DM - Neurology
In India, one in every two persons has a chance of having recurrent headache and one in every 6 persons (17%) has a chance of developing migraine headache. Migraine is a moderate to severe, painful headache that often affects one half of the head or it may involve whole of the head. It may be preceded by a warning sign such as flashes of light, blind spots, tingling in the arms and legs. It is most often associated with nausea, vomiting, and intolerance to light and sound. The headache once started can last for hours or even days.
When to say your headache is migraine headache?
If your headache has any of following features, then you may be having migraine headache
• Recurrent attacks of headache over months to years (at least for more than three months)
• Each episode of headache lasts for hours to days (3-4 hour to 2-3 days)
• Headache is localized to one half of head or a part of head
• If there is a warning sign before starting of headache (flashes of light, zigzag lines, black spots in front of eye, tingling sensation over head, body or limbs, abnormal smell, hearing abnormal sound)
• If headache is associated with nausea, vomiting, intolerance to bright light, loud sounds, pain on touching head or hair (allodynia). Patient likes to lie on bed silently in a dark room.
• If the headache is precipitated by certain triggering factors like prolonged fasting, exposure to strong smell, smell of certain perfumes, following excessive physical or mental stress.
Who gets migraine?
Anyone can have migraine. But it is usually affect people of age group between 15-50 years. But small children also get affected though their presentation is different. People, who have history of other family members suffering from migraine, have increased risk of developing migraine headache. Ladies are 3 times more prone to have migraine than male.
What causes migraine headache?
Migraine is caused or triggered by many factors but many patients usually cannot identify them.
Potential causes that induce migraine are:
• Exposure to bright lights, loud sound and certain odors or perfumes.
• Excessive emotional stress or strenuous Physical activity.
• Less sleep or irregular sleep.
• Allergies and allergic reactions.
• Exposure to smoke or Smoking.
• Frequent fasting or skipping meals.
• Frequent Alcohol intake.
• During period of menstruation, those taking birth control pills, hormone fluctuations during menopause onset.
• Certain Foods like; red wine, aged cheese, smoked fish, chicken livers, some beans, hot dogs and salami, chocolate, nuts, peanut butter, banana, citrus, onions, dairy products and fermented or pickled foods. But not all foods trigger headache in all patients.
Triggers do not always cause migraines and avoiding triggers does not always prevent migraines.
What to do and not to do if you have migraine?
• Consult local physician or neurologist
• Avoid over the counter pain killer from medicine store without advice of doctor
• Sleep in time and sleep adequately (for an adult daily 7 to 8 hours of sleep in night is necessary)
• Avoid fasting and take food in regular time, take plenty of fluid, fruits, vegetables, foods rich in vitamin and minerals.
• Avoid excessive tea, coffee, cold drinks (cola, pepsi), fast foods/junk foods, roasted food items, cheese, cream, red meat, chocolate etc(especially if any of them triggering headache)
• Avoid prolonged exposure to bright lights, loud sounds or music, smoky environments, long time working or walking in sunlight (use umbrella if necessary).
• Avoid alcohol, smoking, excessive emotional stress, severe physical exertion at a stretch.
• Regular practice of yoga, meditation, relaxation therapy, thermal biofeedback with relaxation training help in reducing the frequency and severity of headache.
• Don’t use unknown herbal products. Out of all home remedies, use of ginger and fish oil is effective, safe and proven to reduce severity & frequency of headache.
• When you are experiencing headache, eat something sweet even a teaspoonful of sugar for instant relief.
Dr. Jogendra kumar Bastia,
DM (Neurology); SGPGIMS, Lucknow