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Migraine: The importance of early treatment during the prodromal phase

Migraine headaches: Prodrome is an indication that a migraine attack is beginning. Identify the triggers and symptoms, and start treatment as soon as possible to stop or lessen the severity of the migraine attack.

May 04, 2023 / 10:35 IST
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Prodrome is the first phase of a migraine and is also known as the premonitory phase or “pre-headache (Image: Canva)

Migraine attacks: Migraine is a type of headache that can induce excruciating pain along with a pounding sensation, typically on one side of the head. Something that may feel like a construction crew jackhammering away at solid concrete. A neurological condition with recurring headaches, migraine is often accompanied by other symptoms such as nausea, vomiting, and extreme sensitivity to light (or photophobia) and sound (phonophobia). It is described as a thud that sends shockwaves of pain radiating from the temples to the base of the skull, thus causing one to wince with every pulse.

When a migraine hits, even the slightest movement causes the throbbing to intensify, and the gentlest sounds feel like a knife piercing through the eardrums. No matter how hard one tries, the pain only grows stronger, overpowering every other sensation in the body. Migraine episodes can last for hours or sometimes days, and intense pain can interfere with a person's everyday activities.

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The most common type of migraine is sans aura. A migraine without aura is a recurrent headache attack of 4 to 72 hours occurring unilaterally with moderate to severe intensity that is aggravated by physical activity and associated with nausea. Generally, migraine has a female preponderance, but a variant called 'Cluster headache' is commonly found in men, characterised by unilateral temporal pain that lasts for 15-180 minutes accompanied by rhinorrhea (running nose), tears, and facial flushing.

Episodic syndromes that may co-occur with migraines include various health conditions such as recurrent gastrointestinal disturbances, which entail repetitive abdominal pain and discomfort resulting in vomiting. Benign paroxysmal vertigo, which causes sudden and brief episodes of vertigo or dizziness, may also accompany an attack. In addition, there is benign paroxysmal torticollis, which is marked by repeated episodes of tilting the head to one side.