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Virginia Chachati

Reviewed by Virginia Chachati MPharm
(2013, University College London)
GPhC Registration number: 2087654

Information last reviewed 05/07/2021

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What is a migraine?

A migraine is like a severe headache. It usually causes a throbbing pain on one side of the head. Migraines can also cause nausea, vomiting, feeling sensitive to light and sound, and tiredness.

What causes migraines?

The exact cause of migraines is not known, but many people who experience them have a genetic disposition for migraines. It's thought that temporary changes to the chemicals and blood vessels in the brain result in a migraine occurring. Known migraine triggers include stress, changes to daily routine, caffeine, lack of sleep and dehydration.

What are the different types of migraine?

The different types of migraines are: 

  • Migraine without aura - this is the most common type of migraine. A severe headache may be accompanied by feelings of nausea, tiredness, dizziness, and a sensitivity to light or sound. 
  • Migraine with aura - these migraines cause visual disturbances including seeing coloured spots, zig zag lines or coloured lights. They can also cause vertigo, pins and needles, weakness and temporary blindness. 
  • Chronic migraine - if you have migraines for more than 15 days in one month.
  • Menstrual migraine - when migraines are triggered by your period. 
  • Ocular migraine - a migraine which affects your vision and causes temporary blindness. 
  • Hemiplegic migraine - this is a rare type which results in weakness down one side of the body.
  • Migraine aura without headache - experiencing the other symptoms of a migraine without the headache.

How to keep a migraine diary?

Keeping a migraine diary can help you find your migraine triggers and check if your treatment is working. In your diary, record when migraines occur, how long they last and the details of your surrounding environment. Alongside this, keep note of any medicines you've taken, what you've had to eat or drink, the quality of your sleep, anything causing stress in your life, and exercise you've done. Women may want to record their menstrual cycle too.

Symptoms

What does a migraine feel like?

A migraine feels like an intense, painful headache. It's usually accompanied by feelings of nausea, tiredness, dizziness or vomiting. Migraines can also affect your vision and cause spots of light, flashes of light, or tunnel vision. You may feel sensitive to light and sound, and might need to lie down until the migraine eases off. 

What are some migraine triggers?

Possible migraine triggers include: 

  • Stress
  • Disruption to your normal routine 
  • Lack of sleep or oversleeping 
  • Caffeine 
  • Menstruation
  • Menopause 
  • Environmental factors such as noise, humidity, weather or bright lights 
  • Screen time 
  • Muscle tension 
  • Not eating properly 
  • Certain foods, such as sugary treats and cheese
  • Alcohol 
  • Dehydration 
  • Medicines

Migraine vs headache

It can be difficult to differentiate between a headache and a migraine, as they both cause pain. A headache can be less severe than a migraine, and it should be easy to clear with painkillers. Migraines usually occur on one side of the head and produce a throbbing pain. You may also get other symptoms with migraines, such as nausea, tiredness, dizziness, light sensitivity, or aura.

How are migraines diagnosed?

Keeping a migraine diary will help to establish an accurate diagnosis. Your doctor will ask if you have noticed a pattern before your headaches occur, and what symptoms you have experienced. Your vision and reflexes may be checked to rule out other possible causes. It usually takes time to get a diagnosis as migraines can be sporadic.

What is an aura?

A migraine with aura is experienced by a small number of people who get migraines. Aura is the visual disturbances which accompany the migraine. An aura can come up as: 

  • Blind spots
  • Seeing flashing lights 
  • An appearance of sparkles or stars obscuring your vision 
  • Zig zag lines
  • Tunnel vision 
  • Temporary loss of sight 
  • Coloured spots 

In addition to the visual disturbances, an aura can also cause the following symptoms: 

  • A weakness down one side of the body
  • Pins and needles 
  • A feeling of numbness or tingling 
  • Dizziness 
  • Vertigo (a spinning feeling which affects your balance)

Can foods cause migraines?

Certain foods can cause migraines. These commonly include: 

  • Cheese
  • Red wine
  • Processed meat
  • Alcohol
  • Caffeine 
  • Bananas
  • Beans
  • Chocolate 
  • Nuts
  • Dairy
  • Onions
  • Tomatoes 
  • Citrus fruits
  • Additives 

This is likely to be different for everyone. Keeping a food diary and recording when your migraines take place can help you find out if certain foods trigger your migraines.

Treatment

How to treat migraines?

