Migraine

Also known as:

• Māhunga ānini

• Migraine headaches

Overview

• Sufferers of migraine disease experience severe headaches, which are normally on one side of their head.

• During a migraine headache or migraine attack, they may also become sensitive to light and sound, feel nauseous or even vomit.

• Often people who have migraine attacks will get warning symptoms before the headache begins. This is called ‘migraine aura’. Symptoms include blurred vision, tingling sensations and dizziness.

• Migraine disease is quite common, affecting around 1 in 10 New Zealanders.

• Females are more prone to migraine disease than males.

• Most people get their first migraine attack when they’re aged between 10–30.

• Migraine disease can’t be cured but it can be managed with lifestyle changes, medication and avoiding triggers.

What causes migraine disease?

• The cause of migraine disease is currently unknown, but one theory is that it’s genetic since migraine headaches tend to run in the family. 

• Migraines may also be related to chemical compounds and hormones, such as serotonin and estrogen, which often play a role in pain sensitivity for migraine sufferers.

• Another theory suggests the dilation (enlarging or expanding) of blood vessels in the brain is also thought to be one factor in migraine headaches.

• Attacks can be triggered by a variety of things, and will differ from person to person. Some triggers are: 

  • Fatigue

  • Not enough or too much sleep

  • Dehydration

  • Hunger

  • Intense smells

  • Loud noise

  • Very bright or flickering lights

  • Anxiety

  • Depression

  • Stress

  • Relaxing after being stressed for a prolonged amount of time 

  • Intense exercise without sufficient fitness

  • Caffeine 

  • Alcohol

  • Eating some foods like chocolate, cheese, citrus fruits, onions, brown vinegar and MSG – foods are only considered to be a trigger if they’re eating within a 6 hour period prior to the migraine developing. 

  • Hormonal fluctuations caused by pregnancy, menstruation, menopause, hormone therapy or the contraceptive pill.

  • Long distance travel

  • Temperature shifts

  • Changes in weather

  • Excessive use of pain medications

  • Some angina medicines

Migraine symptoms in adults

Many people who suffer from migraine disease will get warning symptoms before a migraine attack.

These include: 

• Tiredness

• Yawning a lot

• Trouble concentrating 

• Feeling dizzy

• Blurred or impaired vision

• Light sensitivity 

• Sound sensitivity 

• Feeling irritable 

• Feeling anxious

• Experiencing cravings

• Hunger

• Thirst

• Tingling or numbness

When the migraine headache begins, people normally experience intense pain on one side of their head. They may also feel dizzy and/or nauseous. Some people may have difficulty speaking or get a tingling sensation around their mouth.

Migraine treatment for adults

There isn’t a cure for migraine disease but people can learn to manage their triggers and relieve symptoms.

• Patients may find some of the following tactics helpful during a migraine attack: 

  • Lying still in a quiet, dark room

  • Trying to sleep

  • Meditation

  • Playing relaxing music at a low volume 

  • Placing a cold, wet cloth on their forehead or on the back of their neck

  • Avoiding tea, coffee or fruit juice – particularly orange juice

  • Avoiding the television

  • Avoiding driving

  • Not reading

Symptoms and treatment for kids

Migraine symptoms vary between younger children and adults. Caregivers should seek further advice from their GP for assessment and treatment plans.

Medication

• Pain-relief medications can be used during a migraine headache. These include: ibuprofen and paracetamol. Patients need to be careful not to use pain-relief medicines in excess, as they can have a rebound effect, resulting in more headaches.

• Anti-nausea or anti-vomiting medications can be used if the patient is feeling unwell during a migraine attack. Medications include: metoclopramide, domperidone and prochlorperazine. Some of these medications can actually help a person’s body to absorb pain medication if they’re taken around the same time.

• Triptan medications are used to make the blood vessels in the brain contract instead of dilate, which can ease symptoms of a migraine attack.

• Migraine disease affects people quite differently, so it can take time to find the right combination of treatment and medication. Not all medications are suitable for all sufferers, so we always recommended seeing a doctor before trying anything. 

Common over-the-counter medications

• Some pain-relief medications like ibuprofen and paracetamol are available over-the-counter.

Should I see a doctor?

• If you’ve just started to experience migraine attacks, see your GP to figure out how to manage them.

• If you’re not responding to treatments or your migraine headaches are getting worse or more, see your GP.

• If your migraine attacks are triggered by other health conditions, a doctor may be able to help address these.

• If your first severe headache happens when you’re aged 50 or older, you should see a doctor immediately. 

Seek immediate medical attention if your migraine is accompanied by the following:

• Sudden onset headache or a sudden change in baseline headache

• Neck stiffness

• A high fever

• Muscle weakness

• Changes to speech or vision

• Numbness or tingling sensation

• Convulsions

• Confusion or changes in awareness

Proactive protection

• Actively learning about your triggers is the best way to prevent migraine headaches. A good way to do this is to take note of what you were doing before the attack started and see if any patterns develop.

• Changes to your routine can also trigger migraine headaches, so trying to establish some consistent habits may help to prevent attacks.
  
  Some ideas are: 

  • Eating at regularly at consistent times

  • Staying hydrated by drinking plenty of water

  • Reducing stress with meditation

  • Reducing stress with yoga

  • Going to bed and waking up at the same times each day 

  • Avoiding sudden strenuous exercise – instead build up to more intense physical activity gradually

  • Don’t drink too much caffeine.

Glandular fever symptoms? Tend doctors can help

If you have glandular fever symptoms and would like medical advice without needing to leave the house, you can book an online appointment with a Tend doctor through your app.

After the appointment, your doctor may advise that an additional, in-person appointment is required, to ensure you receive complete care. In some cases, we may require this before administering a prescription.

If this is the case, we'll book you for an in-person appointment at a time that suits you, at no extra charge.

Clinically reviewed by: Dr Mataroria Lyndon
Date of review: 5th August 2021