1. Classical migraine is when you have a warning sign, known as aura, before the migraine begins. About a third of people with migraine have this. Warning signs may include visual problems (such as flashing lights) and stiffness in the neck, shoulders or limbs, tingling sensation in the limbs, difficulty in co-ordination or speaking.
2. Common migraine is when there is no aura.
Here are a few migraine facts.
- Migraine is the cause of 20 % of all headaches.
- It affects 15% of adults in the UK.
- They affect women more frequently than men.
- Usually first present before 40 years of age.
- This type of headache occurs when blood vessels of the head and neck constrict, resulting in a decrease in blood flow to the vessels, and then subsequently dilate causing pain.
- Migraine is usually experienced as a severe throbbing pain at the front or on one side of the head. Some people also have associated feelings of sickness and sensitivity to light and sound, sweating, tummy pain, feeling very hot or cold.
- Commonly lasts from a few hours to one or two days in some cases.
How is migraine diagnosed?
Your GP or therapist will ask you about history of any previous illnesses, family background, diet and lifestyle. They will ask for information about the headache, its length, duration, location, associated features, quality and causative factors.
- Medically there are various treatments available for relieving acute attacks, starting with over-the-counter painkillers such as paracetamol or ibuprofen. These are most effective if taken as early as possible into the attack, preferably in a soluble form.
- Triptan medicines such as sumatriptan (Imigran orZomig). They cause the blood vessels around the brain to contract (narrow), as it is the dilating of blood vessels that causes the pain.
- There are also preventative medications such as Beta-blockers eg propranolol, amitriptyline (antidepressants)but are seen to be useful for migraines
- Identify and avoid trigger factors.
- Osteopathy – to look at the body structure, in particular the head and neck for areas of tension or restriction of movement to the neck, but often involves the back too. Often there are preventative measures that can be advised upon to help manage migraines
- Physiotherapy – looks at the structure of the neck restriction of movement.
- Acupuncture – looks both to relieve tension and pain felt from a migraine, often there are preventative measures that can be advised upon to help manage migraines.
New Treatment for Migraine
A new preventative drug - Erenumab, could help those suffering from the most hard-to-treat migraines. It is sometimes possible for people to use an “abortive” medication, which, when taken early, can arrest the migraine process. For many patients, a preventive medication can decrease both the frequency and the severity of the migraines. Researchers have been working for decades to develop a “targeted” preventive therapy specifically for migraine, and now we are finally close to having an exciting new treatment.
In a recent study, 246 people who had an episodic migraine were given injections of either 140 milligrams of Erenumab or a placebo once a month for three months. After three months, 30 percent of the people treated with Erenumab had half the number of headaches compared to 14 percent on placebo. Those treated with Erenumab also saw a reduction in the number of days they had headaches. The safety and tolerability of Erenumab was similar to placebo, and none of the participants taking Erenumab stopped treatment due to side effects.
Professor Uwe Reuter added: "Our results show that people who thought their migraines were difficult to prevent may actually have hope of finding pain relief. More research is now needed to understand who is most likely to benefit from this new treatment.”