by Dr. Anil Venkatachalam
Migraine is a headache experienced with throbbing pain on one side of the head. Conditions that often accompany migraines include nausea, vomiting, sensitivity to light and sound, etc.
The duration of a migraine attack can be anywhere from several hours to days. Pain can often prove to be a major obstacle in the way of daily activities.
Migraines are much more than just headaches. This neurological disease is a public health concern and hence it is imperative to consult a neurologist for correct diagnosis and treatment.
Types of ‘Aura’ and Migraine
Some migraine patients may have a headache immediately before the onset of the headache or accompanied by warning symptoms, or aura, a sign of a migraine attack. This aura can be in the form of blind spots, flashes of light, tingling sensation in the face, and trouble speaking, etc.
Migraines can be of many types. People with episodic migraines (regular migraines) have headaches on days 0-14 of the month. Chronic migraine is a condition in which headaches last more than 15 days a month for three months or more.
Episodic migraines have a tendency to worsen over time and then become chronic migraines.
Although there is no cure for migraine yet, great progress has been made in treating the symptoms.
What is the treatment for migraine?
The response to treatment for migraine and chronic migraine is different. For the treatment of migraine, over-the-counter medications may be recommended. Upon evaluating the frequency and severity of symptoms, prescription medications may also be given. The aim of migraine treatment is to stop the symptoms and prevent future migraine attacks. These may include antihypertensives, antidepressants, and antiepileptics.
However, people with chronic migraine may not respond well to triptans (a group of drugs used to reduce symptoms of a migraine attack) or drugs that block pain pathways in the brain. So, the treatment of chronic migraine is three-pronged – lifestyle and trigger management, acute treatment (ie, treatment given when an attack occurs), and preventive treatment aimed at lowering the frequency of attacks.
Although lifestyle changes help reduce the frequency of attacks, medication or other forms of treatment are almost always needed for chronic migraine patients.
According to the Migraine Research Foundation, migraine is the third most prevalent and sixth most disabling disease in the world. Understanding the severity of migraine attacks is the key to managing them appropriately. Even with new age therapies and treatments, it is the correct diagnosis that matters the most.
The World Health Organization (WHO) states that headache disorders are among the most common disorders of the nervous system, which are underreported, underrecognized and under-treated worldwide. Headache disorders are not taken seriously by sufferers because they are mostly episodic, do not cause death, and are not contagious. This also explains the low consultation rates in developed countries as people are unaware of the existence of effective treatments.
diagnosis of migraine
There are several ways a neurologist can help you with a diagnosis. These include the HIT or headache impact test, CT scan, MRI, eye exam and spinal tap.
The HIT is a tool that measures the impact of headaches on daily tasks, such as not showing up at jobs for adults and going to school for children. HIT is conducted through a questionnaire.
Maintaining a daily headache diary goes a long way in getting the right treatment. A headache diary can help to record the duration, frequency, and severity of headaches. It can also help identify patterns and triggers of headaches and monitor response to treatment.
All of these help determine the right course of treatment.
The author is Consultant (Neurology) and Movement Disorders, Nanavati Max Super Specialty Hospital
See below health equipment-
Calculate your body mass index (BMI)