Migraine– all you need to know about

Migraine is a benign condition. So, reassurance is the first part of treatment. Avoidance of triggers is the key to managing migraine. It includes quitting smoking, avoiding alcohol, reducing excessive caffeine, and avoiding birth control pills in women with migraine.

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Generally, an episode of migraine exhibits 4 phases. (Image Credit: Pixabay)

By Dr. Lakshmi Krishna V

Migraine is the third most common disease in the world affecting 1 in every 7 people globally and it is three times more common in women than men. Migraine affect 18% of women, 10% of children, and 6 percent of men. It is most commonly seen in the 35 to 45 age group.

Migraine is a neurological disease and here a person experiences moderate to the severe one-sided headache that may last for 4-72hrs and is often associated with nausea, vomiting, dizziness and extreme sensitivity to light and sound. Most people with migraine will have only a few attacks per month.2% of total cases seen are chronic migraine cases and they may experience headaches for more than 15 days a month.

There are certain triggers for migraine which include food items like- cheese, wine, chocolate, nuts, processed meals, certain odors, bright light, sleep disturbances, menstruation, menopause, travel, weather changes, and stress.

Generally, an episode of migraine exhibits 4 phases. The first is one Prodrome phase, which happens few hours to days before the headache and during this phase, the person will be irritable, depressed, and will have increased yawning, and food cravings. The second one is the Aura phase, where a person sees flashes of light in front of eyes, seeing zig-zag lines, numbness and tingling in the body. Migraine can occur with and without aura.

Third phase is the Headache phase lasting for 4-72 hrs and the fourth phase is migraine Hangout phase in which the person will be generally unwell,irritable, and confused.

In women, the frequency of migraine can increase during menstruation, possibly due to fall in the hormone levels(oestrogen). In 2/3 of cases, migraine decreases during menopause. But in a few patients, it can begin after menopause.

Children can also get migraine. For them it is usually presented as cyclical vomiting syndrome or abdominal migraine with no headache. Colic in infants may be the earliest sign of migraine. Children with one parent suffering from migraine have 50% chance of getting migraine, and if both parents are affected, then the chancesare 75%.

To diagnose migraine in most patients, an MRI of brain is not needed. But certain cases need investigation with the help of an MRI, when secondary causes are suspected. Migraine is a benign condition. So, reassurance is the first part of treatment. Avoidance of trigger is the key in managing migraine. It includes quittingsmoking, avoiding alcohol, reducing excessive caffeine, and avoiding birth control pills in women with migraine.

Two treatment options are available for migraine – One is to stop an attack and the other option is to take drugs daily to prevent an attack. These preventive therapies help to reduce the frequency of attacks by 50% in 40% of patients. Nonpharmacological therapies like deep breathing, yoga and relaxation techniques are also found to be effective in preventing migraine.

In people suffering from Chronic Migraine, the condition interferes a lot with their education, career or social activities. Making changes to the daily routine can considerably decrease the frequency and severity of migraine attacks.In addition to avoiding the triggers, a healthy lifestyle with healthy foods, being active, staying hydrated and get adequate sleep would be effective in reducing the frequency. It is also recommended to a maintain a migraine diary to understand the correlation between the triggers and onsets and use those learnings to improve the treatment.

(The author is consultant – Neurology, Kauvery Hospitals, Electronic City, Bengaluru. Views expressed are personal and do not reflect the official position or policy of

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