During a migraine, the best thing to do is to lie down in a dark room. Take over the counter painkillers or migraine prescription medicines as soon as you feel a migraine coming on, to allow them enough time to work. Prescription migraine treatments include sumatriptan (Migraitan) and rizatriptan (Maxalt). If you experience nausea or vomiting, then an antiemetic like Buccastem can be prescribed to help. These treatments are all available online from Dr Felix.

 

How to prevent migraines?

Identifying what your triggers are can help you manage your migraines. There are medicines prescribed in special cases to help prevent migraines. These include topiramate, propranolol, amitriptyline and Botulinum toxin type A. If your migraines are caused by your menstrual cycle, taking anti-inflammatories, triptans or the combined contraceptive pill can help.

How to live with migraines?

With good management and treatment, you can learn to live with migraines. The first step is to identify your triggers, and find a way to avoid them. If stress has an impact on your life, consider seeing your doctor or a therapist for advice. Establish which migraine medicines are effective for you and ensure you have access to them. Maintain a good sleeping pattern, a healthy balanced diet and regular exercise.

What are some home treatments for migraines?

Resting in a dark room is the best thing to do during a migraine attack. Placing an ice pack or cold flannel over your forehead or neck can have a soothing effect. Gentle yoga can help you relax and prevent migraines. A neck and shoulder massage with essential oils may help relieve muscle tension. Sip on water or have food that contains ginger if you are feeling nauseous.

Chronic migraine treatment

Chronic migraines need to be treated with a combination of medicines and lifestyle changes. Keeping a migraine diary can help identify what your triggers are and to find ways to avoid them. Taking a combination of painkillers and preventative medicines is also an effective way of managing chronic migraines. You may be referred by your doctor to see a specialist.

Are there any medications that can treat or prevent migraines?

Triptans are a type of medicine designed to treat migraines. They work by reducing the swelling in the blood vessels of the brain. Preventative medicines are prescribed in special cases and include topiramate, propranolol, amitriptyline and botulinum toxin type A.

What are the best painkillers for migraines?

Check with your doctor or pharmacist before taking over the counter painkillers like paracetamol, aspirin or ibuprofen for migraines. They are most effective if you take them as soon as your migraine starts. Triptans, such as sumatriptan and rizatriptan, are available online on prescription from Dr Felix. They are specifically designed to treat migraines so these may be more effective in providing relief, if over the counter painkillers do not help.

Q&A

Are migraines dangerous?

Migraines can feel unsettling and painful, but they are not considered dangerous. However, if you experience migraines whilst taking the contraceptive pill, you should seek medical attention straight away.

What are cluster headaches?

A cluster headache is a sudden and severe sharp pain on one side of your head or around your eye. The pain can last between 15 minutes to 3 hours and they occur daily for several weeks at a time. Cluster headaches usually produce other symptoms which include:  

  • A watery, red eye
  • One swollen, droopy eyelid
  • A smaller pupil in one eye
  • Sweating in the face
  • One blocked or runny nostril 

Is it safe to drive with a migraine?

You should not drive with a migraine. Even if you do not experience any visual problems, the migraine pain may interfere with your reflexes, concentration and judgement. If you feel a migraine coming on while driving, stop until you feel well enough to continue.

Can migraines be related to the menstrual cycle?

Migraines can be triggered by your period. These are known as menstrual migraines. They can be treated with painkillers or anti-inflammatories. Hormonal contraceptives may also provide relief from menstrual migraines.

Does having migraines increase your risk of stroke?

It is very rare for a migraine to cause a stroke. Studies have shown that women over 35 years old who use the combined contraceptive pill and suffer from migraines may be more at risk of a stroke if they have high blood pressure or smoke. However, it is not recommended for women who fall into this group to take the contraceptive pill. Speak to your doctor for further advice tailored to your needs.

Can I take the contraceptive pill if I have migraines?

The contraceptive pill is not suitable for women who experience migraines with aura (visual disturbances) because there may be an increase in your risk of having a stroke. If you are interested in taking the contraceptive pill for migraines with or without aura, speak to your doctor for specific advice.

Can I get time off work for a migraine?

A migraine can affect your ability to work as you may be sensitive to light and sound. You should discuss this with your employer, and inform them that you regularly have migraines, so they can make reasonable adjustments. If your migraine requires time off work, you can get a supporting note from your doctor for your employer.

Can tinted glasses help prevent migraines?

There are special tinted glasses available, known as ‘migraine glasses’ which reduce the amount of light getting into your eyes. These may help reduce migraines for some people.

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