When to worry about migraines Three times more common in women than men, these can be scary when they strike unexpectedly. Here’s what you need to know…

One of my life-long afflictions is migraines. Even as a GP, I’ve had some episodes that have been truly frightening, so I always have empathy when patients have them, too. And

I know it’s easy to worry that it’s an underlying brain tumour or bleed. Plus, with something so debilitating, it can be confusing to know when you need medical attention.

Never had a migraine before? They’re different to an ‘ordinary’ headache – they often (not always) are preceded by an ‘aura’ of numbness or tingling, zigzag lines or flashing lights or dizziness, and are followed by a severe intense throbbing on one side of the head often with an aversion to light (and or sound), and possibly nausea or vomiting.

They usually last between two hours and three days, with some symptoms (such as feeling very tired) starting up to two days before the head pain begins and finishing after the headache stops. Migraines really can have a huge impact on daily life!

GETTING HELP

If you have one that has lasted longer than three days, symptoms of an aura (as above) lasting longer than an hour or so before the

migraine starts (e.g. persistent numbness or visual changes), or a chronic headache that is worse after coughing, exertion, straining or a sudden movement, seek medical advice as soon as possible.

There are also some other ‘red flags’ that need emergency medical attention. These include a headache that came on suddenly and intensely like no other (known as a ‘thunderclap’), problems with speech or memory, vision loss or persisting double vision, feeling drowsy and confused, having a fit, a headache associated with a high fever (possibly with other signs of meningitis like a rash), difficulty moving due to weakness in the arms or legs on one side of your body or a drooping side of face. All of these things individually may sometimes (not always) indicate a brain infection, bleed or lesion, so act promptly.

REDUCE YOUR RISK

If simple painkillers aren’t helping, your GP can trial you on medications (often triptans) to reduce severity. You can help prevent the onset by staying well hydrated, eating at regular times, reducing caffeine and stress, wearing sunglasses in bright light and getting good-quality sleep.

But be wary of popping too many pills – recurrent use of headache tablets can cause rebound headaches or ‘medication overuse’ headaches.

We don’t really know what ultimately causes migraines, but most long-term sufferers know their own triggers. If you aren’t at this point yet, start a diary to keep track of yours.