Understanding migraine

Episodic migraine

Migraine happens when the brain's nerve cells (neurons) become overly sensitive to certain triggers. Imaging scans are not required to diagnose migraine as there will be no structural abnormalities in the brain. A migraine which recurs on less than 15 days a month with pain-free days in between is referred to as an episodic migraine. Treatments include lifestyle changes as well as preventive and rescue treatments which help to abort the migraine attack when taken in time. I can tailor the treatment choices for episodic migraine, including triptans and gepants, to your individual needs.

Chronic migraine

You may be diagnosed with chronic migraine if headaches occur on 15 or more days a month, with migraine symptoms on at least eight days. This disabling condition is rare, affecting around 2% of the UK population. Chronic migraine often develops gradually, with a slow increase in frequency over months and years. To treat chronic migraine, I focus on preventative medications including migraine-targeted treatments CGPR monoclonal antibodies and gepants.

Vestibular migraine

This migraine can be challenging to diagnose and is often confused with BPPV or Ménière’s disease due to overlapping vestibular symptoms such as dizziness, vertigo or imbalance. Vestibular migraine attacks may not always present with a headache but primarily affect the vestibular system, which controls balance and can last from hours to days, often accompanied by sensitivity to light and sound or visual disturbances. Correct diagnosis is a must for correct treatment.

Migraine & hormones

A complex neurological condition, migraine can be significantly influenced by hormonal changes in women. Puberty, reproductive years and perimenopause in women all lead to fluctuations in hormone levels which can affect the frequency and severity of migraines. I can help you understand how your hormonal fluctuations are impacting your migraine patterns.

Menstrual migraine

Many women's migraine is triggered by their menstrual cycle, it is typically without aura and in the days leading up to, or during, menstruation when oestrogen levels drop. An additional trigger can be the high levels of prostaglandin secreted by the uterus during menstruation, especially if there are other co-existing gynaecological issues such as heavy painful periods, endometriosis or fibroids. I can help you manage menstrual migraine by tailoring prevention strategies including hormonal therapies, effective rescue treatment or lifestyle changes.

Migraine & perimenopause

During perimenopause, the female hormones oestrogen and progesterone can fluctuate greatly, often triggering migraine. Other symptoms including poor sleep, stress and anxiety may also exacerbate attacks. To help my patients deal with migraine during perimenopause I closely monitor lifestyle and monitor any changes I recommend.

Children & migraine

Migraine is an inherited condition and typically develops from early to mid-teens so migraine and headache affect a significant number of children. If you, as an adult, suffer from migraine, there's a 70% chance your child will also develop it at some stage. Triggers in children can include stress, tiredness, skipped meals, disturbed sleep patterns and screen time too. I can help identify trigger factors and make changes to lifestyle as well as offer children and teenagers treatments including GON block injection from the age of 15, prescription for rescue treatments like triptans, as well as recommend preventative options including Amitriptyline, Pizotifen and Propranolol. Botox can be offered from the age of 18.