How To Define And Identify A Migraine
A migraine is a strong headache that often comes with nausea, vomiting, and sensitivity to light. It can last hours or days and occur frequently or randomly. Regardless of how long they last, they are hell to endure for the people suffering with them.
Migraines, like people, are bespoke. No two migraines are the same, and, in most people, they unfold in stages giving the person about to be hit that a migraine is on the way before it arrives.
What Is Prodrome
Prodrome is a medical term for the early warning signs or symptoms of an illness or health problem that appear before the major signs or symptoms kick into full force.
Hours or days before a migraine, about sixty per cent of people who suffer from the condition notice symptoms like:
- Rainbow lightning patterns in the field of vision that do not disappear when the eye closes or opens
- Being sensitive to light, sound, or smell
- Severe thirst
- Fatigue
- Aura
- Mood changes
- Food cravings or lack of appetite
- Bloating
- Constipation or diarrhea
These symptoms stem from the nervous system and often involve aspects of vision. They start gradually and build over a 20-minute period. Individuals may experience longer or short transition episodes, but onset signs and indicators of the impending migraine tend to last less than an hour.
You may experience any or a combination of the following pre-indicators:
- See black dots, wavy lines, flashes of light, or things that aren’t there (hallucinations)
- Feel queasy
- Have tunnel vision
- Not be able to see at all
- Have tingling or numbness on one side of your body
- Not being able to speak clearly
- Have a heavy feeling in your arms and legs
- Have ringing in your ears
- Become hyper aware of the smallest sounds
- Notice changes in smell, taste, or touch
What Is An Attack Onset Phase
A migraine headache often begins as a dull ache and grows into throbbing pain. It intensifies during physical activity. The pain can move from one side of your head to the other, be in the front or back of your head, or encase the entire head in one excruciating ball of unrelenting pain.
About eighty per cent of people develop nausea along with a headache, and about half vomit due to the nausea persisting. In some people, the act of physically vomiting when they feel nausea set in can quickly terminate the migraine before it locks in. As can drinking a litre of room temperature water. You may also be pale and clammy or feel faint.
Most migraine headaches last about 4 hours, but severe ones can go for more than three days. It is common for migraine sufferers to get clusters of two to four headaches per month. Some people get migraine headaches every few days, while others get them once or twice a year, and a lucky rare few never get them.
What Migraine Medications Are Available In Australia
For those who suffer from intense migraines, there is some good news in the pain relief department, but the causes may be far more holistic and require a life change, a job change, or psychological counselling to unearth childhood trauma that subconsciously triggers the adult sufferer.
There is no one size fits all remedy, and in some cases, a combination of factors might be required over a period of time.
Triptans. Prescription drugs such as sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt, Maxalt-MLT) are used to treat migraine because they block pain pathways in the brain. Taken as pills, shots, or nasal sprays, they can relieve many symptoms of migraine that the normal list of Panadol or ibuprofen does not have any effect on. These medications are prescription only and cannot be purchased over the counter in Australia.
Over-the-counter: OTC drugs can often work well in the early stage. The main ingredients are acetaminophen, aspirin, caffeine, and ibuprofen.
Never give aspirin to anyone under nineteen (19) because of the risk of Reye’s syndrome.
Be careful when you take OTC pain meds because they might also add to a headache. If you use them too much, you can get rebound headaches or become dependent on them.
If you take OTC pain relievers more than two days a week, talk to your doctor about prescription drugs that may work better. They may suggest prescription medicines that may work well to end your migraine pain, including triptans and the newer Ditans and Gepants. Your doctor can tell you if these are right for you.
Nausea medicine: Your doctor can prescribe medication if you get nausea with your migraine.
Triptans: These drugs balance the chemicals in your brain. You might get a pill to swallow, tablets you dissolve on your tongue, a nasal spray, or a shot. Examples include almotriptan (Axert), eletriptan (Relpax), sumatriptan (Imitrex), rizatriptan (Maxalt), and zolmitriptan (Zomig).
Ergotamine:(Cafergot, Ergomar, Migergot). This also works on the chemicals in your brain.
Lasmiditan: (Reyvow). This drug eases pain, nausea, and sensitivity to light or sound.
CGRP receptor antagonists: Your doctor might give you rimegepant (Nurtec) or ubrogepant (Ubrelvy) if other treatments don’t help.
Preventive medicines: If other treatments don’t work, your headaches are severe, or you have four or more migraine days a month, your doctor may suggest these. You take them regularly to make your headaches less severe or frequent. They include seizure medicines, blood pressure medicines (like beta-blockers and calcium channel blockers), some antidepressants, and shots of botulinum toxin type A (Botox). CGRP antagonists such as atogepant (Qulipta), eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality) can also prevent migraines.
Single-pulse transcranial magnetic stimulation (sTMS): You place this device on the back of your head at the start of a migraine with aura. It sends a pulse of magnetic energy to the part of your brain, which may stop or reduce pain.
