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Dr Susanna Kent - Migranes - 29 July


Migraines affect 18% of women and about 6% of men.

Causes
A combination of changes in the blood vessels in the head and subsequent nerve excitation in the brain. Migraine sufferers have excitable brains. Strong genetic link especially via the mother. (Get dilation of the intracranial extracerebral vessels and subsequent stimulation of the trigeminal nerve pathways leading to pain).

Triggers

  • Foods such as red wine, chocolate, cheese, tomatoes, citrus, onions, MSG.
  • Alcohol
  • Stress
  • Hormones - premenstrual migraine, also if on the pill or hormone replacement therapy
  • Fatigue
  • Stress
  • Over exercise and subsequent low blood glucose
  • Various medications
  • Fluorescent lighting

Two main types of migraine

1.  Migraine with aura.
The aura occurs up to one hour prior to the headache. Mainly visual symptoms such as wavy lights, flashing lights, hole in the visual field, blurred vision. Then comes the headache. As the person ages often they only get the aura and do not get the headache (yahoo for ageing!)

2.  Migraine without aura.
Just the pounding headache.  It is often just on one side of the head.
Nausea and vomiting often occur as well. Also photophobia (intolerance of bright lights)
There is another type of migraine where a person may get symptoms like s/he is having a stroke, eg: half the body gets tingly or has paralysis and speech gets slurred. This is obviously a very frightening experience for anyone (called hemiplegic migraine).

If a person has migraine, s/he is also at increased risk of stroke, epilepsy, asthma, anxiety and depression. 

Prevention

  • Identify triggers and avoid them or manage them (eg: stress, bright lights, smells, poor sleep, missed meals, hormonal disturbances)
  • Medications such as beta blockers (propranolol) or amitryptyline
  • Feverfew, magnesium and vitamin B2 (riboflavin eg: in marmite) are also extremely useful.  (eat a leaf of feverfew every day if you can, or take it in another form. Get a multi-B vitamin and a magnesium supplement - mg aspartate or chelate the best, take at least 500mg/day)

Treatment

Various medications eg: non steroidal anti-inflammatories, and the rectal route is useful if person gets nausea.
Drugs that stop the headache early on, eg: sumatriptan (imigran) 
Anti-emetics such as anti-vomiting medications.
Acupuncture /acupressure especially in the Li4 point.  Also meditation/relaxation.


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