An understanding about one of the most common causes of migraines led to new approaches in its treatment…
Our experts
- A professor of neurology, Peter Goadsby is considered one of the world’s leading experts on headache and migraine disorders.
- Neurologist Dr Brendan Davies has more than 17 years’ experience and a special interest in chronic daily headache disorders.
- Dr Elliot Shevel who works as the medical director at The Headache Clinic, is a maxillofacial headache specialist with 25 years’ experience.
- Dr Andrew Dowson has a specialisation in headaches and migraine.
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Migraines affect one in five women. Sufferers are all too familiar with the throbbing, often one-sided headache made worse by any movement, crippling nausea, sometimes with vomiting, and the acute sensitivity to light, sound, smells and/or touch.
Doctors now recognise migraines as a complex neurological condition with several distinct stages. “New research techniques plus sensitive MRI scans have led to a greater understanding of underlying mechanisms,” says Prof Peter Goadsby, and so, new treatments.
What are the causes of migraines?
Until recently, migraine was often attributed to the widening of blood vessels inside the head. Experts now believe that the cause of migraines is due to certain brain regions being oversensitive to some stimuli, such as dehydration, sleeping too much or too little, skipping a meal, strong smells, sunlight, even eating certain foods or changes in weather.
These stimuli excite the trigeminal nerve (the main sensory nerve in the head), causing it to release chemicals that transmit pain signals to the brain and inflame (widen) the blood vessels. New research also points to muscle tension in the jaw and neck aggravating the trigeminal nerve, setting off the same chain of events.
Before pain sets in, one in five sufferers have auras – unnerving neurological disturbances, such as seeing ‘stars’, or blind spots in vision; trouble finding words, feeling tingling and numbness, or even vertigo.
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A jab to prevent a migraine?
A new class of injectable drugs, specifically designed to target a migraine, is now in clinical trials. A key culprit in migraine pain is an inflammatory compound called calcitonin gene-related peptide (CGRP).
The new drugs, known as CGRP monoclonal antibodies, work by blocking this compound’s action. “It’s a very exciting time. We have the potential of new, groundbreaking treatments that are capable of stopping a migraine before it starts,” says Dr Brendan Davies.
Triggers revisited
It was previously thought that there was a simple relationship between a trigger and the onset of migraine symptoms – sufferers ate chocolate, for instance, which sparked a migraine. But here, too, there has been a rethink.
“In controlled conditions, exposure to triggers doesn’t always bring on a migraine,” says Dr Davies. Instead, research suggests that many supposed triggers, such as craving chocolate, are actually part of the first stage of a migraine, caused – in the case of chocolate – by changes in the brain region that regulates appetite.
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Are genes to blame?
It’s thought genes could be the bullets that load the gun. If one of your parents suffers from migraines, your chance of developing them too is 50%, and this goes up to 75% if both of your parents suffer. Four potential genetic culprits that increase nerve excitability in the brain have already been identified.
Ease your symptoms
For short-term relief, try over-the-counter painkillers, anti-inflammatories, and/or anti-nausea meds. For severe symptoms, triptans, blood-pressure drugs, anti-seizure medications, and antidepressants may be prescribed.
Red flags
Seek medical help if you experience: Sudden onset headaches after the age of 50. An apparent aura for the first time – it can mimic a stroke or TIA (transient ischaemic attack) or mini stroke. A severe and sudden-onset headache that takes seconds to minutes to reach its maximum intensity. A headache with fever and drowsiness, or altered consciousness, memory loss and altered mental state.
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Tips to help yourself
- Keep track – Writing down the frequency of your migraines will help identify patterns over three months.
- Stay balanced – Aim for regular meals, the same sleeping hours and, if possible, maintain equilibrium.
- Move more – New studies have revealed that regular exercise (40 minutes three times a week) can help to reduce migraine attacks.
- Take the right supplements – Vitamin B2, magnesium and CoQ10 have all been used with some success.
DISCLAIMER: You must not rely on the information on this website/newsletter as an alternative to medical advice from your doctor or other professional healthcare provider.
