Migraine but may actually be something more sinister!

 

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