Neuromodulation devices: Other devices can affect the vagus nerve and the trigeminal nerve to give relief from or prevent migraines.
Postdrome After Effects
This stage can last up to a day after a headache. Symptoms can include:
- Muscle pain or weakness
- Feeling tired, wiped out, or cranky
- Feeling unusually refreshed or happy
- Food cravings or lack of appetite
What Causes A Migraine
Migraine headaches are a symptom of a condition known as migraine. Researchers do not have an exact cause or dedicated trigger for migraine headaches. The best guess currently theorises that they correlate to changes in your brain chemistry based around subtle yet intense changes to the nervous system, while others are linking the condition to genetics.
One theory is that parents can pass down DNA migraine triggers.
For many years, scientists theorised migraines occur due to changes in blood flow in the brain. Most now suspect this could contribute to the pain, but it is not what starts the process.
The current working theory is that a migraine likely starts when overactive nerve cells send out signals that trigger your trigeminal nerve, which gives sensation to your head and face. This cues your body to release chemicals like serotonin and calcitonin gene-related peptides (CGRP). CGRP makes blood vessels in the lining of your brain swell. Then, neurotransmitters cause inflammation and pain.
What Are The Migraine Risk Factors
From hormonal changes each month in women to emotional stress or psychological trauma, dehydration, an easy excuse not to do something you don’t want to do, or a drug dependency withdrawal, plenty of factors exist to see a headache or migraine set in for the night.
Family history: People with migraines often have family members with the same condition. If one parent has a history of headaches, their child has a fifty per cent chance of getting them. If both parents have a predisposition to headaches, the risk jumps to seventy-five per cent.
Sex: Women have migraines three times more often than men; however, this statistic has never been scientifically confirmed, only statistically gathered by a range of magazine poles. Even for those who genuinely suffer, it is seen as an excuse for not engaging in sexual relations that have no founding legitimacy in fact.
Age: Most people start developing migraine headaches around the onset of puberty. Many women find that their migraines get better or go away after age 50. This suggests a significant correlation between migraines and hormone imbalances that cease to be a factor when the woman enters menopause. That does not explain why men suffer equally, so it is only considered one possible factor, not a definitive cause.
Other medical conditions: Stress, depression, anxiety, emotional upheaval, bipolar disorder, sleep disorders, and epilepsy can increase the risk factors for migraines even if you only ever get one in a lifetime.
What Triggers A Migraine
Stress: When placed under stress, the brain releases chemicals that can cause blood vessel changes from constriction to dilation, which dictate how little or much blood flows around the brain and can lead to migraines.
Hormone changes: Many women notice headaches around their period, pregnant or ovulating. Symptoms may also be tied to menopause, birth control that causes hormonal imbalances, or hormone replacement therapy.
Foods: Some foods and drinks, such as aged cheese, alcohol, and food additives like artificial colours and flavourings in the red and blue spectrum, nitrates in wine, pepperoni, hot dogs, and monosodium glutamate (MSG), may be responsible in people with sensitivities.
Senses: Loud noises, bright lights, and strong smells
Skipping meals: Food fasting can cause low blood sugar that results in headaches
Caffeine: Getting too much or not getting as much as you are used to can cause headaches. Caffeine itself can be a treatment for acute migraine attacks.
Weather changes: Storm fronts, changes in barometric pressure, strong winds, or changes in altitude.
Medications: Vasodilators widen your blood vessels, increasing the blood flow.
Physical activity: This includes exercise and sex.
Tobacco & Drugs: Withdrawal symptoms from a lack of a dependent drug can cause intense headaches.
Sleep deprivation: You might get headaches when you sleep too much or not enough.
What Types Of Migraine Exist
There are several kinds of migraines. The most common is known as a classic migraine, a migraine that may or may not appear with an aura.
Other types include:
Hemiplegic migraine: You have a short period of paralysis (hemiplegia) or weakness on one side of your body. You might also feel numbness, dizziness, or vision changes. These symptoms can also be signs of a stroke, so get a medical assessment immediately.
Status migrainosus: This severe migraine can last more than 72 hours. The pain and nausea are so intense that you may need to go to the hospital. Sometimes, medicines or medication withdrawal can cause them.
Menstrual migraine: Linked to a woman’s period.
Vestibular migraine: You have balance problems, vertigo, nausea, and vomiting, with or without a headache. This kind usually happens in people who have a history of motion sickness.
Silent migraine: Also known as an acephalgic migraine. You have aura symptoms without a headache.
Migraine with brainstem aura: Dizziness, confusion, or loss of balance can happen before the headache. The pain may affect the back of your head. These symptoms usually start suddenly and can come with trouble speaking, ringing in your ears, and vomiting. This type of migraine is strongly linked to hormone changes and mainly affects young adult women. Seek medical assessment promptly if you experience these symptoms.
Abdominal migraine: Experts don’t know a lot about this type. It causes stomach pain, nausea, and vomiting. It often happens in children and may change into classic migraine headaches over time.
