ICD-10 · G43
Migraine
Migraine is a neurological disorder causing recurrent moderate to severe headaches, usually one-sided and throbbing, often with nausea and sensitivity to light and sound. It affects women about three times more often than men.
Symptoms
Throbbing one-sided head pain lasting 4–72 hours, nausea or vomiting, sensitivity to light, sound and smell, and worsening with routine activity. Some people get a visual aura of flashing lights or zigzag lines before the pain.
Causes & risk factors
Triggers include missed meals, dehydration, poor sleep, stress, bright light, strong smells, hormonal changes around menstruation, aged cheese, chocolate, and monosodium glutamate. Genetics play a strong role.
Diagnosis
Diagnosis is clinical using the pattern and duration of attacks. Imaging is reserved for atypical features such as sudden onset, new headache after 50, or neurological signs.
Treatment options
Acute attacks respond to paracetamol or NSAIDs taken early; sumatriptan or rizatriptan are used when simple painkillers fail. Anti-nausea drugs such as domperidone help absorption. Preventive treatment (propranolol, flunarizine, amitriptyline or topiramate) is considered when attacks occur four or more times a month. Keeping a trigger diary and regular sleep and meals reduce frequency measurably.
When to see a doctor
A sudden thunderclap headache, headache with fever and neck stiffness, weakness or speech difficulty, headache after a head injury, or a clear change in your usual headache pattern.