Migraine Patient Information Leaflet
What is a migraine?
- Migraine is a common cause of headache, affecting around 1 in 5 Australians.
- They may vary in severity and frequency and their impact on daily life.
What are the symptoms of a migraine?
A migraine attack may consist of defined phases:
- A warning phase may occur – a sensation that a migraine is imminent.
- Some people may experience an aura (described below).
- The headache phase.
- The resolution phase when the headache gradually fades.
What is a migraine headache like?
- Migraine headaches are usually severe and throbbing. They tend to involve one side of the head and last between 4 and 72 hours.
What are the other symptoms?
- Sensitivity to light (photophobia)
- Nausea or vomiting
- Sensitivity to sounds (phonophobia)
- Aura – this is a group of symptoms that may precede a migraine attack
- Common aura symptoms may include:
- Visual disturbances such as zig zag lines, flashing lights, shimmering or flickering spots, or even blind spots.
- Sensory disturbances such as olfactory hallucinations (experiencing a smell that isn’t there); numbness affecting the face, arms or legs; rarely weakness down one side of the body.
- Speech disturbance.
What causes migraine?
- The cause of migraine is not entirely clear.
- However, a common theory is that blood vessels in parts of the brain become narrower (go into spasm) which accounts for the aura.
- The blood vessels are then thought to open wide (dilate) soon afterwards, which accounts for the headache.
- There may also be a genetic factor involved as it often occurs in several members of the same family.
Types of migraine
Migraine without aura- ‘common migraine’
The most common type of migraine consists of a severe throbbing one-sided headache. There may be associated symptoms of nausea, vomiting, light sensitivity and blurred vision.
Migraine with aura- also called ‘classical migraine’
Similar to a common migraine but the headache is accompanied by an aura which occurs up to 60 minutes before the headache.
Menstrual Migraine
These are migraine attacks (with or without aura) that are associated with periods (menstruation).
Abdominal Migraine
This usually occurs in children and consists of recurrent abdominal pains in children who may or may not have an associated headache. Commonly, children who have abdominal migraine go on to develop migraine in their teenage years.
Hemiplegic Migraine
This type of migraine is associated with weakness in the arm and leg on one side of the body.
If you have these symptoms for the first time or you are not sure if this is a migraine, please call an ambulance immediately as you could be suffering from a stroke.
Ocular Migraine
This type of migraine causes temporary loss of all or part of the vision in one eye with or without the presence of a headache. You should call an ambulance if you get a sudden loss of vision (particularly if it occurs for the first time) as there are various serious conditions that need to be ruled out before ocular migraine can be diagnosed.
Basilar migraine
This type of migraine is rare and symptoms include headache at the back of the head with associated visual disturbance, dizziness, loss of balance, jerky eye movements, trouble hearing and slurred speech
You should call an ambulance if you get these symptoms as there are various serious conditions that need to be ruled out before basilar migraine can be diagnosed.
What usually triggers migraines?
- Dietary factors- cheese, chocolate, red wine, citrus fruits, and foods containing an additive called tyramine.
- Excessive dieting.
- Psychological factors- stress/anxiety, depression and sleep disturbances.
- Environmental triggers- bright lights, loud noises or strong smells.
- Medications- for example HRT and the contraceptive pill.
- Menstruation and the menopause.
How is migraine diagnosed?
- Migraine is usually diagnosed by your GP on the basis of symptoms and clinical examination.
- Further investigation such as a brain scan may be organised to exclude other causes.
Treatment options
Pain relief
Paracetamol, Ibuprofen or aspirin (all available over the counter at any pharmacy) may work well for migraine attacks. They should be taken at the onset of symptoms.
Aspirin 900mg as a single dose can be very effective.
Soluble preparations of these medicines are preferable as they may work more quickly.
Triptans
The group of medications known as “Triptans” specifically target migraines.
They should be taken at the first sign of migraine.
Triptans are not usually prescribed for people under 2 or over 65.
Common side-effects include drowsiness, nausea, dizziness, dry mouth, tingling, flushing, heaviness or pressure in the face, limbs or chest.
Triptans should not be used if you:
- Have uncontrolled high blood pressure.
- Have an increased risk of cardiovascular disease (such as angina or heart attacks).
- Have a history of stroke or mini-stroke (TIA).
- Are pregnant or breastfeeding.
Medication Overuse Headache
- Using pain relief or triptans too often may cause medication overuse headache.
- If you take pain relief or triptans on most days, this may be a factor in your headaches and you should see your doctor for further assessment.
Migraine Prevention
- If your migraines occur very frequently (more than twice/month) then you may benefit from taking a regular medication for migraine prevention.
- The main types of medications used are beta-blockers (such as Propranolol), Amitriptyline and anti-convulsants (such as Topimirate).
- If you feel that your migraines have increased in frequency or severity then we advise you to see a doctor for review.