Ophthalmic migraine: This is also known as an ocular or retinal migraine. It causes short-lived, partial, or total vision loss in one eye and a dull ache behind the eye, which may spread to the rest of your head. Get medical help right away if you have any vision changes.
Ophthalmoplegic migraine. This causes pain around your eye, including paralysis of the surrounding muscles. This is a medical emergency because the symptoms can also be caused by pressure on the nerves behind the eye or by an aneurysm. Other symptoms include a droopy eyelid, double vision, or other vision changes.
Three Levels Of Migraine Frequency
Doctors divide migraine into three levels of frequency.
Episodic migraine means you get migraine sporadically. High-frequency episodic migraine means you get eight to fourteen headache days per month. This condition also makes you more likely than others to develop chronic migraine.
Chronic migraine means you have headaches on more than fifteen (15) days of the month, and eight of those days have migraine features such as:
- Moderate to intense head pain
- Pain throbs or pulsates
- Pain gets worse when you move
- Nausea or vomiting
- Sensitive to light and sound
- Pain is on the side of the head (one or both)
Chronic high-frequency episodic migraine can be a disabling condition. The higher the pain intensity of each headache, the more disabling. Working closely with your doctor on a treatment plan is important, and your employer understands your condition before employment.
Can Migraines Be Cured
No cure exists for migraines yet. Several medications can help prevent, control, or stop their onset. They may keep your symptoms from getting worse, and they are listed in one of the sections above under Migraine Medications Australia.
Avoid foods and situations you have established trigger your migraines. Lifestyle changes like easing stress and establishing consistently good sleep habits.
Are Migraines Fatal
While it will not feel like it at the time, most migraines do not cause lasting harm. As with everything in life, there is always an exception to the general rule. In this case, there is an extremely rare complication called migrainous infarction. Migrainous strokes are rare and account for only 0.8 per cent of all strokes. This occurs when you have a stroke while you are having a migraine. But there is no clinical evidence supporting that migraines can trigger a stroke.
Also extremely rare, a hemiplegic migraine can sometimes lead to a coma or other serious complications and brain injuries.
A very intense headache that starts suddenly can signify another, more serious condition, like a stroke or aneurysm. Dial 000 emergency services for an ambulance immediately.
When To Seek Medical Assessment
See your treating GP, physician, or medic whenever a headache doesn’t go away or returns within fifteen minutes.
See a health care provider immediately or go to the emergency room if you have a headache with a stiff neck, fever, vomiting, numbness or weakness in the limbs, or trouble speaking.
How Is A Migraine Diagnosed
Your doctor will ask about your general health and any family history. It may help if you have a diary of your symptoms and any triggers you have noticed. Write down:
- What symptoms do you have, including where it hurts
- How often do you have them
- How long they last
- Any other family members who have migraines
- All the medicines, vitamins, and supplements you take, even herbal over-the-counter ones
- Other medicines you remember taking in the past
Your doctor may order tests:
- Electroencephalogram (EEG)
- Migraine Treatment and Home Remedies
- Blood tests
- Imaging tests like MRI or CT scans
Home Remedies For Migraines
- Resting with your eyes closed in a dark, quiet room
- Putting a cool compress or ice pack on your forehead
- Drinking plenty of liquids
- Complementary and alternative treatments
Some people get relief with therapies they use in addition to or instead of traditional medical treatment. These are called complementary or alternative treatments. For migraine, they include:
Biofeedback. This helps you take note of stressful situations that could trigger symptoms. If the headache begins slowly, biofeedback can stop the attack before it becomes full-blown.
Cognitive behavioural therapy (CBT). A specialist can teach you how actions and thoughts affect how you sense pain.
Supplements. Research has found that some vitamins, minerals, and herbs can prevent or treat migraines. These include riboflavin, coenzyme Q10, and melatonin. Butterbur may head off migraines, but it can also affect your liver enzymes.
Body work. Physical treatments like chiropractic, massage, acupressure, acupuncture, and craniosacral therapy might ease headache symptoms.
Talk to your doctor before trying any complementary or alternative treatments.
Migraine Prevention
- Manage stress. Relaxation techniques like meditation, yoga and mindful breathing can help.
- Eat on a regular schedule.
- Drink lots of fluids.
- Get plenty of rest.
- Identify and avoid triggers. Keep track of your symptom patterns in a diary to figure out what is causing them.
- Get regular moderate exercise.
- Ask your doctor about preventive medicines if you get migraines around your period or if lifestyle changes don’t help.
Some new devices available on the market can also prevent migraines with varying levels of success that are individually based.
Cefaly is a headband-like gadget that sends electrical pulses through the skin of your forehead. It affects your trigeminal nerve, which is linked with migraine headaches. You use Cefaly once a day for 20 minutes. When it’s on, you’ll feel a tingling or massaging sensation. Another stimulator, gammaCore, sends a mild electrical signal to the fibres of the vagus nerve in your neck to relieve pain and help prevent migraines.
