How to stop migraines, the stubborn acute headache

Headache is one of the most common pains humans go through and though there are different types of headaches such as tension headaches and cluster headaches, migraines are usually one of the most severe types.

A migraine headache usually occurs on one side of the head and is accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Several factors can trigger an attack. Some of these factors include loud noises, little or much sleep, stress, menstruation in women, depression, strenuous exercises, etc.
Beyond the obvious discomfort associated with migraines, new research published in the online issue of Neurology, the medical journal of the American Academy of Neurology, suggests that older people who experience migraines may have an increased risk of stroke, but only if they are smokers, though there are other factors which are combined oral pills, HTN, diabetes, family history of arteriosclerosis and alcohol consumption. Among smokers, migraine was associated with a three-fold increased risk of stroke, whereas among non-smokers, migraine was not associated with a stroke risk. Also, earlier studies had shown that women younger than 45 who have migraine with aura (a distinctive sensation or visual disturbance that may signal the beginning of an epileptic episode or migraine) are also at an increased risk of stroke. Doctor Gbenga Israel Durosaro, a medical practitioner with Zoe Hospital spoke with Saturday Tribune and sheds light on the disorder called migraine.

What is the link between smoking, migraine and stroke?
There are different types of stroke such as ischemic stroke, haemorrhagic stroke. However, migraine headaches have been linked more with ischemic strokes not haemorrhagic stroke. There are more factors other than cigarette smoking that contribute to triggering a migraine headache that causes stroke. These are age, caffeine consumption, alcohol, women on oral contraceptive pills, especially combined pills, i.e. those containing oestrogen and progesterone.  Also, we have history of stress, family history and recent travels. For the two co-morbidities (migraine and stroke), it is not uncommon for cigarette smoking to be implicated in it. There is a documentation that says those that take caffeine have a higher risk of developing a migraine headache than those who don’t take it. Caffeine can be found in coffee and some other beverages.

Is there an actual cause of migraine?
There is no particular cause because when it comes to headaches, there are primary headaches and there are secondary headaches. Primary headaches are those kinds of headaches that do not have a particular cause while secondary headaches are those that have a recognised cause. Examples of primary headache include migraine, cluster headache, and tension headache. However, there are things that can predispose one to having such headaches. Causes of secondary headaches are numerous. They can be from simple infections, plasmodium infection and bacterial infection like meningitis, then tumours, vascular diseases, especially vascular haemorrhages in the brain. All those things will cause headaches. So there is no particular cause. However there are epidemiological distributions, i.e. things that make the person become more predisposed such as  women taking certain contraceptive pills, intake of caffeine and/or alcohol, smokers,  those under extreme stress, those who undertake recent travels.

Are there foods or fruits that can trigger or stop an attack?
 Cheese (wara) is the only food I know that can trigger the attack. Scientifically, there is no food or fruit that can stop the attack.

How does one differentiate a migraine headache from other types of headaches?
The World Health Organisation has a scale of diseases and there are those called delimitating illnesses which means the person is almost useless. Amidst those delimitating illnesses are paraplegic patients who cannot move the hands and legs. Migraine is classified among delimitating illnesses. It is as severe as that.
A person with such severe headache has to see a doctor and a clinical diagnosis would be made, that is, we don’t particularly have to run a test to make that assessment as there are criteria for making such diagnosis. The International Headache Society came up with the criteria but you must have a good understanding of the classification of migraines which are majorly two. We have the migraine with aura and without aura. For migraine without aura, there are about five diagnosis criteria. That includes a patient complaining of headache of about five to seven episodes; another is characterised by a throbbing headache on one side of the head which is usually worsened by physical activities and is debilitating enough to affect daily activities. Each episode must last for about four to 72 hours so that all the doctor’s investigation does not reveal any other pathology whether infectious, history of trauma to the head, history of tumour in neoplasm or any other drug related causes, for example, those on certain drugs might oftentimes have headaches. For migraine with aura, this will not be in five to seven episodes. They will be in at least two episodes with visual symptoms, somatosensory symptoms and speech symptoms. The visual symptoms may be in those people who may find it difficult to read. All the words become muddled up and you start seeing dots. For speech symptoms, the person might be unable to say some words and this is not intentional. It is called phoneme substitution. Then there are somatosensory symptoms in which the person might have tingly sensation even to the extent of numbness, i.e. the inability to feel. Some of them also have motor symptoms, i.e. the eye will move to one side or unable to move one eye; this is called ophthalmoplegia. Some may have difficulty in saying some words. So all these things are some of the things we need to check and ask the patient if they occur or not.

What treatment options are available for migraine sufferers?
The management of migraine headaches pans through lifestyle modification and drug treatment. There are preventive measures and definitive management for the drug treatment, i.e. it is possible for us to prevent an attack such that when a patient comes in with a migraine-headache and is diagnosed, we treat and afterwards, we place them on drugs for preventive purposes. The classes of drugs for the treatment range from Non-Steroidal Anti-Inflammatory Drugs (like aspirin or ibuprofen), ergot compounds, some classes of anticonvulsant agents and anti-seizure drugs. But these medications should be used as prescribed by a doctor. Self-medication is wrong because there are contraindications for the use of some of these drugs. For instance, ergots cannot be taken by patients who have a history of heart disease as well as pregnant women. For lifestyle modification, those who are prone to migraines should avoid those things that trigger the attack. The triggers differ based on individuals, so sufferers should know what triggers the attack in them. When someone has this attack, you should stop any physical activities and put a cold or warm compress on the head and the affected sides.

Is there any proof that aromatherapy eases migraine?
Aromatherapies are long conventional methods of management. There is no scientific basis for curing migraine. They are alternative medicine.

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