What can you do about migraines?

What is Migraine?

“According to official guidelines, a person has a migraine if he or she has had at least 5 severe headache attacks with nausea and/or nuisance from light or sound. Many people have to lie in a quiet, dark room during such an attack. People also speak of migraine if someone has had at least two attacks with aura. With an aura, there are complaints with sight, feeling or speech prior to the headache.

How do aura complaints arise?

“An aura is like a kind of electrical impulse that travels from the brainstem through the brain. It starts at the back of the head, where the center for vision is also located. As a result, people start to see flashes of light, or spots, or a part of it hits. the field of view is turned off.The electrical impulses can then spread over the entire brain and thereby cause other complaints, such as tingling in the arms, impairment of memory or speech.In very severe cases, there can even be temporary paralysis.After the migraine aura there is often a headache, but that is not necessary.”

Is Migraine Different From Headaches?

“Yes, migraine is not a headache that you can treat with paracetamol. Migraine is a brain disorder. You cannot function normally during an attack. Most people lie in bed for hours or days during an attack.”

Who does migraines occur in?

“There is a hereditary factor. Both men and women with migraines have a greater chance of having a child with migraines. The annoying thing is that these children often suffer more from migraines than the parents, and that they suffer from migraine aura more often. Migraines are also more common in women than in men. We don’t know exactly why, but it is expected that it is due to the female cycle. An attack occurs, for example, when the hormone estrogen drops sharply just before menstruation. more than 10 percent of the Dutch population has migraine attacks every year.The average frequency is two attacks per month.Everyone will have one or two attacks at some point in their life. “

Isn’t it weird that women don’t understand this principle yet?

“It has never been properly researched, and that is very strange indeed. I am participating in the WHAT study. WHAT stands for ‘Women, Hormones, Attacks and Treatment’ (Women, Hormones, Seizures and Treatment, ed.). I work with gynecologists and we want to find out how hormone fluctuations can trigger a migraine attack. In the first phase of the study, we used diaries to look at which factors can trigger an attack, and whether there is a connection with the cycle. It is striking: some women say that there is no connection at all between the cycle and migraine, but then find out that there is by keeping a diary. Other women think there is a connection, only to discover that it isn’t. In a second part of the study, we want to see whether swallowing the contraceptive pill can reduce the seizures. And in the third part, we measure hormone levels in women, both of reproductive age and around the menopause. Incidentally, participants can still register for this study.”

Here you will find more information about the WHAT study and you can register as a participant.

How can migraines be treated?

“There are better and better medicines. There are medicines that help prevent an attack, and medicines that you can take if you already have a headache. But we can’t help everyone yet. My own daughter, for example, has migraines, and the medicines don’t work for her. effect.”

Some people feel an attack coming…

“Yes, that’s right. For example, they get cold, or become irritated, or suddenly have an incredible appetite for chocolate. These symptoms are very similar to those of the premenstrual syndrome. But there is a difference: if someone eats a bar of chocolate and the the next day, he or she will not think: “See, that’s because of the chocolate!” But that happens with a migraine. People feel like chocolate, eat chocolate, have a migraine attack and then think that it is because of the chocolate comes. But that is not the case. You have to be careful with limiting yourself too much anyway. If you think all kinds of things can trigger an attack, then you are too busy living according to your condition. to map out your triggers well, for example by means of a diary. Then you can recognize patterns or recognize in time when an attack is coming. But then again: my daughter is a student, and she also just wants to go to rooms and to parties. they leave it because can she get migraines? I do not think so.”

Can migraine not cause permanent damage?

“No, an attack does not cause permanent damage to the brain. It is true that people with aura migraine have a slightly increased risk of a brain haemorrhage. Migraine is also a disease of the blood vessels in the brain. especially smoking is a bad idea, or the combination of smoking and the contraceptive pill in young women with aura migraines.”

Do supplements or a certain diet help?

“I recently had a visit from two patients, one with epilepsy and one with migraine. They both had positive experiences with the ketogenic diet and wanted to discuss this. I then contacted a dietitian who specializes in this diet and received a research grant. I always like to receive questions and suggestions from patients and I am open to new ideas. But I do think that it should be well researched and, above all, that you should also keep a good record of the effect in a diary. If you impose a strict diet on yourself for a long time, you have to be sure that it works. When it comes to supplements, little has been scientifically proven. Vitamin B12, B2, D and E: there is still too little evidence.”

Is there a stigma on migraines?

“Yes, that is certainly the case. You see it in films or television series, for example, that migraine is used in the script as an ‘excuse’ to get out of something. The patient association for example, has also been looking for a celebrity with migraine for some time, to make migraine more open to discussion as a role model. Can not be found! While I know from practice that those people do exist. There is a kind of taboo about it, migraine seems to be a sign of weakness. Apart from the attacks, you don’t notice anything about people with migraines, and during the attacks people lie in bed. So the outside world hardly knows about it. But employees or tutors should take migraines seriously. That stigma really needs to go.”

The podcast with Gisela Terwindt can be listened to below.