Symptoms of Migraine? What are they? How will it help to sort out a headache problem?

However, in people who have go on to develop a chronic daily headache, symptoms of migraine can be more difficult to identify.

For people with pain in the head every day, knowing if you have had migraine in the past is very important.

Why?

Well the treatments for chronic migraine are well known and specific.

Treating a chronic headache (which is actually chronic migraine) without using a specific migraine strategy is a bit like putting cooking oil into your car instead of gasoline and expecting it to run!

When I see someone with a disabling headache disorder, I need to work out if there have been symptoms of migraine in the past.

Here are the clues to a diagnosis of migraine:

1. Have you previously taken sickening headaches that made you want to lie down?
2. Have you ever had to take time off school or work because of a headache?

3. Did you ever get travel sickness as a child?
4. Are you bothered by headaches at the time of the menstrual period?
5. Does stress bring on headaches?
6. During a headache do you prefer the dark? Or peace and quiet? Or to be left alone?
7. During a headache do smells or scents become unpleasant?
8. Do any of your family (brothers, sisters, parents or children) get headaches?

Answering yes to any of these makes it likely that your current headache problem are, in fact, symptoms of migraine.



I would then ask more searching questions about symptoms of migraine, remembering that migraine has 4 possible stages:

1. The Prodrome
• In the 6-12 hours before a migraine, people will often experience a feeling that a migraine is coming - "I just know".

  Some people experience food cravings which can lead to the view that foods act as a trigger, when in fact it is a migraine symptom making you look for chocolate or bread or cheese etc.

  Euphoria and feelings of extreme wellbeing can occur, as can depression and feelings of irritability.

  Bodily symptoms like diarrhoea, a desire to pass urine all the time, loss of appetite, or stiffness in the neck can happen.

  That all this might be symptoms of migraine is often a surprise to people.

2. Migraine Aura
• Migraine aura causes visual disturbance, sensory symptoms like numbess or tingling, weakness, vertigo (a spinning sense of dizziness), confusion, deep sleep and even speech loss.

  These symptoms usually evolve over several minutes and last for about an hour or more.

  About 75-80% of aura episodes are followed by a typical migraine headache, but many are not.

  Almost everybody who gets migraine aura will at some point have had typical migraine visual aura - shimmering lights or, zig-zag wavy lines in the field of vision.

  Younger people will often experience a problem with perception - everything looks too small (called micropsia) or too large (called macropsia).






3. The Migraine Headache Itself
• The classic symptoms of migraine headache are a throbbing one-sided headache with nausea and is severe enough to make you want to lie down.

  However, the typical migraine symptoms only happen in about 60%.

  Some will get non-throbbing pains like an ache or pressure in the head - which is often misdiagnosed as tension-type headache.

  A good test for migraine is that any headache that brings on nausea and makes you want to lie down is probably migraine.

  It does not have to be throbbing or pounding, although many are. Its the disabling nature of the headache and the "sensory sensitivity" that are the key to migraine diagnosis.

  What do I mean by sensory sensitivity?

  Sensory sensitivity is the term that describes the heightening of the senses which are so typical of migraine symptoms:

  • Intolerance of light / preference for the dark
  • Intolerance of noise / preference for quiet
  • Nausea
  • Vomiting
  • Intolerance of movement or physicial activity / preference to lie still
  • Intolerance of smell ("osmophobia")
  • A preference to be alone and left in peace (I think this is an expression of intolerance of physical contact!)

  A migraine headache episode will usually last no more than 24 hours from start to finish.

  It usually takes about an hour for migraine headache symptoms to build to their peak.

  This means that there is a narrow gap in which to get medications in, if you need them.

  At its height almost everybody will rate the pain of migraine as severe. On a zero to ten scale, where 10 would be the worst pain imaginable, the overall average pain rating from people with migraine is about 7.5 out of 10!






4. The Aftermath
• Most people after a migraine feel tired and sluggish afterwards. A few will feel elated or "high", but tiredness is the norm.

  After a severe migraine many people will feel like it takes another day to get over the headache completely.

Migraine usually has its first appearance in the teenage years.

However, migraine headaches can happen for the first time at any age.

Most people will have had their first attack by the age of 25 years.

There are people in their 70s or older who get a migraine for first time (having taken care in an older person to rule out other causes of headache!).

Most people with chronic migraine are diagnosed in their 30s-40s, so may have had 20 or more years of dealing with nauseating headaches.

Women are twice as likely as men to get headaches.

It is estimated that 18% of women and 6% of men will experience migraine headache symptoms at some point in their lives.

A family history of migraine is often found, but is not essential for diagnosis of migraine.

If there is a history of symptoms of migraine, then treating a chronic daily headache as chronic migraine is more likely to succeed.

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