How Migraine Differs from an Ordinary Headache

1. Characteristics of Ordinary Headache:

Common headaches, such as tension-type headaches, are usually milder and less debilitating.

Typically described as a dull, aching, or squeezing pain around the head or neck.

Pain is generally bilateral (on both sides of the head).

Usually not associated with other symptoms like nausea, vomiting, or visual disturbances.

Tension headaches can last from 30 minutes to several hours and often improve with rest, hydration, or over-the-counter pain relief (e.g., paracetamol, ibuprofen).

 

2. Characteristics of Migraine:

Migraines are more severe and often described as a throbbing, pulsating pain, usually on one side of the head.

Lasts longer, typically between 4 and 72 hours.

Often accompanied by nausea, vomiting, and sensitivity to light, sound, and smells.

May include an aura (visual disturbances such as flashing lights, zigzag lines, or temporary vision loss) that occurs before the headache phase.

Physical activity or movement usually worsens the pain.

When to Seek Help:

If headaches are sudden, severe, or different from your usual headache pattern.

If they are accompanied by neurological symptoms (e.g., confusion, vision changes, or difficulty speaking).

If there is an increase in frequency or severity, or if headaches interfere with daily activities.

Treatment Options for Migraine

Acute Treatment (During an Attack)

Pain Relievers: Over-the-counter medications such as ibuprofen, aspirin, or paracetamol can be effective if taken early in the attack.

Triptans: Specific migraine medications like sumatriptan or rizatriptan help relieve pain by targeting serotonin receptors and reducing inflammation.

Anti-nausea Medications: Metoclopramide or other similar medications may help if nausea or vomiting is present.

Ergotamines: These are less commonly used now but may be effective in some cases (e.g., dihydroergotamine).

Preventive Treatment (If Migraines Are Frequent or Severe)

Beta-Blockers (e.g., propranolol) and calcium channel blockers (e.g., verapamil) help reduce migraine frequency.

Antiepileptic Drugs: Topiramate or valproate are effective for migraine prevention.

Antidepressants: Low doses of amitriptyline can be beneficial, especially if there is a co-existing mood disorder.

CGRP Inhibitors: Newer medications like erenumab target calcitonin gene-related peptide and are effective in preventing migraines.

Botox Injections: For chronic migraines (15 or more headache days per month), Botox may help reduce the number of attacks.

Non-Pharmacological Treatments

Lifestyle Modifications: Regular sleep, hydration, and stress management are essential.

Dietary Supplements: Magnesium, riboflavin (vitamin B2), and coenzyme Q10 have shown promise in reducing migraine frequency.

Cognitive Behavioural Therapy (CBT): Can be helpful, particularly if stress is a major trigger.

References:

NHS Guidance on Migraines: Offers practical advice on migraine triggers, treatment, and management options.

NICE Guidelines: Provides comprehensive information on the treatment of migraines, including recommendations for both acute and preventive therapy.

 

Dr Geranmayeh