Migraines are also called vascular headaches, because they usually involve spasm of the arteries of the head, resulting in a pulsating pain. The headaches may last from a few hours to several days.
About 10 per cent of migraine sufferers experience a warning aura before the headache starts; this early symptom involves a visual disturbance, such as partial or temporary loss of sight or flashes of light and colour. An aura may also cause tingling on one side of the face or body or a disturbance in the sense of smell. Even those who don’t experience an aura may have warning signs in the few hours leading up to a migraine, such as feeling cold, craving a specific food, mood changes, a sudden burst of energy or frequent yawning.
Migraines affect about 15 per cent of women and about 6 per cent of men, and are most common in the 25 to 34 age group, but some start in childhood. Doctors think that dietary, hormonal, emotional and environmental triggers may cause blood vessels in the brain to constrict and then relax. The distorted blood vessels prompt nerve endings to send out pain signals.
Relief from Migraines
Try relaxation techniques. In addition to using relaxation techniques, some doctors suggest taking a course in biofeedback to learn how to raise the temperature of your hands, thereby diverting some of the blood flow from the head to another part of the body. This technique can be used at the start of an attack.
Medications. For acute attacks, a simple analgesic such as aspirin, paracetamol or a nonsteroidal anti-inflammatory drug (NSAID) may also help, but can cause gastrointestinal problems. NSAID products available include ibuprofen and naproxen. Products combining paracetamol with codeine may also give relief, although they usually cause constipation. An anti-emetic (metoclopramide or domperidone) may be needed to stop vomiting. Specific anti-migraine drugs such as sumaptriptan (Imigran) may be used. Sumatriptan is a serotonin antagonist available as an oral medication, a nasal spray or injection. It may not be effective if taken during the aura phase. Migraine headaches are thought to be due to some blood vessels widening, and sumatriptan aims to normalise these blood vessels.
If there are more than two attacks a month, they are increasing in frequency, causing severe disability or you cannot tolerate the drugs used in acute attacks, doctors may prescribe pizotifen (Sanomigran) which is an antihistamine and serotonin antagonist; beta blockers (such as propranolol); topiramate (Topamax) which is an anti-epileptic drug used only under supervision; amitriptyline (which is as yet unlicensed); or sodium valproate (an anti-epilepic drug, also unlicensed as yet). In addition, high-dose riboflavin (400mg) has been tested for preventing migraine, but the initial results from one small study have not been duplicated in placebo-controlled trials. Coenzyme Q10 looks more promising, but more studies are required. Magnesium is also being examined for its anti-migraine affects.