“26-year-old Shweta Nanda, software engineer by profession consulted
with Dr. Prashant Makhija, Neurologist at, Wockhardt Hospital Mumbai central
for her frequent headaches.
She
reported that her headaches started at a much younger age and almost 20-30
minutes prior to the headaches she would notice blurring of vision,
subsequently she would start having pulsatile headache. She initially consulted
an Ophthalmologist who suggested correction of a minor refractive error but as
the headaches persisted she consulted a Physician who attributed it to exam
related stress. In the last 3-4 yrs., headaches became more frequent and many a
times without “visual warning” and lately she started having analgesics on
multiple days in a month. Dr. Makhija found out that Shweta’s neurological
examination was within normal limits and all her routine blood investigations
as well as repeated brain scans were normal. A detail interview with the patient
revealed that what started as infrequent “Migraine with aura” was becoming more
frequent and many a times without the “visual auras”.
This
further transformed over time to “Chronic daily headache”. She was asked to
maintain a headache dairy and started on Migraine prophylactics and explained
that she may have to continue the medications for a reasonable period of time.
She showed remarkable response in three weeks and over time her headaches resolved. Shweta not only regained her confidence at work place but her
personal life was also back on track.”
There are four major types of
headache: vascular, muscle contraction (tension), traction, and inflammatory.
The most common type of vascular headache is a migraine
A migraine is a severe, painful headache that can be preceded or accompanied by sensory warning signs such as
flashes of light, blind spots, tingling in the arms and legs, nausea, vomiting,
and increased sensitivity to light and sound. The excruciating pain that
migraines bring can last for hours or even days. The typical headache of migraine starts on
one side of the head usually around the eye or forehead.
A migraine occurs when
hyperactive nerve cells send impulses to blood vessels. These blood vessels
then constrict, resulting in the release of substances that cause severe pain
and discomfort. Migraines differ from a typical headache because they last much
longer. Migraine is 2 to 3 times more frequent in women than in men.
A person suffering from migraines
will always like to relax in the dark and quiet place and most of the times
relief can be obtained only when vomiting takes place. Many things can trigger
a migraine.
These include:
• Poor
coping life skills
• Anxiety
or Stress - related to exams, Deadline, work related, interpersonal, family
etc.
• Travel
• Lack
of food Lack of sleep or sleeping more than usual
• Exposure
to bright sunlight
• Hormonal
changes (in women)- premenstrual migraine
• Certain
food like cheese, banana, curds, coffee
Treatment is definitely required
and it is best to see a Neurologist to determine the type and cause of
headache. Management of Primary headache disorder in general involves a
combination of lifestyle modification, judicious use of analgesics and
prophylactics medications if the patient is having frequent Migraine headaches.
While management of Secondary headache, apart from symptomatic management with
analgesics, is directed towards treating the underlying brain disorder.
Most of the time, a headache is
self- treated and isn’t properly clinically diagnosed. This causes a longer
diagnosis period, making treatment difficult. In India, headaches are
underestimated, under-recognised and under-treated.
To know more about headache and
diagnosis please consult our neurology department at Wockhardt Hospital.
The Neurosciences department at Wockhardt Hospitals is well-equipped to take care of patients with complex
neurological and neurosurgical problems. In particular, our focus areas are
stroke, migraine, Parkinson’s disease and other movement disorders, Epilepsy,
vascular malformations and brain/spinal cord tumours. Our renowned team of
neurologists evaluate all neurological disorders and have been successful in
treating various conditions at the hospital.
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