I'm a GP with a particular interest in women's health.
Migraine is an incredibly common problem that
affects around 6 million people in the UK and two-thirds of those are women.
I do see a lot of people who describe their headaches as migraine and in fact
I think we have to be careful that as miserable as
headaches are they are not all migraines and migraines classically are one-sided
headaches, often associated with nausea, quite often, actually make you sick. Usually people
feel they have to just lie down in a darkened room. They don't like the lights and they feel...
...they really are severe headaches which last for several hours and then some poor folk
will last for two or three days. A migraine can be very frightening. In its most severe form
I have seen people who think they've had a stroke because actually they lose the use of one side of
their body during the attack. That is thankfully not common but it's very common for people to
lose part of their visual field so they can't see anything on one side or everything in one part
of their vision has zig-zag lines through it and that's very common. 1 in 6 migraine sufferers
will suffer with that and can be very frightening particularly the first time it happens.
My cutoff really is if you are suffering with migraines more than once or twice a fortnight, really you
should be having a chat to me about what else we can do to try and prevent them. There's been lots
of debate about what really causes migraine and I think the jury is still out. One theory is that for
some reason, particular triggers in susceptible people and it does seem to run in families, will
cause a spasm of the blood vessels supplying the brain. So that temporarily the blood supply
is impaired which is what gives the problems with vision and so on and then as the blood
vessels dilate after the spasm, you then get the pounding headache.
The thing about migraine is recognising what triggers it for you and really the first thing I do with any of my patients who
we think may have a migraine is to get them to keep a symptom diary and a food and drink diary.
What we usually find, relatively quickly, is you can identify your own triggers. So really it's a
case of trying to identify what will cause it for you and then avoiding those triggers and
for many people, actually, that's all they need to do. If despite all that, you're still struggling with
symptoms then many will cope with their symptoms with simple over-the-counter remedies but for some
we need to give prescription drugs which will actually stop an attack when it starts.
Now of course it rather depends on whether you get any warning about your migraine attacks. Some people
will get a warning up to 24 hours before. They may just feel a little bit stiff in the neck
they may not like lights very much, feel a little bit lethargic and off-color but nothing like the
full-blown attack and that will go on for up to 24 hours. Only 1 in 6 people will get the classic
flashing lights or the slight loss of vision that people associate with migraine, which means that
of course 5 out of 6 won't and some will just suddenly develop the one-sided headache which
is classic of migraine and can last for several hours. If you have a warning and you are unable
to control your attacks with simple analgesics that you can buy from the chemist there are lots
of prescription drugs and in fact some now that are available over-the-counter that your chemist
can advise you on. There are however, still sadly, a few people whose attacks are so frequent that
they need to take regular medication to prevent the attacks occurring in the first place and
that means taking medication on a daily basis. We know that migraine can be linked to hormones
and in a very small number of women when they start the oral contraceptive pill they suddenly
start getting migraines and in that group of women they really should be thinking about
an alternative contraceptive because there is a very, very small but it's a risk of going on
to have a stroke if they continue on the pill. My own daughter suffered with something called
abdominal migraine and that again is quite common, it tends to occur in children who are at high risk
of migraine, so have a strong family history of migraine but instead of getting the headache
they get episodes of tummy pain and vomiting, usually when they've got over tired and it's the
classic eating junk food on a sleepover and not going to bed and the following day they
pay the price, where they feel a lot of tummy pain, sickness, pretty miserable and just sleep it off
for a few hours and they're right as rain but actually that may well, if that's the sort of
thing that's happening on a regular basis, when your son or daughter is very tired, it may well
be that that's an abdominal migraine. I do think with migraine, prevention really is better than
cure and so it is really worth taking some time to keep a diary quite accurately, work out what
triggers your own migraine and trying to avoid it. For more information visit www.nhs.uk