Migraine is a common disabling primary headache disorder. In the Global Burden of Disease Study 2010 (GBD 2010), it was ranked as the third most prevalent disorder in the world. In GBD 2015, it was ranked third–highest cause of disability worldwide in both males and females under the age of 50 years. It affects 1 in 5 women and 1 in 15 men.
Migraine headaches are very complex disorders. The typical features of migraines are that usually the headache is throbbing in nature with moderate to severe pain that gets worse with movement or physical activity. The pain typical affects the forehead, the temple as well as around the eyes. It’s worth noting though that sometimes it may involve the whole head. The headache can last 4-72 hours. It can be accompanied by nausea and vomiting. Excessive light and sound also makes it worse and often patients want to lie down in a dark quiet room to alleviate the symptoms.
There are several factors that can trigger migraines. One of the commonest triggers of migraines is emotional stress. Other emotions such as worry, anxiety and excitement can also make migraines more severe. Other triggers include caffeine, light, certain preservatives in food, hormonal changes in women in particular during menstrual periods and daily use of pain killers. Regular use of pain killers can cause a rebound headache.
The diagnosis of migraines is usually clinical. The treating physician will look for a typical history of features that meet the criteria for migraine headache. If these criteria is met, no special tests or brain scan is required.
The treatment of migraines can be complicated. It is important for one to identify the triggers of their migraines. Each individual will have triggers that are specific to them. One then need to avoid triggers where possible. Medications for migraines is divided into abortive and prophylactic treatment. These medications are prescribed by the treating doctor. Abortive medications can possibly stop the headache process and help stop or decrease the migraine symptoms. They are best taken when experiencing the first sign of a migraine and while the pain is mild. Prophylactic medications on other hand are meant to prevent the occurrence and severity of migraine attacks. This are prescribed for patients with debilitating headaches and who have headaches more than 4 times a month. This medication should be taken on a daily basis even when headache free.
Migraine headaches can be debilitating if not managed properly. It is important to get the right diagnosis and be on the appropriate abortive and prophylactic treatment. Identification and avoidance of triggers where possible is also an important cornerstone of the management of migraines.