MORE THAN HALF a million people in Ireland live with migraine. Yet it remains under-diagnosed and undertreated in 50% of individuals.

Despite being ranked by the World Health Organisation as the 6th leading cause of disability worldwide, migraine is often dismissed as ‘just a headache.’

Affecting 1 in 7 of us, migraine is inherited in up to 60% of sufferers and affects three times more women than men.

Although there is no cure, migraine is treatable. By getting informed, keeping a migraine diary and learning about triggers, those living with migraine can manage to reduce the impact of migraine.

Symptoms

Symptoms of an attack can include:

• An intense throbbing headache
• Confusion
• Nausea and vomiting
• Extreme sensitivity to light, noise, and smells
• In severe cases, loss of consciousness or paralysis on one side. 

An attack can be utterly debilitating, and can last 4-72 hours.

About 20% of people experience migraine ‘aura’ which refers to a range of neurological disturbances, e.g., visual such as flickering lights or blind spots; muscular weakness; numbness; slurring of speech; loss of coordination or confusion.

While some people experience only one or two attacks a year, others suffer on a weekly or even daily basis, to the extent that their quality of life is substantially reduced. In fact, around 30,000 people in Ireland live with ‘chronic migraine’; that is over 15 days a month.

What causes migraine

Unfortunately, no one really knows what causes migraine, but there is evidence to suggest that it might be related to;

• Blood flow and serotonin levels in the brain
• The release of certain amino acids in the brain
• Electrical waves passing over the brain
• Various trigger factors

Trigger factors, while they do not ‘cause’ migraine, can precipitate an attack. While some people may be very sensitive to specific triggers, others may be vulnerable only when several triggers combine at once.

Common triggers include:

• Stress
• Lack of sleep
• Meteorological triggers, such as sudden changes in weather and heat or cold
• Environmental factors, such as bright lights, loud noises,  and strong smells
• Staring at a computer screen for an extended period
• Travel
• Too much or not enough exercise
• Lack of food, delayed meals, irregular eating patterns, fasting and dieting (all leading to lowered blood sugar levels)
• Specific foods, such as chocolate, red wine, MSGs found in takeaways, cheese, and caffeine
• Hormones

Hormones often play a role in women’s migraines, with migraine often starting for during puberty and getting worse during menstruation. Conversely, migraine can improve when women are pregnant or after menopause. However, in rare cases, it can get worse after these events.

Some patients learn over time to spot the symptoms of an attack coming on. One of the most common is yawning and fatigue, or feeling moody or irritable.

Treatment

There are over the counter medications for the pain from migraines, such as paracetamol, ibuprofen, and aspirin, as well as migraine-specific drugs such as Migraleve, which includes anti-nausea medication. It is recommended that you take these as early as possible during an attack.

However, overuse of these medications can lead to a medication overuse headache.

There are other medications which can be prescribed by your GP if you find painkillers ineffective.

Non-drug treatments include:

• Sleep/rest
• Cold therapy, such as using a cooling pack on your forehead
• Massage
• Increasing water intake
• Small frequent snacks

Another non-drug treatment is biofeedback, where you use instruments to measure physiological activity such as brainwaves, heart function, breathing, muscle activity and skin temperature. With the aim of monitoring and changing these rates to see if they improve the illness.

The  top tips for managing and preventing migraine are:

• Get a diagnosis from your GP
• Learn about migraine triggers
• Keep a migraine diary to see if there are any common triggers
• Try to keep to a routine – regular sleep and eating patterns
• Engage in some light exercise, yoga and/or meditation to reduce stress
• Get advice on medication use to avoid medication overuse headache

For more information visit the Migraine Association of Ireland website.

Jane Whelan is the communications and information officer of the MigraineAssociation of Ireland.

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