Migraines can be truly debilitating. Episodes can last anything between four and 72 hours and affect around 15 per cent of the global population. It can lead to absences from work or school as people confine themselves to a darkened room in an attempt to alleviate the throbbing pain. Recently, the headache disorder made headlines following the invention of a new drug, which is the first of its kind in 20 years. The laboratory-made antibody blocks a neural pathway called CGRP and a trial of 1,000 people found that it cut between three and four incidents of migraines a month.
Dr Abu Bakr Al Madani, Head of Neurology Department at Rashid Hospital, says that migraines can be caused by a number of different factors. Light, noise and stress have all been proven to induce the disorder and its symptoms include nausea and vomiting.
There is speculation as to what exactly is the cause of migraines and while genetics have been suggested as a factor, Dr Al Madani explains that the prevalence of the condition makes it difficult to establish a direct link. “Migraines are so common that you rarely see families that don’t have someone who suffers from them. We know that people who suffer from migraines have more family members who suffer from them than with people’s families who don’t have migraines.”
Dr Al Madani explains that migraines affect more women than men and that the ratio is around 3:1. The disorder often manifests in childhood, adolescence or early adulthood and sufferers can experience signs one or two days ahead of an episode, which is referred to as prodrome. The Mayo Clinic says that prodrome is when people receive subtle warnings such as food cravings, increased yawning and mood changes, which can indicate an imminent episode. Dr Al Madani says women experiencing the menstrual cycle and certain medicines can also be migraine triggers.
Solving the pain
He says DHA has a multifaceted approach to treating migraines, which are adapted on a case-by-case basis. Initially, migraine sufferers are encouraged to avoid bright lights and drink plenty of water but if this fails to alleviate the symptoms, there are alternative avenues that can be explored, ranging from drug prescriptions to the use of magnets.
Dr Al Madani commonly prescribes beta blockers, which lower blood pressure. Patients are encouraged to take beta blockers daily, regardless of whether they are suffering from migraines or not. He also uses migraine-specific drugs such as triptans, which make blood vessels constrict and block pain pathways in the brain.
If certain drugs are unsuccessful, the neurologist may also prescribe medication that is ordinarily used to treat different conditions. “We have drugs such as topiramate, which is used for seizures and we put people on antidepressant medication like amitriptyline, which is a tricyclic antidepressant.”
Dr Al Madani and his team also resort to Botox in cases where drugs fail. “We believe that the Botox blocks the inflammatory distribution of the nerves.” Patients receive the injections in the neck and head every two months and Dr Al Madani says the procedures have had some remarkable results, referring to a reduction in prodomes by as much as 57 per cent.
DHA is also open to exploring less conventional solutions to people’s migraines. Dr Al Madani says he has used a magnetic device that patients clip to their head for 20 minutes a day to stimulate the brain’s occipital cortex.
Seeking the right advice
Dr Al Madani believes that anyone who experiences frequent or acute headaches should consult a specialist. While you may not be suffering from a migraine, headaches could be indicative of another problem, such as inflammation or an injury. A correct diagnosis can also improve your friends’, family’s and colleagues’ understanding of migraines.
Speaking to the Independent newspaper, Simon Evans, CEO of the charity Migraine Action, said, “Migraine is too often trivialised as just a headache when, in reality, it can be a debilitating, chronic condition that can destroy lives.” With proper treatment and sensible lifestyle choices, there is a chance that you can significantly reduce the amount of migraines you suffer from and live a far happier life.
Aura
A minority of people who suffer from migraine also experience episodes of aura. Aura is a visual condition where people can see different shapes and flashes or spots of light. It is often a sign of an imminent migraine and the symptoms are:
- Uncontrollable jerking or other movements
- Visual phenomena
- Vision loss
- Pins and needles sensation in an arm or leg
- Weakness or numbness in the face or one side of the body
- Difficulty speaking
- Hearing noises or music
- Source: Mayo Clinic
