The silent pulsating noise in your head Thu , Mar 14

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Migraine

Migraine is a primary headache disorder (headache with no underlying cause) which can lead to significant disability and suffering. Migraine usually results in a combination of severe headache (pulsatile or throbbing type) with nausea, vomiting, light sensitivity and/or sound sensitivity

Causes of migraine

Migraine is a primary headache syndrome with no obvious etiology. Several factors contribute to migraine including genetic predisposition, underlying physical illness, poor sleep, excess mental stress, certain food items, dehydration and hormonal factors in women (menstruation, medications and menopause)

Symptoms of migraine

The duration of migraine usually lasts for around 4 hours, although severe ones can last much longer.
- Sensitivity to light, noise and odours.
- Nausea and vomiting, upset stomach and abdominal pain.
- Loss of appetite.
- Feeling very warm (sweating) or cold (chills).
- Pale skin colour (pallor).
- Feeling tired.
- Dizziness and blurred vision.

Diagnosis of migraine

The diagnosis is essentially clinical. There are no blood tests or scans to confirm the diagnosis of blood test. Tests are however done at the discretion of the doctor to rule out other causes of headache mimicking migraine

Migraine triggers

- Stress
- Prolonged screen time
- Flickering TV screen
- Loud noise
- Dehydration
- Fever
- Hunger
- Weather changes
- Certain food – chocolate, cheese, food additives or preservatives.
- Certain chemicals – perfume, petrol
- Excessive exposure to sunlight or sweating
- Prolonged device exposure
- Menstrual cycles

Treatment for migraine

Lifestyle changes are essential in improving migraine
- Improving sleep hygiene
- Reducing screen time
- Physical activity
- Healthy diet
- proper sleep hygiene
- Relaxation techniques and
- Good work-life balance.
During an acute attack, painkillers in the form of tablets or injections with medications to reduce nausea/vomiting can be done to abort the headache.

Patients who require prophylactic migraine medications

Patients with chronic migraine may require daily prophylactic medications to prevent future attacks.

If the patient has any of these features prophylactic medications are required
- 3 or more attacks per month
- Acute medications (painkillers or triptans) are ineffective or cannot be given
- Headache significantly impairing daily activities or quality of life
- Presence of frequent and unpleasant aura
- A single attack leading to significant disability
- Patient preference

Do’s and Don’ts in managing migraine-

Do’s	Don’ts
Maintaining a nutritious balanced diet Adequate hydration Avoid triggers Practice relaxation techniques (medication, yoga, breathing exercises) Follow good sleep hygiene Maintain a healthy work-life balance	Consume sugary snacks Get too little or excessive sleep Excessive caffeine and alcohol consumption Exposure to bright light or heavy noise or strong odours Seeing flickering lights Starvation

For inquiries or to schedule a consultation, please call us at 044-4524 2407. We have a team of expert neurologists dedicated to treating and managing patients with frequent migraines.

Reviewed by
Dr Shrivarthan
Consultant
Department of Neurology