Fit & Proper: Do you suffer from migraine?

Raveena Mall is a 25-year-old producer at an entertainment company and is prone to pulsating headaches every week, often accompanied by nausea. On an average, she works 18 hours a day on the film set, where infrequent meals and irregular sleep cycles are the norm. Mall is one of millions of people who suffer from migraine, a chronic neurological disease, characterised by recurrent headaches of varying severity. Here is what the doctor has to say about this lifestyle disorder.
Migraine is a type of a primary headache, which means that there is no definitive cause known for its origin. This is a neurological problem where the brain suffers from an abnormal sensitivity to various factors. Half of the patients are not diagnosed properly, and hence, not treated correctly. Though it affects people across ages, the common age group is 15-40 years. Women suffer from migraine thrice as much as men.

A headache is a migraine when it is moderate to severe in intensity, with a throbbing pain that is often one-sided and lasts usually for four to 72 hours if left untreated. It is sometimes accompanied with nausea and vomiting and intolerance for bright light and sounds. Another distinguishing characteristic is that a migraine is episodic and a patient can even have up to 10 episodes a month. Patients usually also have a family history of such headaches.

There are two types of migraine. The first is the kind with an "aura", where there can be warning symptoms before the onset of an episode. The second type, without any warning signs or "aura", is more prevalent and accounts for 80 per cent of the cases.

Migraine is diagnosed by understanding the nature of the headaches because no investigations can conclusively prove that a headache is indeed a migraine. While there is no known cause for migraine, genetic abnormality is considered to be a factor in its occurrence.

Migraine can have various triggers. These include certain food items (like fried food, fruits with citric acid, chocolates and caffeine), lifestyle and physical issues (menstruation in females, stress and irregular sleep) and a change of climate (exposure to sunlight and long-distance travel).

QUICK TIPS

• Change your lifestyle: Medication forms only a part of migraine management. Patients should consider a change in lifestyle, such as regular physical exercises and meditation. Another technique that can help is biofeedback, where patients are taught how to control their autonomic nervous system that controls involuntary body functions.
   
• Age matters: Most people experience fewer headaches as they reach 45-50 years
   
• Seek medical help: Majority of migraine episodes can be controlled properly if the patient consults headache specialists, especially during the beginning of the episode. This can significantly improve his or her quality of life.
   
• Prevention is better than cure: A patient should pay attention to what triggers their headaches. Preventing a migraine is often much easier than dealing with an episode.

With no known cure, most medicines today can only prevent or control a migraine attack. If the headache is occasional, such as once in two to three months, it can be managed with simple over-the-counter medications like paracetamol. When it starts to occur frequently - four to five times a month - and is prolonged and severe, it is better to seek medical advice to detect triggers and discuss preventive medications.

Sreekanta Swamy
Senior neurology consultant, Apollo Hospital, Bengaluru