Migraine

[PerkyOchrePeer]

Recently I've been getting migraines. I've had one every couple of weeks whereas before they were every couple of months and before that every two or three years. I had one this evening.

Previously I have asked the doctor to send me to a migraine clinic but each time I ask, they say no because my migraines are not severe. As they are now more frequent I contacted the doctor again and was given tablets. These are meant to calm the migraine and so it doesn't last as long without the tablet it lasts 20 minutes but I took a tablet this evening abd the migraine had died down in 5 minutes.

That us good but I am getting scared because of the frequency cy and I am on tenterhooks now knowing from day to day if i am going to get a migraine. H can't live like this. I am having sone blood tests too try and determine what is causing these migraines. I dont think it's food. I would like a brain scan but I dont think I will get one

20 minutes with no medication doesn’t sound like a migraine, they’re classified as lasting for 4-72 hours. 5 minutes with medication is also very unusual. So that’s likely why they’re not taking it seriously. Are you sure you’re describing them correctly?
What symptoms do you have? They may be cluster headaches, which are different and usually shorter.

I get zig zag lights in the corner of my eye and a doctor said they were ocular migraines. If you google ocular migraines you will see that they are non headache migraines with just flashing lights

A migraine with just flashing lights is a type of silent migraine (also called acephalgic migraine or migraine aura without headache), where the visual aura occurs without a subsequent headache. These visual disturbances, which can also include zigzag lines,

Just looked online and an aura migraine lasts anything from 20 minutes to an hour

I dont get cluster headaches as they are very severe sharp pain. If I get geadacges they are dull which are tension headaches. Anyway I am glad they are investigating my symptoms because I want to know what's causing them

I get these all the time. They last about 20~30 mins. A lot of people get them. I have brain scans (mri's) regularly - about 4 times a year. Nothing else there. Its normal.

So why do some people never get them?

A migraine aura, yes. It lasts from 20 to 60 minutes and it’s generally followed by the headache. An aura is a specific phase of a migraine attack (prodrome, aura, headache, postdrome, in that order) which lasts anything from 4-72 hours altogether.
You can have a migraine aura without the headache, but you’ll probably still have other migraine symptoms before the postdrome kicks in. Fatigue, nausea, dizziness, all sorts.
Ocular migraines are a specific form of migraine.
I think you need to stay away from Dr Google.

The same reason some people never get hayfever. Some people have it, some don’t. It’s nothing more than luck and genetics.
Hayfever symptoms are normal in someone who has it.
Migraine symptoms are normal in someone who has them.

Well according to the Internet migraines are not normal

You’re determined to be desperately ill, aren’t you? You’re one of those.

Migraines are common. Migraine symptoms in people who suffer from migraine disease are normal. Like runny noses are normal in people who suffer with hayfever. Usual.

Im not prepared to be desperately ill. On the other hand, if you dont know what's causing.g a condition it's alarmint. I dont drive, but supposing I was driving and out of the blue I had a flashing g lights migraine, it could cause me to have an accident as the lights would obscure my vision. I once had one of these migraines where it stopped after 20 minutes but started up again and stopped again after another 15 minutes and started up again which was the final time. I've never had that since. Normally a migraine comes and goes once not over and over again. I that occasion I was quite worried due to the frequency I went to A and E only to be told by a doctors that they could not help me. I was shocked at least my GO gave me some migraine tablets and wants ne to have blood tests. I am thankful for that and she is not dismissing me like the other doctors sod

That's not true. The international classification is also only really an approximation - plenty of us have attacks that last minutes or weeks.

My dad gets the same attacks as OP, lasting about the same time.

Mine are chronic and can last days and days.

@PerkyOchrePeer referrals to neurology are not the norm per NICE guidelined (see below). It took me decades to see one. You could see the Migraine Clinic privately on London.

https://cks.nice.org.uk/topics/migraine/management/adults/
When should I refer a person with migraine?

Consider admission or urgent referral if:
A serious cause of headache is suspected (see the section on Red flags in the CKS topic on Headache - assessment).

The person is in severe, uncontrolled status migrainosus (migraine lasting for more than 72 hours).

Seek advice/refer to neurology (with urgency depending on the clinical situation) if:

A complication of migraine has developed.

Atypical symptoms (such as motor weakness or poor balance) are present.

The diagnosis of migraine is uncertain.

Optimal treatment in primary care does not adequately control the symptoms (medication overuse headache should be cons idered).

Migraine affects approx 1:7 people in the world. It's extremely common.

It's also a complex neurological condition and no they don't know the cause.

Familial links (genetic) are very common.

Im not prepared to be desperately ill. On the other hand, if you dont know what's causing.g a condition it's alarmint. I dont drive, but supposing I was driving and out of the blue I had a flashing g lights migraine, it could cause me to have an accident as the lights would obscure my vision. I once had one of these migraines where it stopped after 20 minutes but started up again and stopped again after another 15 minutes and started up again which was the final time. I've never had that since. Normally a migraine comes and goes once not over and over again. I that occasion I was quite worried due to the frequency I went to A and E only to be told by a doctors that they could not help me. I was shocked at least my GO gave me some migraine tablets and wants ne to have blood tests. I am thankful for that and she is not dismissing me like the other doctors sod

But you know what’s causing it. You have migraines. That’s what’s causing it.

It’s really that’s simple.

What you’re doing is the equivalent of someone breaking their leg, knowing they’ve broken their leg, then experiencing pain in their leg and wondering why their leg hurts.

The symptoms you are experiencing are all well known and common components of the aura phase of a migraine attack. A migraine isn’t just a headache.

