Consider Migraine
Migraine
Migraine is typically a recurrent disorder of headache and other symptoms, normally lasting between 4 to 72 hours. The pain often occurs on one side of the face or head, is pulsating in nature and of moderate to severe intensity. The pain of migraine can also be aggravated by routine physical activity like walking or climbing the stairs, and frequent accompanying symptoms include feeling sick, being sick, and an over sensitivity to light and/or sound.
Some forms of migraine also have symptoms of ‘aura’, which usually develop over 5 to 20 minutes and last for less than an hour. These comprise of problems with seeing, feeling or speaking/understanding, that come before or during the headache.
Due to the similarity of the underlying symptoms, many cluster headache (CH) sufferers (particularly females) are often misdiagnosed with migraine. The most useful features for differentiating CH from migraine include that CH attacks:
- Are shorter lasting
- Have an abrupt start and finish
- Occur at regular times during the day
- Are triggered within an hour of drinking alcohol
- Are associated with restlessness
- Clustering of attacks broken by periods of pain-free remission (in Episodic CH)
For more information about migraine visit the Migraine Trust and the Migraine Action websites at:
If this brief description does not match your headache type, consider Tension Type Headache.
Treatment
Non-steroidal anti-inflammatory drugs and gastrokinetic antiemetics are usually the analgesics of first choice for the acute treatment of individual attacks. Various triptans, agonists at 5-HT receptors can also be highly effective as analgesics, and short-term opiates, for example codeine, can be useful, but can lead to a dull background headache.
Preventative therapy is normally considered in sufferers with frequent attacks, or those who respond poorly to acute analgesic therapy. Beta-blockers and pizotifen are normally the first choice preventative drugs and trycyclic anti-depressants, valproate, methysergide and regular non-steroidal anti-inflammatory drugs are also of proven efficacy.
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