That hell of a pain called migraine

Classified by WHO as a ‘primary headache disorder’, it mainly affects those in the 35 to 45 age group

October 30, 2019 06:20 am | Updated 12:48 pm IST

A dull pain that often starts on one side of your head and shifts to the other. It can also affect the entire head or only the front part, and gradually advance into a throbbing ache, often accompanied by nausea and sensitivity to light.

Migraine, this hell of a headache, has been classified by the World Health Organisation (WHO) as a “primary headache disorder”. Most often it begins at puberty and mainly affects those in the 35 to 45 age group. The disorder is more common among women, because of hormonal influences, says the WHO.

Causes

“Sleep deprivation, stress, prolonged travel, chocolates, coffee and ice-cream are some of the triggering factors. Among women, hormonal changes during menstrual cycle can be a reason,” says V.G. Pradeep Kumar, senior consultant neurologist with Baby Memorial Hospital, Kozhikode.

Dr. Pradeep Kumar says that these triggering factors cause a “cortical spreading depression”, a neurovascular event that leads to narrowing and dilatation of blood vessels in the brain. This has been cited as a reason for migraine with aura and the patients may see blind spots, zig-zag floaters and sparkles.

The blood supply to the brain will be reduced temporarily. There could be release of inflammatory mediators which affect neural branches and pain, says Dr. Pradeep Kumar.

The WHO says migraine is often life-long and recurrent with nausea being its most characteristic associated feature. The attacks can be of moderate or severe intensity. They can be aggravated by routine physical activity and prolong for hours or up to two to three days.

The attack frequency can be anywhere between once in a year and once in a week. Among children, they tend to be of shorter duration and abdominal symptoms can be more prominent.

Social impact

This disorder can have a social impact as well. It was found to be the sixth highest cause of “years lost due to disability” in the Global Burden of Disease Study, updated in 2013. Anxiety and depression are significantly more common in people with migraine than in healthy individuals. The WHO reports that 30% of those in 18-65 age group have reported migraine last year. Dr. Pradeep says that medicines are available to prevent this disorder. Physical exercise such as walking for half an hour to one hour will help reduce its chances.

“Avoiding caffeinated drinks such as coffee can be useful. Treatment is available for acute migraine attacks,” he points out, adding that self-medication should be avoided at any cost.

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