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Read articleMigraine is a recurring headache disorder, typically one-sided and throbbing, often with nausea and an intolerance of light and sound. It is not a sign of a brain tumour, but it is disabling enough that many people lose working days to it every month.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- Throbbing or pulsating headache, often on one side of the head
- Nausea or vomiting during the attack
- Discomfort in bright light and loud noise; a wish to lie in a dark room
- Visual disturbance before the headache — flashing lights, zigzag lines or blurring
- Headache worsened by routine activity such as climbing stairs
- Attacks lasting from a few hours to a couple of days
When to see a doctor
Do not wait these out
If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- The worst headache of your life, of sudden onset — attend the emergency department
- Headache with fever, neck stiffness, vomiting, confusion or a seizure
- A new headache after the age of 50, or one that wakes you from sleep
- Headache with weakness, numbness, double vision or loss of vision
- Headaches needing painkillers more than twice a week
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Clinical diagnosis from the pattern of attacks — most migraine needs no scan
- A headache diary recording frequency, duration, triggers and medication use
- Blood pressure measurement and eye assessment
- Haemoglobin and thyroid function where headaches are frequent
- CT or MRI of the brain only when warning features are present
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- Specific medication taken early in the attack, in a quiet dark room
- Preventive medication when attacks are frequent or disabling
- Trigger management — irregular meals, poor sleep, dehydration, glare, stress
- Avoiding overuse of painkillers, which itself causes daily headache
- Treating associated anaemia, high blood pressure or uncorrected refractive error
This page is general information, not a diagnosis
Migraine can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the Neurology department. If a symptom is sudden or severe, call 9281862028.
