There are no diagnostic tests for migraine, but it is usually easy to recognize.
So, what are the symptoms? Migraine attacks occur from once a year to several times a month. Headache is the main feature, but you may feel irritable, depressed or tired for some hours before the headache. Some people also have an aura before the headache. Aura is a brain signal, which usually lasts for 10 to 30 minutes. You may notice bright lights or coloured zigzags in your vision, or, less often, pins and needles on one side of the face or in one hand. The headache itself is often one sided, severe and throbbing, and lasts for a few hours or up to three days. You may feel and be sick. You may find light and noise very uncomfortable, and need to rest in the dark and quiet.
These symptoms make it difficult to work, or carry out daily activities.
Understanding your migraine will help you to take control of your it, rather than let it control you.
Many attacks happen for no obvious reason, but sometimes so-called triggers play a part. Triggers vary greatly, and not everyone has them. If you do, and can recognise them, you may be able to avoid them.
Common triggers are delayed or missed meals, particularly in young people, changes in sleep pattern (especially at weekends), intense exercise, jet lag, bright lights, and emotional upset. In women, monthly periods are often a trigger. Tiredness, anxiety and stress can all make attacks more likely.
Migraine cannot be cured, but treatments are available to relieve it.
Medicines or tablets to treat the migraine attack are called acute treatments. They can be very helpful. They include over-the-counter painkillers, most of which contain aspirin or ibuprofen. Paracetamol is not as helpful. Codeine is not useful for headache, and often has side effects. Whichever you use, soluble or effervescent preparations generally work faster.
If these do not work, there are specific anti-migraine drug called triptans. Triptans do not tackle pain, but undo what is happening in your brain to cause an attack. In some countries, triptans can be obtained from pharmacists. In others, they need a doctor’s prescription.
All of these must be taken correctly. Some simple measures help: always carry at least one dose, and take it as soon as an attack begins. Do not take more than you need: too often (more than 2-3 days a week), they can cause a daily headache called medication-overuse headache.
When attacks are not well controlled with acute treatment, other medications, which are different, can prevent migraine attacks from starting. These should be taken daily, and your doctor will need to prescribe them.
Exercising regularly will help. A diary can be useful, noting each day you have a headache, how long it lasts, how bad it is, and any other symptoms. A diary can help you recognise triggers, and judge how well treatments work.
For most people, attacks become less frequent and less bothersome in later life, and they may stop altogether.
