By Dr Umberto Russo MBBS, FRACGP
As an after hours Doctor, I am often called out to see patients suffering from migraine. It is one of the most common acute conditions requiring urgent medical care – with 7% of men and 18% of women in the population suffering from migraines.
People often think migraine is simply a bad headache, but as sufferers of migraine will know only too well, it is much more than that.
Migraines can strike anyone
It is estimated that two million people in Australia suffer from migraines, including many children. It seems to be most common in adults in their 20s and 30s, and is less frequent in the older years.
Migraines are one of the least understood, and poorly treated medical conditions. It is not understood what causes migraines - with some professionals describing the neurological disease as a “brainstorm” in an attempt to describe the “excruciating, debilitating, pulsating pain” that sufferers experience.
Nor it is understood why twice as many women as men suffer from migraines – hormones are thought to play a part.
Migraine sufferers can sometimes identify a ‘trigger’- such as eating certain foods or changes in a sleep schedule - that can set off a migraine. But this is not always reliable, as like all things associated with migraine, the causes are complex. The triggers can vary from dietary, environmental, hormonal, and physical or emotional.
It is also believed that migraines are genetic, so for example if your mother suffers from migraines, you might also.
What is a migraine?
What happens during a migraine attack is very different from a headache. Although there is no “typical” migraine, there are certain symptoms that commonly appear. The symptoms include nausea, vomiting, sensitivity to light and an acute, throbbing headache which can last from 4 hours to 4 days. For many years, it was thought to be a vascular disease, i.e. cause by the flow of blood to the brain, but now it is recognised as a complex disorder involving brain chemicals and nerve pathways.
5 stages of migraine
There can be up to five stages of the migraine, beginning with early warning signs such as mood changes, nausea and drowsiness, or muscular aches and pain. Then 30% of sufferers will experience what is known as an “aura”, which are visual disturbances, flashing light and zig zag lines. What follows then is the dreadful headache, which can completely disable the sufferer. The recovery phase then leaves the patient exhausted and drained, often for up to a day.
Treatment for migraine
Unfortunately, as yet, medicine has not yet found a cure for migraine. The patient should cancel all appointments, and find a quiet, darkened room to rest in. While the migraine can be treated with acute headache medication, the ongoing management of the disease should be a partnership between you and your GP.
It is estimated that up to 50% of migraine sufferers are not diagnosed. If you think you may suffer from migraines, you should consult your Doctor to develop a treatment plan.
There are acute medications developed specially for migraine, and often the migraine can be reduced in severity if the patient takes medication as soon as they experience the early warning symptoms. However patients should beware of taking acute headache medications too frequently, as this can result in medication overuse headache (MOH).
13SICK is there for you
Almost half of migraines tend to occur in the hours before dawn, when GP Practices are closed. If you need assistance for yourself or a loved one, you can call 13SICK for a bulk billed home doctor visit. Our Doctors will be able to diagnose and supply you with a starter pack of the appropriate acute medication if required.
Dr Umberto Russo MBBS (Adelaide) FRACGP is Chief Medical Officer at 13SICK, National Home Doctor Service. He has more than 25 years' experience as both a General Practitioner and a visiting home doctor, with a special interest in urgent medical care.