There are lots of different types of headaches, but the one most frequently referred to and loathed (or loved, if you happen to be interested in neurology, like Oliver Sacks writing his first book in 1967) is the migraine.  Other headaches types are many and varied and include tension, cervicogenic, cluster and viral, all having their own symptoms and management issues, but about one in ten people will experience at least one headache categorised as a migraine per year making it a fairly common, fairly miserable experience.

Migraines are interesting from a medical point of view it is not just a sore head. Depending on the type of migraine you experience (and you can have more than one type of migraine) there are many other changes that can go along with them – nausea, abrupt mood changes, vertigo, heart palpitations, visual changes, and sometimes weakness or changes to sensation in part of the body. Some of these symptoms are a lot like the symptoms of a stroke, so best to get checked out in an emergency department very urgently if it is not absolutely beyond doubt one of your usual migraines.

The first step in working out how to best manage migraines is to collect some information. Keep a headache diary which tracks the times, triggers, symptoms and any treatment you’ve tried for the headache. Some migraines can be completely prevented by avoiding specific triggers (e.g., cheeses). Other migraines will respond very well to simple analgesia like paracetamol if taken very early in the episode.

If you are having frequent migraines (more than one per month) you could consider if a preventer treatment would help reduce the number of days you are affected by migraine symptoms. There are a wide variety of prevention treatments – including simple blood pressure medications, muscle relaxing injection and now some immune mediators, some of which can only be recommended and prescribed by a specialist neurologist.

One thing to remember about migraines is that they are often part of more complex processes. Migraines can be associated with increased risk of stroke (one reason GPs will not prescribe the oral contraceptive pill for patients with migraines with aura), heart disease, vascular, neurological and mental health conditions. For this reason, it is a good idea to discuss with your GP that you experience migraines so they can work with you regarding how best to manage the symptoms, and also manage your risk factors for other diseases.

Dr Cath Hester

These articles are not intended to replace a one-to-one relationship with a qualified health professional or as specific medical advice. They are intended as a sharing of knowledge and information from experience and research in the scientific literature. I encourage you to make your own health care decisions based upon a partnership with a qualified health care professional.