Migraine is a periodic disorder characterised by paroxysmal, severe unilateral headache, vomiting, photophobia with or without visual aura. Though migraine is benign and not likely to cause any complication, the symptoms are so severe that it is disabling. It commonly affects young adults. Ambitious, tense young adults often suffer from migraine. Women are more affected than men.

Often, the attacks are preceded by or associated with visual aura like colored halos, bright lights or spots in front of the eyes. Sometimes an attack may be associated with total blindness for the entire duration of the headache, but this becomes very frightening for the individual especially for the first time. Nausea and vomiting can occur with the attack, thus causing further disability in the individual. Attacks of migraine may subside spontaneously or after rest in a quiet, dark room. The duration of an attack may be variable, lasting from one to two hours to two to three days and even a week in some cases. Sometimes, one may feel very weak after an attack. A person may get the attacks as frequent as 3 or 4 times per week or there may be an interval of about few months or years in between the attacks.

Bright lights, loud sounds, emotional tension, anxiety and even foods, especially chocolates, can precipitate the attacks.

It is very easy to diagnose headache as migraine when it presents in the typical way. But not all attacks of migraine may present in this way. Sometimes the headache may be mild and tolerable. The duration may be short. Site of the headache may be posterior or diffuse. The patient may complaint of a tight band like sensation all around the head. Instead of the usual visual aura a person may feel giddiness or difficulty in walking during an attack. Pain may even be localized around the jaw instead of the typical throbbing one sided pain.

A clinician needs to be aware of all these variants of migraine. Of course other causes of headache have to be ruled out by suitable tests. Various scans of the head are done to exclude other causes of the severe headache and then a person is diagnosed to be suffering from migraine. If scans are not feasible, response to rest and anti-migraine medications indicate the headache to be migraine.

Migraine is said to be due to an intracranial vasomotor phenomenon caused by emotional stress. There are several medicines used to provide relief in migraine. Ergot alkaloids, Beta-blockers sedatives and antidepressants have been tried successfully to abort the attacks. But these medications only suppress the pain during the attack. They have no preventive function against further attacks.. Avoiding situations likely to precipitate attacks of migraine is very important. One knows from their past experiences very well what is likely to cause an attack.

Being physically and mentally relaxed always helps to prevent attacks of migraine. One should know very well that nothing is more important in life than being alive itself. Keeping this theory in mind, one should not bother about other trivial issues. In fact with a cool mind one can find a solution to any other problem being faced.

Relaxation techniques, if practiced regularly, help to tame the mind and keep away migraine. Migraine is a debilitating painful condition but can be very easily prevented.

Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital