Migraine
Not just a bad headache — a treatable neurological condition.
Migraine is a recurrent neurological disorder characterised by throbbing, often one-sided headaches lasting 4-72 hours, typically with nausea, light and sound sensitivity, and sometimes aura. Modern treatment separates acute relief from prevention.
Causes & risk factors
- Genetic predisposition
- Hormonal fluctuations (menstrual migraine)
- Sleep disruption
- Certain foods (aged cheese, red wine, chocolate)
- Stress and post-stress letdown
- Bright lights, strong smells, weather changes
Symptoms
- Throbbing one-sided headache
- Nausea and vomiting
- Light and sound sensitivity
- Visual aura (flashes, zigzags) in 25%
- Tingling or speech changes with complex aura
- Exhaustion for 24 hours after
How it's diagnosed
- Clinical — based on pattern of attacks
- Headache diary noting frequency, triggers, response
- MRI only if red flags or atypical features
Evidence-based treatment
- Acute: triptans, NSAIDs, anti-emetics, gepants
- Prevention: propranolol, topiramate, amitriptyline
- CGRP antagonists (erenumab, galcanezumab) for frequent migraine
- Botox for chronic migraine
- Lifestyle: sleep hygiene, hydration, trigger avoidance
Prevention
- Consistent sleep and meal times
- Hydration through the day
- Limit caffeine to under 200mg
- Identify and avoid personal triggers
Related symptoms
Migraine — FAQ
When should I see a neurologist for migraine?
If attacks are more than 4 per month, if acute treatment isn't working, or if features are atypical (new in middle age, with neurological signs, worst-ever).
Are migraines hereditary?
Yes. If one parent has migraine, your risk roughly doubles; both parents, it triples.
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This page is general information, not medical advice for any specific person. For diagnosis and treatment, book a consultation.