There are different triggers for migraine,
one of them for instance can be daily stress, can be stress at work, in personal life and
other factors. Hormones play an important part in migraines, we know that the majority
of our patients are female patients. These patients often do much worse when they have
their menstruation, they do better when they are pregnant and interestingly they often
do better when they are through menopause so we know for a fact that hormones play a
big part in migraines. There are different triggers for migraines
and also the causes for migraines have been debated in the past. Many of our patients describe it as a band around the head, like a pressing band, a band
that develops into massive pain, quite quickly sometimes. Patients have auras, warning signs,
flashing lights, sensitiveness to noise, mood swings, depression and abdominal symptoms.
Many of our children who suffer from migraines have a tummy ache and the migraine is then
developing into an excruciating head pain. A migraine is more severe than a normal headache.
The normal headache, for instance a so called tension type headache which you can get with
daily stress fades away with painkillers whereas a migraine often does not and a migraine is
associated with other symptoms such as sensitiveness to noise and sensitiveness to light, which
we call phono and photophobia. Patients have to lie down in a dark room, they are very
sensitive to migraines, they feel sick, they even vomit and the pattern of a migraine is
therefore quite different to a normal headache a lot of us have. The management of migraine can be very different and with every patient very individual. A
lot of our patients watch their diet which makes sense as a healthy diet does help, patients
for instance with gluten or other intolerances to food have to watch their diet very carefully
because if they don’t follow the guidelines with their diet then that also triggers the
migraine. Daily stress in work, other stresses including bad stress like bereavement for
instance also induces migraine. The daily management otherwise with migraine
means that you take medication, means that you go and see a specialist, that you are
in good contact and good rapour with your GP who keeps a watchful eye on you and that
you lead a normal healthy life. What does that mean? That means that you sleep enough,
at least six hours, that you have a regular pattern of sleep, that you preferably do not
smoke, that you don’t take any drugs and that you don’t drink too much alcohol. Migraines do normally not raise the risk of a heart attack. A heart attack is caused by
other risk factors such as high blood pressure, increased weight and smoking, however a migraine
can increase the risk of a stroke or of a mini stroke. This has been debated a lot and
the latest research actually shows that this is not as evident as we always thought however
frequent migraines can cause so called neurovascular problems and therefore these patients possibly
have to undergo a scan and also a vascular risk profile needs to be assessed by a specialist.

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