What are migraines?

Migraines are severe headaches that typically last for between 4 and 72 hours. Migraine sufferers may experience nausea and vomiting as well as sensitivity to light or sound. They also frequently report throbbing pain that worsens with normal activity.

Migraines are common and usually very painful. There may be ways to prevent them, and there are good treatments for them.

When should I call an ambulance?

Most headaches are not serious. But headaches can also be a sign of a serious illness, such as a stroke or meningitis.

Call triple zero (000) and ask for an ambulance, or go to the hospital emergency department if you have a headache and:

• it comes on suddenly, is very severe, or has made you lose consciousness
• you have suffered a head injury
• you have trouble seeing, walking or speaking
• your arms or legs feel numb
• you have nausea or vomiting (if not clearly related to a flu or hangover)
• you have a high fever (above 38° C)
• you are sensitive to light and have a new rash

What are the symptoms of a migraine?

Many people who have migraines feel vaguely unwell for a day or two beforehand.

Some people get what is called an aura. An aura is when someone sees flashing lights or a change in their vision, while others can find problems with their speech, and some feel pins and needles in their arms and legs. This can happen before or during a migraine.

When the migraine starts, it is a severe pain usually only on one side of the head (unlike a tension headache, which is usually felt on both sides of the head). Your heads throbs, and it might hurt to see bright lights or hear noises. You might feel sick, and you might vomit. This can last anywhere between a few hours and a few days. A migraine can be so painful and distressing that everyday activities become impossible.

What causes a migraine?

Nobody knows what causes migraines, although genetics and environmental factors seem to have a role. Migraines are thought to be caused by temporary changes in blood vessels and chemicals in the brain. They can run in families, but just because one family member gets them doesn’t mean another will.

What triggers a migraine?

Some people find that migraines are triggered by certain things, including:

• missing meals — this is the strongest dietary trigger
• eating certain foods, such as cheese, chocolate, citrus, red wine and food additives (for example, monosodium glutamate)
• altered sleep patterns — too much or too little sleep
• changes in the weather
• hormonal changes, such as menstruation, and the oral contraceptive pill for women
• alcoholic drinks (especially red wine and beer)

6 migraine triggers

When should I see my doctor?

If you get severe headaches but don’t know what’s causing them, or if the pattern of your headaches changes, it is important for you to consult a doctor. Even if you have previously consulted a doctor and been diagnosed with migraines, but your prescribed treatment has not been successful, it is worth going again. Migraines can be managed.

How are migraines diagnosed?

Your doctor will diagnose migraines by talking to you and examining you. There is no specific test to diagnose migraines. However, your doctor may do tests to exclude other causes of headache.

How are migraines prevented or managed?

There are many ways to manage migraines — both to prevent an attack and to treat an attack once it starts (known as acute treatment). It is important to have a migraine management plan and this will probably involve lifestyle changes and medication.

If you suspect you are getting a migraine, you may get some relief from pain-relief medicines. Some people find they can prevent a migraine by treating it early.

Some people can manage migraine with pain relief available from pharmacies; others might need prescription medications to deal with an acute attack. Talk to your doctor or pharmacist about options.

During the migraine, rest in a quiet, dark room. Get as much help as possible with responsibilities at work, for family and so on.

If you get migraines fairly often, there is a wide range of preventive medicines that can reduce the number and severity of the attacks.

If you have just started getting migraines, keeping a diary about them can help you understand when they happen, and what triggers them. That may help you prevent them, and may also help you to explain what you are experiencing with your doctor.

In the longer term, non-medicine therapies can also help to prevent migraine. These include:

• regular exercise
• psychological therapy, such as cognitive behavioural therapy
• acupuncture
• relaxation training, such as yoga and meditation