migraine attacks

Migraine Attacks – Where Should I Go?

Migraines are a fairly common condition that affect one in every five women and one in fifteen men. They are severe to moderate headaches characterised by a throbbing sensation located in either side of the head.

Other symptoms include feeling nauseous, vomiting and an increased sensitivity to light and sound. The Migraine Trust estimates that around 190,000 migraine attacks are experienced across the UK on a daily basis.

While some people only experience them on occasion, with months in between migraines, others experience them on a more frequent, weekly basis. A migraine attack is considered to be chronic if it lasts for fifteen days or more.

Different types of migraines

There are several types of migraine attacks, which include:

  • Migraine with aura – this is where a specific warning is triggered before the migraine, such as seeing flashes of light
  • Migraine without aura – the most common form of migraine, there is no warning sign to signal that the migraine is about occur
  • Migraine aura without headaches – also known as a silent migraine, other symptoms of a typical migraine can occur without the throbbing sensations in the head

Causes of migraines

While the exact cause of a migraine attack is unknown, it is thought to be a result of temporary changes to the chemicals, blood vessels and nerves in the brain. It could also be a hereditary condition, as around half of those who experience migraines have a close relative who also suffers from them.

There are common causes of migraine attacks, which include:

  • menstruation
  • experiencing stress
  • being overly tired
  • eating certain foods and drinks

How to prevent a migraine attack

Two new clinical trials have potentially found groundbreaking new ways to prevent migraine attacks. The treatment is the first of its kind to use antibodies to change the activity of chemicals in the brain.

While further tests will need to be undertaken to assess the long-term effects, the research has shown that calcitonin gene-related peptide (CGRP), a chemical in the brain involved with sound and light sensitivity as well as pain, can be neutralised with antibodies.

Four drug companies are in the development stages of generating antibodies to neutralise CGRP, and the two studies have now been published in the New England Journal of Medicine.

The antibody erenumab, produced by Novartis, was trialled on 955 participants who experienced episodic migraine attacks. At the beginning of the trial conducted at King’s College Hospital, patients experienced an average of eight migraines per month; the study halved this number for half of those involved with the trial. However, around 27% of participants experienced similar results without treatment, reflecting the fluctuating nature of migraine attacks.

The second antibody, fremanezumab, produced by Teva pharmaceuticals, was trialled on 1,130 participants who experienced chronic migraine attacks. Nearly 41% of patients halved their daily migraines compared to 18% of those without treatment.

Despite the positive results from the two clinical trials, using antibodies to prevent migraine attacks is costly compared with the alternatives. Other preventative treatments for migraine attacks include botox and medication formerly used for epilepsy and heart disease.

There are also non-medical lifestyle changes that can help to prevent migraine attacks. Taking regular exercise, eating a balanced diet and staying well hydrated can help to reduce your risk of a migraine attack. Ensuring that you get enough sleep and limit your intake of stimulants such as caffeine and alcohol can also help.

If you believe that your migraine attacks have dietary triggers or are stress-induced, making positive lifestyle changes could help to reduce migraine attacks.

What to do when experiencing migraine attacks

Simple pain killers such as paracetamol and ibuprofen may help to alleviate symptoms, however taking too many of these tablets can create the risk of dependency, and can also decrease the ease of treatment for headaches over time.

Some people find that sleeping or lying in a dark room can help to alleviate symptoms. If your migraine attack is chronic or you are experiencing severe symptoms, ensure that you promptly contact your GP. If your surgery is closed, our out of hours services are help to help during evenings, weekends and bank holidays. Please call 111 to be directed to the right service.

An ambulance should be called immediately if migraine symptoms include:

  • paralysis or weakness in one or both arms, and/or facial paralysis
  • slurred speech
  • a sudden, agonising headache never experienced before
  • a fever/high temperature, stiff neck, mental confusion, seizures, double vision and a rash alongside a severe headache

These symptoms could be signifying a more serious condition such as meningitis or a stroke.