How much do we really know about migraines?

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The word Migraine comes from the Greek word “hemicrania” – meaning “half the skull”, and has been well documented as a condition as far back 400BC. Migraine is the third most common disease in the world, with around 1 in 7 people being affected, and 25 million days lost from school and work. The cost of absenteeism from migraine alone costs the UK economy at least £3.42 billion per year, in addition to the £150 million per year cost to the NHS. Migraine is ranked as the seventh most disabling disease, and sufferers spend an average of 5.3% of their lives experiencing an attack. Severe migraine attacks are classified by the World Health Organisation (WHO) as being among the most disabling illnesses, in the same class as dementia, quadriplegia and active psychosis. Depression is three times as common in migraine sufferers as in healthy individuals. Migraine/chronic headache is the second most frequent cause of short term absenteeism in non-manual employees.

What causes migraine?

The cause of migraine is still largely a mystery, however they do seem to run in families – suggesting a genetic link. It is known that there is abnormal brain activity during migraine attacks, but we still don’t know why!

What triggers migraine?

This varies between individuals. Women often experience migraines around the time of their period, suggesting a hormonal trigger. Emotional triggers include stress, anxiety, tension, depression and shock. Many people have physical triggers including: tiredness, irregular sleep due to things like shift work, poor posture, neck or shoulder tension, jet lag, low blood sugar, irregular meals, alcohol, dehydration, caffeine or specific foods, and sudden changes in exercise patterns. For migraine sufferers even the environment can cause attacks. Bright lights, flickering screens, smoke, loud noises and changes in temperature are all identified triggers.

What are the symptoms of migraine?

·        A severe throbbing or pulsing headache

·        Increasing pain with physical activity

·        Inability to perform regular activities due to the pain

·        Feeling or being sick

·        Increased sensitivity to light and sound, which may be relieved by lying in a quiet dark room

·        Around 1/3 of people have migraine with aura, manifesting in visual disturbances such as seeing flashing lights, zig zag patterns or blind spots

·        Numbness or pins and needles usually starting in one hand and moving up the arm before affecting the face

·        Difficulty speaking

How can you treat migraine?

Migraine remains undiagnosed and under treated in around half of sufferers. In the UK only 3% of GP consultations are for headache, despite it being so common. The biggest advance in migraine management was the release of triptans, a class of drug that works on serotonin receptors. Triptans work by constricting blood vessels in the brain, reducing the inflammation. They are highly effective in 70-80% of patients. If triptans don’t work for you, there are an increasing number of other options. Speak to your GP and ask to be referred to a proper headache clinic. The waiting lists will probably be long as there are only around 12 trained headache specialist nurses in England. I was lucky enough to go to a fantastic migraine clinic in London with my mother – a long term migraine sufferer. I was fascinated to hear about the new therapies that they are using – with great success. Nerve blocks, botox, and a device that interferes with electrical signals in the brain are all being used under the direction of a consultant. Don’t suffer in silence, make a fuss and get referred – there is help out there for you!