Migraine or Headache

Hello everyone, I am Dr Sankalp Mohan Neurologist at Artemis Hospital, Gurgaon, Saket, New Delhi and visit Neurologist in Panipat. Today I would be speaking on Migraine, Migraine is a very common disorder it affects about 14% of the general population. It is more common in females, 25% of females are affected and 9% of males are affected. Typically there are two types of a migraine, migraine without aura, which is known as a common migraine and migraine with aura which is known as a classic migraine. Now some people experience certain symptoms like visual symptoms, blurring of vision, seeing flashes of light or certain zigzag lines, some of them experience sensory symptoms like paresthesia abnormal sensation, some have autonomic symptoms, like palpitations or sweating etc., prior to the onset of a headache. This is typically followed by a headache which is one-sided although it can be both sided, it was accompanied by nausea or vomiting, some people have an intolerance to bright light or loud sound this headache attack is typically relieved by sleeping or rest. Now the duration of the attack typically lasts for 4 to 72, hours the frequency of the attack is variable. It may last once in 15 days or once in a week or sometime it may be almost daily. Now those people who experience almost daily attacks or more than 15 days a month are classified as a chronic migraine, now migraine is classified as a primary headache disorder that is it does not have any cause, most of the times we do not require any imaging CT Scan or MRI but however if your Neurologist feels that it might be due to a secondary headache that is due to some cause or there are certain red flag sign in that case and MRI may be needed. As far as the treatment of a migraine is concerned, if you are having very infrequent attacks like less than once a month or less than once in 15 days, in that case, all you need is a simple painkiller like paracetamol, brufen etc. during the attack and to avoid the trigger in factors. Now that triggers for a Migraine may be variable some people have an intolerance to light, sound etc. some people have chocolate, caffeine has a trigger, some people have bright smells as triggers so avoidance of the triggers is important. Those who have frequent attacks or very disabling or severe attacks they may require a long-term treatment which is known as prophylaxis, these include various kind of drugs like a beta blocker, amitriptyline, valproate, topiramate etc., special precautions need to be taken in pregnancy because some of these drugs cannot be given during pregnancy. Now those who have a chronic migraine may be more resistant to treatment, apart from taking regular profile access some other treatment modalities may also be given like botox injections or occipital nerve block. Now the effect of these injections typically last for 3 months and the injections may be repeated later. So the taken message is a migraine is a very common disorder if you are having infrequent attacks all you need is to avoid the triggers, have a good sleep, take less stress and to take painkillers during the attack but if you are having frequent or severe attacks then you need to consult a Neurologist. Thank you.