A migraine headache causes a pulsing or an intense throbbing sensation in one area of the head. It is often accompanied by nausea, vomiting and sensitivity to sound and light. A migraine attack can cause intense pain for hours and even days, and can be severe enough to affect the person’s daily life.
Some migraines are accompanied or preceded by sensory warning symptoms known as aura, such as blind spots, flashes of light,or tingling in your leg or arm.
Neurology is an underdeveloped speciality in Myanmar with 10 Neurologists for 55 Million people, and headache is a common complaint in neurological practice. In Yangon General Hospital’s outpatient clinic, patients with headache represent second most common (19 percent) referral. Headache medicine is not a well-developed practice from conceptual or practical standpoint.
In most cases, migraine headaches start in childhood, adolescence or early adulthood. It normally progresses through four stages as described below. However, you may not experience all the stages. Each stage causes its own set of symptoms that include:
It starts a day or two before a migraine attack, and you may begin to notice slight changes that may signify an oncoming migraine attack including:
- Neck stiffness
- Food cravings
- Uncontrollable yawning
It may precede or accompany migraine headaches. Auras can be described as nervous system symptoms that normally manifest as visual disturbances such as flashes of light. In some cases, auras can be sensory, motor or speech disturbances. The symptoms usually begin gradually, and builds up over few minutes and may last for 20 minutes to an hour. Some examples include:
- Vision loss
- Visual phenomena that includes seeing various shapes, flashes of light, or bright spots
- Pins and needles sensations in an legs or arms
- Speech or language problems
If left untreated, a migraine attack may last from 4-72 hours, however, the frequency of headaches may differ from person to person. Symptoms include:
- Pain on one or both sides of head
- Pulsating or throbbing pain
- Nausea and vomiting
- Sensitivity to sound, light or even smell
- Lightheadedness, sometimes followed by unconsciousness
- Blurred vision
It is the final phase that occur after the attack. You may feel drained out, and some may feel mildly euphoric.
When to see a doctor
Migraine headaches are often left undiagnosed and untreated. It is important to keep a record of signs, symptoms and attacks, and how you treated them. If you have a history of headaches and you notice a change in pattern, or the headaches start feeling different, you should consult a doctor.
You should immediately visit a doctor if you experience any of the following signs or symptoms:
- A sudden, severe headache
- Headache after a head injury
- Headache accompanied with symptoms such as double vision, seizures, fever, stiff neck, trouble speaking and numbness
- New headache if you are older than 50
- Chronic headache that becomes worse with exertion, coughing, straining or sudden movement
Migraines can be difficult to treat in spite of all the medical advances. About 50 percent of the patients stop getting treatment, because they are not satisfied with the therapy. Migraine treatment can be abortive or preventive.
Abortive: Its goal is to prevent an attack or stop it once it begins. The medications stop a headache in the prodrome stage or when the attack begins. The medication may be administered as injection into the thigh, nasal spray or wafer that melts on the tongue. These medications work quickly and is especially beneficial for those who have nausea or vomiting. Triptans and narcotics are used to relieve pain.
Preventive: If the patient experiences more than one attack a week, he may be given preventive treatment to reduce the frequency and severity of migraine headache. Preventive medication include beta blockers, anti-depressants, antihistamines and anti-seizures.
The prognosis is very good once the headache is under control. It may take several attempts before the treatment works, so patience is the key. No single drug or treatment is effective for every patient, and often a combination of drugs in needed to treat chronic or resistant headaches.
To prevent migraine it is important to identify and control migraine triggers. You may have to make lifestyle changes such as avoiding certain types of food or emotional situations.