Migraine

Migraine is a recurrent headache disorder characterised by moderate to severe, often one-sided, throbbing headaches, frequently accompanied by nausea and sensitivity to light or sound.

• Moderate to severe headache, often throbbing and one-sided
• Nausea, and sometimes vomiting
• Sensitivity to light (photophobia) and sound (phonophobia)
• Some people experience an aura beforehand — temporary visual disturbances, such as flashing lights or zigzag lines, or other sensory changes
• Attacks typically last from several hours up to about three days

• The exact cause is not fully understood but involves changes in brain activity and blood vessels.
• Common triggers include stress, lack of sleep, certain foods, dehydration, hormonal changes, and skipping meals.
• Family history of migraine is common among people who experience it.

• Diagnosed clinically based on the pattern, frequency, and character of headaches, together with associated symptoms such as nausea, light sensitivity, or aura.
• Additional investigation or referral is considered for headaches with unusual features — such as sudden severe onset, new neurological symptoms, or a change in a previously stable pattern — to rule out other causes.

Acute attacks are treated with simple pain relief, such as paracetamol or an NSAID (e.g., ibuprofen), taken as early as possible in the attack, together with rest in a quiet, dark room.

An antiemetic may be added if nausea or vomiting is prominent.

For frequent or disabling migraines, a preventive daily medicine (such as a beta-blocker or another agent used for migraine prevention) may be considered to reduce the frequency and severity of attacks.

Patients with a sudden, unusually severe headache ("worst headache of my life"), new neurological symptoms, or headache with fever and neck stiffness should be assessed urgently to exclude more serious causes.

• Identify and avoid personal triggers, such as specific foods, poor sleep, or dehydration.
• Maintain a regular sleep schedule and meal pattern.
• Manage stress through relaxation techniques or regular physical activity.
• Keep a headache diary to help identify patterns and triggers.