How to identify and prevent a migraine

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The Claire Byrne Show 8 min 1 speaker 7 chapters transcribed just now
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What exactly is a migraine and how does it differ from a regular headache?

Dr Damien Ferguson 0:01
The
Clare Byrne 0:02
Claire Burns
Dr Damien Ferguson 0:03
Show
Clare Byrne 0:03
on
Dr Damien Ferguson 0:03
News Talk. With Aviva Insurance.
Clare Byrne 0:09
Do you suffer with migraines? If so, do you know what you can try to do to prevent them? I'm joined by doctor Damien Ferguson, who's a neurologist who runs the migraine clinic in St. James's Hospital. Good morning to you.
Dr Damien Ferguson 0:23
Good morning, Claire. Thank you very much for giving me the opportunity to speak to you. Not at all. Delighted delighted
Clare Byrne 0:28
to have you. Yeah, because so many people really suffer with migraines, don't they? Can you maybe start by telling us what they are and what makes them different from a normal headache?
Dr Damien Ferguson 0:38
Absolutely. Yeah.

What are the early warning signs (prodrome) of a migraine and how can they be recognized?

Dr Damien Ferguson 0:39
So migraine is a recurrent headache disorder, which has criteria that we use to diagnose it. So usually the person will have a headache lasting for between four and seventy two hours. It'll be medium to severe on a pain scale. It might be unilateral and pounding in nature, and it comes with some associated symptoms such as fear of light, fear of sound, and nausea or vomiting.
Clare Byrne 1:04
Very debilitating in some cases, right?
Dr Damien Ferguson 1:07
Absolutely. So it's um recognized worldwide to be the third most common cause of disability across all diseases. And in young women in particular of reproductive age, it's actually the leading cause of disability.
Clare Byrne 1:23
And is there any reason why some people are susceptible to them and others are not?
Dr Damien Ferguson 1:28
So in very, very rare cases there's a um inherited genetic disorder um where the person may have inherited. an abnormal gene which passes it down to from from generation to generation. But the current understanding really is that it's a a polygenic disorder, meaning that the person has inherited many different um types of uh gene variations that interact with each other and then the environment that they live in and uh the their uh situation throughout their life then that gives them uh migraine disorder.
Clare Byrne 2:03
And Damien for some people they might get some signs up to forty eight hours before the onset of the headache. Is that right?

What is the aura phase and what symptoms might someone experience during it?

Dr Damien Ferguson 2:10
Absolutely. Yeah. So this is called the the prodrome phase, um, which is more and more recognized now. And it often includes things like feeling fatigued or having difficulty concentrating, some stiffness in your neck, sensitivity to light or sound, nausea, yawning or craving certain foods or feeling very thirsty.
Clare Byrne 2:32
So if you're aware of those signs you might have a good indication of what's coming down the track for you, which is that awful pain that you described earlier.
Dr Damien Ferguson 2:39
Absolutely. Yeah. So this the second phase for some people is a is the pain phase. And for other people there's just before the pain phase, there's another phase called the aura phase. Um, but usually the the person is able to identify the prodrome once we've explained what it means to them. Okay.
Clare Byrne 2:57
And the oraphase then, what does that look like for some people?
Dr Damien Ferguson 3:01
So the aura happens in about 30% of people with migraine and it's different from person to person and each episode can be slightly different, but it's usually five to sixty minutes of transient neurological symptoms, meaning that they might get some visual disturbance, maybe some pins and needles traveling from one spot to the other. Um or they might have some weakness or dizziness associated with their uh uh just before at the same time as the headache phase beginning.
Clare Byrne 3:29
So then you have the headache, how long does that last for?

How long does the migraine pain phase typically last and what does the post‑drome feel like?

Dr Damien Ferguson 3:32
This can be quite debilitating. So the majority are up to about two days if the person's left untreated. The treatments we use try to really reduce this down to a shorter duration so the person can get back to their daily activities. But in rare cases it can go up to seventy-two hours and beyond.
Clare Byrne 3:50
And then afterwards you have that feeling, don't you? Which has been described to me by people who suffer from migraines as being almost like a hangover where you're exhausted and you've got low energy.
Dr Damien Ferguson 4:01
Yes, yeah. So we call it the post drome phase, but um often people will describe it like a hangover.
Clare Byrne 4:06
So just going back to the prodrome phase, which you've explained so well to us, twenty four to forty eight hours where you know something just isn't right, is there anything you can do?

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