If it starts while you’re driving then you pull over and stop, or you don’t drive on a day when you think you may have one. You don’t even drive, so why are you even worrying and catastrophising about that?

As for why you’re experiencing migraines - who knows. People get migraines in the same way that they get any other condition. Sometimes it’s easy to identify triggers and sometimes it’s more challenging, and they’re different for everyone. Some big ones for me were tomatoes (especially concentrated like purée), citric acid in food and disturbed sleep patterns. Hormones too. Mine - which were debilitating and lasted days and so frequent I couldn’t work - stopped almost completely after menopause, as did my mother’s.

Migraine attacks usually have a prodromal phase of anything up to a couple of days beforehand where things don’t feel quite right. If you can spot that early, you can take steps to abort them before the symptoms start. That’s what I suggest you focus on. Keep a food and sleep diary and see if anything you do or eat regularly about 24-48 hours before an attack is a repeated link.

Ultimately it usually comes down to taking medication to manage them, which you’re already doing. Honestly, a thing that lasts five minutes really isn’t worth getting your knickers in such a twist about. You’re very fortunate. Many peoples’ attacks last five days!

Yes, it is alarming. But I'm afraid it also becomes your normal.

I've had a sudden attack at the wheel of the car. I pulled off the road, threw up, took some meds and lay in the grass verge for an hour until I was fit to drive again. Unfortunately, this is my normal although that was not a typical attack for me.

I rarely get the kinds of migraine you get, but I do get hemiplegic attacks which mimic a stroke. They're not fun at all.

There are no tests or blood tests to diagnose migraine, it's done on the basis of reported symptoms. Any other testing is to exclude other diagnoses but what you've described is classic migraine with aura.

Have a read through this website - https://migrainetrust.org . It's an excellent organisation with calm, clear and well informed descriptions of what migraine can look like, treatment options and how to live with the condition. My neurologist was the head of it for many years.

I have epilepsy, Multiple Sclerosis and Strokes... these zig-zag line are the least of my problems.

They are normal.

Have you kept a migraine diary to try and identity the triggers and the phases you’re experiencing?

What age are you op? My migraines increased in frequency dramatically when I hit perimenopause. Maybe you should discuss taking something to prevent them happening in the first place, rather than something to treat them once they occur. I’ve found amitriptyline has worked really well for me, and I have very few migraines now. Beta blockers are another type of medication that can help prevent migraine, so there are various options.

I suggested the same thing. It’s the first thing a
migraine clinic will ask her to do so she may as well get cracking with it now.
Look for common triggers 24-48 hours beforehand.

Blood tests and brain scans aren't really part of the management of migraine.

Why do some people have migraine and not others? Just random genetic variation.

There are a lot of migraine triggers and often you can reduce the frequency of attacks by lifestyle changes eg regular meals, regular bedtime, reducing caffeine, avoiding fragrance, alcohol. These are boring but genuinely work.

Some triggers are unavoidable like atmospheric pressure and hormonal changes such periods or perimenopause.

If you are getting a lot of attacks your GP can work with you to find a preventer medication that works for you.

Neurology only gets involved for complicated cases who have tried and failed several preventer medications - I'd failed on 5 and was having disabling migraine most days to get my referral.

I've still never had a brain scan.

Migraine services are over subscribed for the most part and it can be difficult to get to see a specialist. I have been in attendance at the migraine clinic for 15 years now and to be honest none of the treatments really work that well but I am on the very severe end of the scale. I'd be thrilled to only be getting a migraine every couple of weeks as mine are almost daily but I do understand the uptick must be very distressing for you and obviously the trajectory is concerning.

You can ask your GP to try you on first line preventatives such a beta blockers and there are a few others you usually have to do them for 3 to 6 months and try at least 2 different first line preventatives before you get referred to a specialist so perhaps a 9 months to a year and then you might have to wait longer to see the specialist.

I had a brain scan ordered by my neurologist but I was a patient at the migraine clinic for a while and had failed a few 2nd line preventatives prior to getting this. They did do a neurological screening which I think aims to rule out something like a tumour earlier. In your case OP you have had migraines for a while and unfortunately especially for women it isn't uncommon for them to become worse and more frequent. It is very unlikely that you need a brain scan or that you will get one anytime soon.

Migraine is very common really and most people do find relief with first line treatments. Educate yourself on Migraine, some people also find relief with supplements like magnesium, Riboflavin, Omega 3 or CoQ10. Medication can help as can ensuring you are properly hydrated, have slept enough and eating on a regular schedule the migraine brain loves predictable routine. Also if you drink consider stopping or cutting back and also cut out caffeine as much as possible. This can reduce attacks and also means that you can use caffeine occasionally to help stop a migraine but drinking a full sugar cola or a coffee.

Try your best to get them under control now and avoid overuse of triptans and painkillers as over time using these a lot can make things worse.

Your first step though is to go back to your GP and ask about starting a first line preventative that they can give you such as Propranolol which works well for many, many people.

Regular reminder to the migraine community that it is very common and very normal NOT to have ANY triggers.

But common triggers are high histamine foods, alcohol, heat, cold, light, perfumes / scents and a host of other environmental factors.

Equally, people often report triggers which are actually not triggers but are linked with prodromal changes such as sensitivity to smells, lights, food cravings and so on.

@JurassicPark4Eva Good point, I don't really have triggers maybe missing a meal or the weather or hormones but a lot of the time I can be doing everything perfectly, conditions are perfect and still the migraine comes. Migraine is largely genetic and some people with a high genetic load are just going to get them pretty much no matter what.