Lakshmishree Sinha remembers the day she was making an important presentation at an office meeting when a nagging headache intensified. She abruptly rushed out and a friend followed her to the washroom. “She saw me pulling my hair with both hands and banging my head on the wall,” says the Delhi-based communications professional. She was rushed to the hospital and administered an injection that helped quell the intensity.
Lakshmishree had mild headaches since college. An attack of vertigo took her to the neurologist, who identified it as migraine. In her early 40s now, she says the attacks have ceased with regular medication and she continues to take precautions like avoiding crowded places, wearing sunglasses when out in the sun, and doing yoga. There’s also research that suggests avoiding the 3 Cs — cocoa, cheese, coffee — helps.
Given its non-life-threatening nature, migraine remains under-reported and under-diagnosed, says Dr Neethi Arasu, a Madurai-based neurologist. “When a teenager complains of headache, it is often dismissed as exam stress or indigestion. When an adult complains of the same, it is seen as something routine stemming from exhaustion, anxiety or sleep deprivation,” he says.
Here, doctors give us practical steps to take, to help resolve or manage the condition.
Maintain a headache diary
Dr VG Pradeep Kumar, Senior Consultant – Neurology with Baby Memorial Hospital, Kozhikode, says it helps to record the periodicity and intensity, so your physician can prescribe the right therapy or medication to prevent frequent recurrence. He says it is essential to follow medical advice and take the prescribed drugs for six to eight weeks, even if symptoms subside.
Know the triggers
Neurologists describe migraine as a multi-factorial disease most impacted by hormonal changes and environmental factors. It could be triggered by anything from a loud noise, bright light, season change, to irregular eating habits or fasting, lack of sleep, tension at work or home. Add to this our gadget addiction. The pain ranges from mild to acute, and usually starts from the back of the head and radiates to the front, in between the eyebrows or to the sides of the eyes.
A US-based study based on epidemiological observation suggests the incidence of migraine among women to be three times more than in men. Which means women must stop multi-tasking, for starters. “Many are anaemic, they get up early, sleep late, have a wide fluctuation in hormonal levels, and coupled with hereditary to environmental factors, anything can be a trigger,” says Dr Sivarajan Thandeswaran, Senior Consultant, Stroke and Neurovascular Medicine at Kauvery Hospital, Chennai.
Ask for professional advice
The Botox injection is the last resort for chronic migraine, says Dr Thandeswaran. He says the drug is injected at specific points in the forehead, back of the head, neck, shoulder and sides of the scalp to numb the nerves that trigger migraine. It has to be taken every three months for at least a year or till the person goes into remission. Each sitting costs around ₹50,000. On an average, he does one case a week.
Check this device
If you don’t feel better after taking precautions and trying conventional medicines and optimal drug doses, Dr Arasu recommends FDA-approved non-invasive magnetic devices. The popular one is Cefaly. Shaped like a tiara, it sits on the forehead in between the eyebrows. Electric current is passed across certain nerve points to reduce the intensity of headache.
A 20-minute session is required with the device when acute headache hits. Depending on the intensity of symptoms later, the device can also be used daily for 20 minutes for a month to see the efficacy.It costs around ₹25,000 and is available in pharmaceutical shops in metros.
