Migraine Clinic

 

Could you have migraine?

 

 

· Recurrent headaches separated by periods of feeling normal.

· Headache usually felt on one side of your head or confined to a small area.

· Headache follows a visual disturbance known as an aura.

· Pain builds up  over an hour or two steadily getting worse.

· Pain is of a throbbing type.

· Headache lasts for some hours at least and may last overnight.

· Upset stomach , even vomiting , also present.

· Other symptoms may include sensitivity to bright lights or loud noise.

· Feeling of being clammy , lightheaded , such that you might faint .

· Tenderness on touching the painful area of your scalp.

· Strong feeling that you want to lie down and find it very difficult to continue what you were doing.

· Problems suggesting your brain may not be working correctly . For example, thinking is sluggish , difficulty in finding the right words , speech seems slurred , afraid others may think you are drunk.

· Other, more rare symptoms, can include partial loss of sight , altered feeling or loss of power on one side of your body leading you to believe you might be getting a stroke.

 

 

 

What is migraine?

 

For many years migraine was believed to be a    condition based in blood vessels around the head and eye . However, research conducted during the 1990s using advanced scans during a migraine attack has led to a completely different understanding.

Migraine is now seen to be a neurological illness i.e. the problems begin in nervous tissues especially in the grey matter of the brain at the back of the head . This is also the area of the brain where vision is processed . Hence , the aura at the beginning of some migraines causing visual disturbances is occurring in the brain and not in the eyes.

An electrical change develops which spreads across the surface of the brain very slowly leading to the appearance of the full range  of symptoms. Some of the nerves involved are connected to major arteries in the head and cause them to be painful giving the typical throbbing headache.

The underlying fault is often a genetic one , explaining why migraine so often affects several members and generations in a family.

 

Migraine Triggers

 

The underlying genetic fault in migraine may be viewed as causing an underlying instability or tendency for the faulty electrical activity to start. People with migraine learn by experience that repeatable situations or substances  may trigger a headache.

Foods, as illustrated above, would be recognised by many migraine sufferers as being almost certain to cause a headache in the hours after consumption.

The issue of triggers is a complex one and would attract a lot of attention on your first visit to the Migraine Clinic. Keeping a diary of your headaches and foods eaten provides a wealth of information which can be usefully applied to reduce the burden of migraine.

 

Other Headaches

 

Headache may be due to a range of problems other than migraine. It is a major aim of the Clinic to establish a firm diagnosis so that suitable treatments can be offered.

Closely allied to migraine but very distinctively different is cluster headache . This is characterised by fairly brief, intense bursts of pain centred around the eye, which repeat numerous times each day. It mostly occurs in men who smoke.

Tension headache is felt as a tight band around the head but does not have the other debilitating features of migraine. While painful, sufferers can usually keep doing their daily routines.

Chronic daily headache is common but relatively unrecognised. It is headache occurring more than 15 days out of each month and often follows the overuse of pain relievers containing codeine.

Pain felt in the head may be arising from nearby areas such as the neck, jaw joint, teeth, inflamed arteries or rarely from tumours.

 

Special Considerations

 

Children get migraine, often at a very young age when the symptoms may be emphasised differently to migraine in adults. Much of the upset may be referred to the tummy area and nausea may be prominent. The recurrent nature of the symptoms and a family history of migraine can provide the clue to the likely cause. By the age of 7 most children have the vocabulary to describe their problem clearly. The more simple treatments are usually effective and , if not, non-medication approaches are especially useful.

Migraine in pregnancy can be particularly difficult to treat as most of the common medications cannot be used. Other means such as relaxation training, tens , bio-feedback, and Migraid devices can be offered.

 

Stress

 

Stress is the commonest trigger, causing 73% of headaches according to a recent survey in Ireland. When stressed your other triggers will become more active.

Stress is a state of mental and physical arousal designed to help us survive in a moment of danger and at such times is a natural protective feeling. It involves the release of adrenaline, changing the body’s heart rate, breathing, muscle tone, reflexes and mental state. These changes are designed to be resolved through physical action and over a short time.

If we feel the above changes at rest and in normal situations we are said to be stressed and will feel unwell. Feeling stressed is very common in modern life.

Resolving stress is fundamental to reducing the frequency and severity of your headaches.

 

Biofeedback

 

The Migraine Clinic is equipped with the very latest biofeedback equipment available.  This is a means to show you the level of stress in your body. The changes are collected by sensors placed on you which then display in a visual way on a screen the presence and severity of the changes stress has produced.  This forms a solid basis on which to proceed with training in relaxation exercises.  The improvements in muscle tension, blood vessel constriction, breathing pattern, sweating and skin temperature are clearly visible on the screen.

The Migraine Clinic is also equipped with other pain reducing aids which can be used during a migraine. Some patients will find these useful to use as they may allow you to reduce the amount of medication you would otherwise need.

       

 

Why a clinic?

 

The burden of headaches and migraine in particular is high. Migraine is consistently under-diagnosed , not only because it can be difficult , but also, because at least 30% of migraineurs have never discussed their headache with a doctor often because they believe nothing can be done.

Well, a lot can be done! Knowledge has increased , better medicines are available and a range of treatments, both medicines and non– medicated, can be applied to the wide range of issues that contribute to the onset of headache.

By establishing a Migraine Clinic the Practice can provide for a more detailed examination of your problem . A Clinic also allows the skills of different professionals in the Practice to be more co-ordinated for your care. People such as a practice nurse , physiotherapist , dietician and a local psychotherapist all contribute.

A range of special equipment is available to help where medication is undesirable due to other health problems or in pregnancy or where children are concerned.

A written report will be forwarded to you after your first appointment summarising all the relevant issues identified.

 

Making an appointment

 

           Appointments may be made through any of the receptionists. However, it is important to state that you want an appointment for the Migraine Clinic as it is not possible to offer the service during a regular consultation.