Overview

Migraine is a neurological condition that causes recurring headaches, often accompanied by symptoms such as nausea, vomiting, and sensitivity to light or sound. Some people may also experience an aura before the migraine attack. Early treatment and appropriate self-care can help relieve symptoms and reduce the impact of an attack.

 

Causes

The exact cause of migraine is not fully understood. It is believed to involve changes in the activity of the brain, affecting nerves, brain chemicals, and blood vessels. Genetics also play a role, so people with a family history of migraine are more likely to experience it. Migraine is also more common in women than in men.

 

Many people find that certain factors can trigger a migraine attack. Common triggers include:

• Hormonal changes, such as during menstruation
• Stress, anxiety, or depression
• Tiredness or lack of sleep
• Skipping meals or eating irregularly
• Excessive caffeine intake or caffeine withdrawal
• Lack of regular physical activity

Migraine triggers vary from person to person. Keeping a migraine diary to record your symptoms, activities, diet, and possible triggers can help you identify patterns and avoid factors that may increase your risk of an attack.

 

Symptoms

Migraine symptoms vary from person to person, but commonly include:

• A moderate to severe headache that may start as a dull ache and gradually become throbbing or pulsating
• Pain that is often felt on one side of the head, although both sides can be affected
• Nausea or vomiting
• Increased sensitivity to light, sound, or sometimes smells

 

Some people experience early symptoms (prodrome) at the start of a migraine attack. These may include:

• Feeling unusually tired or yawning frequently
• Food cravings or increased thirst
• Changes in mood
• Neck stiffness

 

Some patients with migraine experience an aura (warning signs that a migraine is about to occur). Aura symptoms are temporary and may include:

• Visual disturbances, such as flashing lights, zigzag lines, or blind spots
• Numbness or tingling, usually affecting one side of the face or one hand
• Dizziness
• Difficulty speaking

Treatments

Although migraine cannot be cured, treatments can help relieve symptoms during an attack and reduce the frequency of future episodes. The most suitable treatment depends on how often your migraines occur and how severe they are. It may take time to find the approach that works best for you.

 

To relieve migraine symptoms, treatment may include:

• Pain relievers such as Paracetamol, Ibuprofen or Paracetamol with codeine and caffeine

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• Prescription migraine medicines, such as triptans
• Medicines to help relieve nausea or vomiting

For best results, pain relief should be taken as early as possible after migraine symptoms begin.

 

When to see a doctor

Migraine attacks can be managed with self-care measures and appropriate medicines. However, some symptoms may indicate a more serious condition and should be assessed by a doctor.

 

See a doctor if:

• Your migraine does not improve within 3 days despite treatment.
• Your aura symptoms last longer than 1 hour or become more severe.
• Your usual migraine treatment is no longer effective.
• Your headaches become more frequent, more severe, or the pattern of your headaches changes.
• You experience difficulty speaking, changes in vision, weakness, problems with movement, or loss of balance.
• Your headache is worse when lying down.
• Your headache starts suddenly and reaches maximum intensity within a short period of time.

 

Lifestyle measures

In addition to medications, simple self-care measures and healthy lifestyle habits can help relieve migraine symptoms and reduce the risk of future attacks.

During a migraine attack:

• Drink plenty of water to stay hydrated, especially if you have nausea or vomiting.
• Rest in a quiet, dark room to minimise exposure to light and noise.
• Apply a cool compress or cloth to your forehead or the back of your neck to help ease discomfort.
• If possible, stop activities and rest until your symptoms improve.

To help prevent future migraine attacks:

• Identify and avoid your personal migraine triggers, such as certain foods, lack of sleep, or stress.
• Eat regular, balanced meals and avoid skipping meals.
• Maintain a regular sleep schedule and aim for adequate sleep each night.
• Exercise regularly, as appropriate, and stay well hydrated.
• Practise stress management techniques, such as deep breathing, mindfulness, or relaxation exercises.
• Avoid smoking and limit alcohol intake.
• Moderate your caffeine intake and try to consume it consistently, as excessive amounts or sudden withdrawal may trigger migraines in some people.

 

References

https://www.healthhub.sg/health-conditions/migraine

https://www.nhs.uk/conditions/migraine/