Migraine headache

Migraine is a complex disorder characterised by recurrent episodes of headache, most often unilateral and in some cases associated with visual or sensory symptoms. It may occur with symptoms such as nausea, vomiting, or sensitivity to light and sound. In many people, a throbbing pain is felt only on one side of the head.

Causes

Though migraine causes are not fully understood, genetics and environmental factors appear to play a role. Most medical experts believe the attack begins in the brain and involves nerve pathways and chemicals. Changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway, might be involved.

Migraine attacks may be triggered by any of the following:

• Caffeine withdrawal
• Changes in hormone levels during a woman’s menstrual cycle or with the use of birth control pills
• Changes in sleep patterns, such as not getting enough sleep
• Drinking alcohol
• Exercise or other physical stress
• Loud noises or bright lights
• Missed meals
• Odours or perfumes
• Smoking or exposure to smoke
• Stress and anxiety
• Chocolate
• Dairy products, especially cheese
• Meat containing nitrates (bacon, hot dogs, salami, cured meats)
• Peanuts and other nuts and seeds

Symptoms

Migraines can progress through four stages: prodrome, aura, attack and post-drome, and not everyone who has migraines goes through all stages.

Prodrome

• Mood changes, from depression to euphoria
• Food cravings
• Neck stiffness
• Increased thirst and urination

Aura

• Visual phenomena, such as seeing various shapes, bright spots or flashes of light
• Vision loss
• Pins and needles sensations in an arm or leg
• Weakness or numbness in the face or one side of the body
• Difficulty speaking
• Hearing noises or music
• Uncontrollable jerking or other movements

Attack

• Pain, usually on one side of your head, but often on both sides
• Pain that throbs or pulses
• Sensitivity to light, sound, and sometimes smell and touch
• Nausea and vomiting

Post-drome

• After a migraine attack, you might feel drained, confused and washed out for up to a day.
• Some people report feeling elated.
• Sudden head movement might bring on the pain again briefly.

When to see a nurse or doctor

• If you regularly have signs and symptoms of migraine
• If you have a history of headaches
• If you have an abrupt, severe headache, like a thunderclap; headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking

Home remedies

• Turn off the lights and relax in a dark, quiet room.
• Apply hot or cold compresses to your head or neck.
• Establish regular sleep hours. Wake up and go to bed at the same time every day, even on weekends.
• Do not skip meals. Fasting increases the risk of migraines.
• Avoid foods that trigger migraines such as cheese, chocolate, caffeine or alcohol.
• Engage in regular physical activity.
• Avoid stress.

Medication to be used

• Paracetamol
• Ibuprofen

MIGRAINE SELF ASSESSMENT

INSTRUCTIONS: Please answer the following questions about ALL of the headaches you have had over the last three months.

Scores as follows:

• 0–5 No risk
• 6–10 mild risk
• 11–24 moderate risk
• 24+ severe risk

If your assessment score is six and above, please seek medical help: [email protected]