It is most common to hear people complain that they are suffering from ‘migraine.’ A colleague, a friend, or a friend of a friend, you are sure to have heard that claim from at least one person in your circle.
But what is a migraine? How is it different from a regular headache for which you promptly pop in a pill? And, if it is that severe a problem, is it at all treatable?
Headaches are an unavoidable part of our lives often triggered by overexertion, stress or simply flatulence.
But the International Headache Society (IHS), a consortium of doctors and researchers working on ‘headache science,’ defines ‘migraines’ as pain in the head occurring up to 15 days a month. Notably, the pain is felt in one part of the head – left, right, front or the back – is pulsating and often accompanied by dizziness, nausea and vomiting.
Though headaches may have a recognisable cause but not trigger, migraines are almost always ‘triggered’ by factors such as exposure to too much light, noise, lack of sleep, delayed meals, even certain food items such as wine, chocolate and cheese, and in women, frequently, menses.
Often, people suffer from migraines for decades, almost making them a companion for life, before seeking medical help.
Dr Rajesh Garg, Chief of Neurology, Fortis Hospital, Shalimar Bagh, says, “Almost 70 per cent of those who experience migraines are women. It is established that due to certain hormonal combinations, women are more prone to this problem.
Worldwide, 15-20 per cent of the female population goes through migraines while only five-six per cent of men experience it. There is an element of genetic predisposition here. In at least 70 per cent of the cases, we find a positive family history.”
Though reasons for migraines are not fully understood still, doctors like Atul Prasad, Director, Neurology, BLK Super Speciality Hospital, attribute it to “hyperexcitability of the cerebral cortex - a part of the brain that plays a key role in attention and perceptual awareness - and/or abnormal control of pain neurons in the trigeminal nucleus of the brainstem.”
He says, “This hypersensitivity leads to an aggravated response to light (photophobia) and sound (phono phobia), nausea and diarrhoea in the sufferer. In extreme cases such people avoid going in crowded areas and like to be left alone in a ‘dark room.’
These days, we are encountering cases of childhood migraine too. We see school children coming in with complaints of migraine.”
A worrying trend is that annually, at least three-four per cent cases of migraine convert to ‘chronic migraine’ (headaches over 15 days a month), globally.
Such persons have been additionally found to be victims of obesity, anxiety or other psychological disorders. Also, chronic migraine can result from consuming too many ‘over-the-counter headache pills.’
“For the same reason,” says Dr Garg, “It is important to seek medical help and not self-medicate. Treatment of migraine involves a combination of analgesics, blood pressure suppressants, anti-depressants and even anti-epileptic drugs. It can only be recommended by a doctor.”
“What the patient, on her part, can do is avoid recognisable triggers and maintain a ‘migraine diary’. Note down the time, duration, frequency of the attacks along with the part of the head affected, triggers and symptoms. It can be a great help to the doctor and the patient.”