Migraine: Do you also have frequent headaches? 🧠⚡

The woman (age 26) who came to my clinic last Thursday is a clerk at a private bank. She was holding her forehead tightly as she entered the clinic room.

"Dr. Priya, I get an unbearable headache at least once a week. It's not just a normal headache, it feels like a throbbing pain on one side of my head. At that time, I can't tolerate any light or sound. Only after I get nauseous and vomit does I get some relief. I miss all my work," Kavindi described her ordeal.

I examined Kavindi's condition and explained: "Kavindi, what you are describing is a migraine . This is not a common headache, but a chronic neurological disease caused by changes in the chemical and nerve activity in the brain. During a migraine attack , there is a prodrome , an aura , which causes visual changes, and a post-drome, which is a severe headache and mild fatigue. We can accurately assess how much your migraine is interfering with your daily life using the MIDAS (Migraine Disability Assessment) calculator below."

🚨 Red Flags that require immediate medical attention

Not all headaches are migraines. If you experience the following dangerous symptoms, you should seek immediate medical attention:

• Thunderclap Headache - This may be bleeding inside the brain.
• High fever with headache, inability to bend the neck (neck stiffness) or loss of consciousness (may be signs of meningitis).
• A new onset of severe headache in a person over 50 years of age.
• Headache accompanied by numbness, facial drooping, numbness, slurred speech, or double vision (may be symptoms of a stroke).

The main stages of migraine and their symptoms

A migraine attack can typically last from 4 hours to 72 hours (3 days). It consists of 4 main phases:

1. Prodrome: Occurs a day or a few hours before the headache. Symptoms include frequent urination, constipation, neck stiffness, changes in appetite, and mental stress.
2. Aura phase:Occurring in only one in three patients, it lasts from 5 to 60 minutes and is characterized by seeing colored lights before the eyes, zigzag patterns, numbness in the hands and feet, and difficulty speaking.
3. Headache Phase: Severe throbbing pain on one side of the head. In addition, nausea, vomiting, and sensitivity to light (photophobia) and sound (phonophobia) occur.
4. Post-drome: The intense fatigue and heaviness in the head that occurs after the headache has subsided.

Main factors that cause migraine attacks (Triggers)

• Hormonal changes: Estrogen hormone fluctuations during women's menstrual cycle, pregnancy, and menopause.
• Stress: Severe pressure at work or in family life.
• Food and drink: Cheeses, sweets, alcohol such as red wine, excessive caffeine consumption, and processed foods containing MSG.
• Sleep changes: Not getting enough sleep or sleeping abnormally too much.
• Environmental factors: Strong sunlight, strong perfumes, tobacco smoke, or excessive noise.

Comparing medications for migraine

SEEDS Healthy Habits for Migraine Management

The SEEDS lifestyle regimen that doctors recommend to reduce the frequency of migraines is as follows:

• S - Sleep: Make it a habit to go to bed and wake up at the same time every day.
• E - Exercise: Do gentle exercise (walking, swimming) for 30 minutes 3-4 days a week.
• E - Eat: Never skip meals and eat a balanced, nutritious meal at the right time. Drink plenty of water.
• D - Diary: Identify triggers by recording the days, times, and foods you ate before your migraines.
• S - Stress Management: Reduce stress by practicing yoga, meditating, or listening to music.

Scientific sources (References)

• 📚 Migraine - NHS
• 📚 Migraine management - PMC