Migraine

General Information on Migraine

Migraine consists of two main types, migraine with aura and migraine without aura. The latter type is the most prevalent (aura is absent in 80% migraine attacks).

Causes

• Brought on by dilatation of blood vessels in the head and surrounding nerves becoming very sensitive resulting in pain signals being sent to the brain.
• Very often migraine is triggered by certain factors (e.g. food, emotion)

Signs and Symptoms

• Severe, recurring one-sided or two-sided pain on head usually accompanied by nausea and vomiting.
• Face turns pale.
• Aversion to light, pungent smells and noise.
• Some people experience warning signs/ aura (e.g. flashing lights, tingling/ numbness on one side of the body, blurred vision/blind spots) coming about 20 minutes before onset of migraine.
• Preliminary signs e.g. depression/irritability, loss of appetite, drowsiness, craving for sweets and mood swings, may appear 24 hours before a migraine attack starts.
• Often bright lights, exercise, movement and any noise can exacerbate the headache.

Self Care

• Identify and avoid trigger factors (See Box 1).
• With the help of a doctor/pharmacist, devise a treatment plan to deal with the migraine.
• Be prepared. Keep supplies of medicine. It is most effective when taken during the early stages of a migraine attack.
• Get sufficient sleep.
• Relax, plan ahead and manage your time well to avoid stress. Seek help from colleagues, family and friends.
• Follow a healthy, balanced diet.
• Wearing sunglasses where appropriate helps reduce glare.
• Avoid driving or operating any machinery during a migraine or when using certain migraine medicines (ask a pharmacist).

Medicines

Anti-migraine preparation

• Ergotamine (Cafergot)
• only be used a few times a week
• not for pregnant women and breastfeeding mothers
• Sumatriptan succinate (Imigran)
• Relief of acute migraine
• Flunarizine (Sibelium)
• Prevents migraine
• The effect may not be seen for several weeks. Do not stop taking the medication although no effect is evident within the first 6 to 8 weeks
• Pizotifen hydrogen malate (Sandomigran)
• Prevents attack of migraine
• Does not work during a migraine attack
• Can be taken everyday even if you feel well

Supplements

• Feverfew
• Prophylaxis of migraine
• Reduces the symptoms and frequency of headaches and migraine when taken regularly.
• Reduces the frequency and severity of attacks and also nausea and vomiting.