Orris

Migrane

Reading File
Finding Sources
Searching PubMed

migraine

Searching the Web

migraine symptoms treatment red flags official guidance

Migraine is a recurrent headache disorder, often causing a throbbing or pulsating pain, commonly on one side of the head. It may come with nausea, vomiting, and sensitivity to light, sound, or smells. Some people have an aura beforehand, such as flashing lights, zig-zag lines, tingling, or temporary speech difficulty. Migraine can occur with or without aura. Bradley and Daroff's Neurology in Clinical Practice, pp. 204-207, 239-262.

What can help during an attack

  • Rest in a dark, quiet room, hydrate, and eat if you have missed meals.
  • Take early treatment if you normally use it. Common options include paracetamol/acetaminophen or an anti-inflammatory medicine such as ibuprofen, if safe for you.
  • A clinician may prescribe migraine-specific medicines such as triptans, or anti-nausea medication.
  • Avoid using pain medicine on many days each month, since this can itself cause medication-overuse headaches.

Prevention

Keeping a headache diary can identify triggers such as irregular sleep, missed meals, dehydration, alcohol, stress, hormonal changes, or particular foods. If attacks are frequent or disabling, a clinician can discuss preventive treatment. Current guidance includes established preventive drugs and, for appropriate patients, CGRP-targeting therapies, as summarized by the American Migraine Foundation.

Seek urgent medical care now if the headache is:

  • Sudden and maximal within seconds to minutes, often described as the worst headache ever
  • New after head injury
  • With weakness, facial droop, confusion, fainting, seizure, persistent speech problems, or loss of vision
  • With fever, stiff neck, rash, or severe illness
  • New during pregnancy or soon after delivery
  • A major new change from your usual headache pattern, particularly after age 50
The American Migraine Foundation red-flag guide also advises evaluation for sudden onset or non-migraine-like systemic symptoms.
If you tell me your symptoms, how long they have lasted, and whether this is your usual type of headache, I can help you judge whether it sounds like migraine and what next step is safest.

Give me answer to write on migraine

Reading File
Finding Sources
Searching PubMed

migraine treatment

Searching the Web

migraine diagnosis treatment NHS

Migraine

Migraine is a common recurrent primary headache disorder. It is characterized by attacks of moderate to severe, usually unilateral, pulsating headache associated with nausea, vomiting, and sensitivity to light and sound. It is more common in females and may have a family history.

Types

  1. Migraine without aura: Headache occurs without preceding neurologic symptoms.
  2. Migraine with aura: Headache is preceded or accompanied by reversible neurologic symptoms, most often visual disturbances such as flashing lights, zig-zag lines, or blind spots. Sensory or speech symptoms can also occur.
  3. Chronic migraine: Headache on 15 or more days per month for over 3 months, with migraine features on at least 8 days per month.

Causes and triggers

The exact cause is not fully understood. Migraine involves altered brain pain pathways and activation of the trigeminal nerve system. Common triggers include:
  • Stress or anxiety
  • Lack of sleep or excessive sleep
  • Skipping meals and dehydration
  • Bright lights, loud sounds, or strong smells
  • Menstruation or hormonal changes
  • Alcohol, excess caffeine, and some foods
  • Certain medicines

Clinical features

A migraine attack may have four stages:
  1. Prodrome: Tiredness, yawning, irritability, food cravings, and poor concentration.
  2. Aura: Visual symptoms, tingling, dizziness, or speech disturbance.
  3. Headache phase: Throbbing headache, often one-sided, worsened by routine activity. Nausea, vomiting, photophobia, and phonophobia are common.
  4. Postdrome: Fatigue, weakness, and difficulty concentrating after the headache resolves.

Diagnosis

Diagnosis is mainly clinical, based on the pattern of recurrent headaches and associated symptoms. A headache diary helps identify triggers and frequency. Brain imaging is not routinely needed unless there are warning signs or abnormal neurological findings.

Treatment

Acute treatment

  • Rest in a quiet, dark room and maintain hydration.
  • Paracetamol/acetaminophen or an NSAID such as ibuprofen may help in mild attacks, if safe for the patient.
  • Antiemetics such as metoclopramide may be used for nausea and vomiting.
  • Triptans such as sumatriptan are used for moderate to severe attacks or when simple analgesics fail.
  • Opioids/narcotics should generally be avoided.

Preventive treatment

Preventive therapy is considered when attacks are frequent, prolonged, or disabling. Options include:
  • Beta-blockers, for example propranolol
  • Antiepileptic drugs, for example topiramate
  • Antidepressants, for example amitriptyline
  • CGRP-targeting medicines in selected patients
  • Regular sleep, meals, exercise, stress management, and avoiding identified triggers
Overuse of painkillers can cause medication-overuse headache. The NHS migraine guidance advises avoiding painkillers on more than 2 days per week where possible.

Red-flag symptoms

Urgent medical assessment is required for a sudden severe "worst-ever" headache, headache after injury, fever with neck stiffness, seizures, fainting, weakness, persistent speech difficulty, or a major change in the usual headache pattern.

Conclusion

Migraine is a recurrent disabling headache disorder that may occur with or without aura. Early treatment of attacks, avoidance of triggers, and preventive treatment for frequent attacks can greatly reduce symptoms and improve quality of life.
This is a shared conversation. Sign in to Orris to start your own chat.