A migraine is a severe and painful headache. They 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 Migraines can be preceded by an aura of sensory disturbances followed by a severe, often one-sided headache The cause is still largely unknown and they tend to affect people aged 15-55. Not everyone will have a ‘typical’ migraine. There are different types of migraines with different symptoms The most common symptoms of a migraine attack include throbbing headache, sensitivity to light and noise, nausea (feeling sick), vomiting (being sick) and lethargy (lack of energy).
Migraine attack stages or phases
It is often difficult to predict when a migraine attack is going to happen. However, you can often predict the pattern of each attack as there are well defined stages. It is these stages and their symptoms which distinguish a migraine from a headache.
In adults, we can divide a migraine attack into four or five stages that lead on from each other:
- Premonitory or warning phase
- Aura (not always present)
- The headache or main attack stage
- Recovery or postdrome stage
Learning to recognise the different phases of a migraine attack can be useful. You might suffer from one, all, or a combination of these stages, and the combination of stages may vary from attack to attack. Each phase can vary in length and severity.
Recognising different symptoms at different times during your headache attack can give a doctor information which may help diagnosis. Also, taking medication before the symptoms have fully developed may reduce the effect of an attack. A child’s migraine attack is often much shorter than an adult’s attack, and it may therefore not be possible to fully make out the different headache phases.
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.
The aura of migraine includes a wide range of neurological symptoms. This stage can last from 5 to 60 minutes, and usually happens before the headache. Migraine without aura does not include this stage.
In some people, changes in the cortex area of the brain cause changes in their sight, such as dark spots, coloured spots, sparkles or ‘stars’, and zigzag lines. Numbness or tingling, weakness, and dizziness or vertigo (the feeling of everything spinning) can also happen. Speech and hearing can also be disturbed, and sufferers have reported memory changes, feelings of fear and confusion, and more rarely, partial paralysis or fainting. These neurological symptoms are called the ‘aura’ of migraine. In adults, they usually happen before the headache itself, but in children, they may happen at the same time as the headache. It is possible to have the aura symptoms without the headache.
The headache or main attack stage
This stage involves head pain which can be severe, even unbearable. The headache is typically throbbing, and made worse by movement. Some sufferers describe a pressing or tightening pain. The headache is usually on one side of the head, especially at the start of an attack. Some sufferers get pain on both sides of the head, or over the forehead, but not usually at the back of the head. Nausea (sickness) and vomiting (being sick) can happen at this stage, and the sufferer may feel sensitive to light or sound, or both.
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. Many children find that sleeping for just a few minutes can stop their 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. Symptoms can be similar to those of the first stage, and often they are mirrored symptoms. For example, if you lost your appetite at the beginning of the attack, you might be very hungry now. If you were tired, now you might feel full of energy.
There are several categories of methods used to prevent migraine, ranging from diet changes and exercise to prescription drugs; these include:
- prescription beta blockers
- botulinum toxin A (Botox)
- herbs and vitamins such as cannabis, coenzyme Q10, feverfew, magnesium citrate, riboflavin, B-12, melatonin
- spinal cord stimulator implantation
- hyperbaric oxygen therapy
- vision correction
- exercise, sleep, sexual activity
- visualization and self-hypnosis
Some people find that special diets such as gluten-free can help. It is worth noting that some people can get a medication overuse headache (MOH) – or rebound headache – when taking too many medications in an attempt to prevent migraine.
In the last decade, novel approaches to the treatment of migraines have been developed. Botulinum toxin (Botox) injection and surgical decompression of the extracranial sensory branches of the trigeminal and cervical spinal nerves have been shown to reduce or eliminate migraines in patients who don’t respond to traditional medical management. This was highlighted in a review published in the journal Plastic and reconstructive surgery in 2014.
Triggers include smoking and alcohol, avoiding triggers can help prevent migraines or reduce their severity.
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, and excitement
- physical triggers such as tiredness, jet lag, and exercise
- changes in sleep patterns or irregular sleep
- smoking or exposure to smoke
- skipping meals or fasting causing low blood sugar
- hormonal triggers such as menstrual cycle fluctuations, birth control pills, and 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, and hormone replacement therapy
Triggers do not always cause migraines and avoiding triggers does not always prevent migraines.
This relieves headaches with the feeling of head fullness, and sensitivity to noise and light.
This remedy can be helpful if a person has a heavy or “splitting” headache,. Pain is worse from any motion, even from moving the eyes, and the person wants to lie completely still and not be talked to or disturbed..
This remedy relieves congestive headaches at the base of the head, as well as headaches around the eye, caused or aggravated by stress.
This remedy relieves sudden headaches, with fullness of head and feeling of heat, and aggravated by heat.
Other remedies used for migraines depending on symptoms are Ignatia, Iris versicolor, Natrum muraticum etc