Neurologist answers questions about debilitating migraines

Migraines, much more than ‘just headaches’, can be hugely debilitating and cause a variety of symptoms in addition to headaches.

But there are still many misunderstandings about migraines, which affect one in seven people.

The Migraine Trust say migraines are more common than diabetes, epilepsy and asthma combined.

It’s Migraine Awareness Week between September 6-12, and the charity is highlighting migraine triggers, including stress, poor sleep, alcohol, hunger, hormonal changes, and the environment.

It’s also a great opportunity to make people aware of the symptoms of migraines, including painful headaches, vision problems, sensitivity to light, sound and smells, plus nausea and vomiting.

Here, Dr. Ben Turner, a neurologist consultant at London Bridge Hospital (part of HCA Healthcare UK), explains more about the condition.

What Causes Migraines?

“In neuroscientific terms, migraine is a” disorder of central sensory processing, “or in non-medical terms,” ​​incorrect signals in the brain. ”

Essentially the cause of migraines is the complexity of the brain – 86 billion neurons will occasionally fail, ”says Turner.

“The brain is a highly sophisticated computer and, like computers, can inexplicably freeze and restart. On an individual level, the main risk factors for migraines are genetic – i.e. a family history – and lifestyle, lack of meals or sleep. “

Are some people more likely to get migraines?

Migraines are more common in women, especially between the onset of menstruation and menopause. People with relatives, such as parents or siblings with migraines, will also be more prone to suffering. “

What are the treatments and how successful are they?

“There are three pillars of treatment: lifestyle, treatment of individual attacks (acute treatment) and preventive treatments (prophylaxis),” explains Turner, who emphasizes that these can all play an important role in managing migraines.

“Lifestyle is about a routine, regular diet – breakfast, lunch and evening meals – and avoiding low blood sugar, which is a biological stress and trigger.

“Whether individual foods act as triggers is less clear, but chocolate, caffeine and dairy are considered potential triggers, along with alcoholic beverages – although triggers are often unreliable and individual. Shiftworkers have been found to be more prone to migraines, so regular sleep patterns have been found. reduce the risk Regular exercise is also protective.

“Acute treatment is about taking medication early, such as soluble aspirin in a carbonated drink with caffeine. Alternatives to aspirin include the triptan family, which is now available without a prescription. Both approaches should relieve two-thirds of migraines – they don’t stop all attacks, but doses can be repeated as needed. If nausea is a factor, using medication to treat it is important.

“Prophylactic treatment required regular medication such as a beta blocker, antidepressant or anti-epileptic for weeks or months. More recently, a new group of drugs targeting the calcitonin gene-related peptide pathway has shown good results. On average, these preventive treatments reduce migraine attacks by 50%. “

How psychologically harmful are migraines?

“Regular migraine sufferers are more prone to mood and anxiety, not only because of the frequent threat of debilitating attacks, but it appears that the changes in the brain before and after migraines also lead to a bad mood,” Turner says.

“Give it up” for migraines

The Migraine Trust asks the friends and family of people with migraines to participate # GiveUpForMigraine campaign, by thinking of something they love to do and that they are willing to give up a month, and donate the money they save by not doing it to The Migraine Trust.

The idea is that sacrificing what they love will give people insight into an important part of living with migraines, as the condition is often caused by things that people like to do, such as drinking alcohol or coffee, and they need to give up. to try to prevent their migraines.

“A migraine attack is often triggered by something, and understanding what triggers your attacks can help you control them,” said Migraine Trust spokesman Una Farrell. “Triggers vary for different people – alcohol can trigger one person, while hormonal changes can cause monthly attacks in one woman but not another.”

Farrell says identifying a trigger isn’t always easy, and they can sometimes be misidentified. “For example, at the beginning of an attack, before the pain starts, you may crave sweet things,” she says. “If you eat some chocolate to satisfy this craving and then get a headache, you can recognize chocolate as one of your triggers. You even started having migraines before eating the chocolate. “

A good way to identify triggers, she says, is to keep a detailed diary of your activity, food and drink, changes in your mood and body, and external factors such as weather and room temperature, to help you spot patterns and so identify it. your real migraine triggers.