Migraine is NOT just a headache. It is a neurological condition that can be well controlled with the right approach.
Migraine is a neurological disease — not a regular headache and definitely not a sign of weakness. It is caused by changes in brain chemicals and blood vessels.
Imagine your brain has an alarm system (like a home burglar alarm). In migraine, this alarm is extra-sensitive — it goes off even with small triggers like bright light, stress, or skipping a meal. The alarm itself causes the pain, nausea, and sensitivity.
Migraine has a strong genetic basis — if one parent has migraine, there is a 50% chance the child may develop it too. But genes alone don't determine how often or how severely you get attacks. Lifestyle is the dial that turns the volume up or down.
An erratic lifestyle — irregular sleep, skipping meals, chronic stress, dehydration, inconsistent daily routine — can dramatically increase the frequency of attacks in a genetically susceptible person. Conversely, a disciplined lifestyle can reduce attacks significantly, even without medicine. You cannot change your genes. But you absolutely can change your lifestyle — and that is where the real control lies.
Patients who master lifestyle changes early tend to need shorter courses of preventive medicine and experience fewer relapses. Those who continue an erratic routine may need longer treatment. The faster you take control of your lifestyle, the faster your brain recalibrates its alarm system. Treatment is always tailored to how well your lifestyle responds.
Most common (80%). Throbbing, one-sided headache with nausea, sensitivity to light & sound. Lasts 4–72 hours.
About 20% get a "warning" 15–30 min before: zigzag lines, flashing lights, tingling, or speech difficulty. Then headache follows.
Just like a movie trailer gives you a preview of what's coming, an aura is your brain's preview signal. It's telling you: "A migraine episode is about to start." This is your window to take medicine early!
Migraine has 4 phases (not everyone gets all):
Mood changes, food cravings, yawning, neck stiffness, increased urination
Visual disturbances (zigzag lines, blind spots), tingling in face/hands, speech difficulty
Throbbing/pulsating pain (usually one side), nausea/vomiting, extreme sensitivity to light, sound, smell
Feeling washed out, confused, weak for up to a day after the headache resolves
Think of triggers as "buttons that press the alarm". Identifying YOUR triggers is half the battle.
Skipping meals, fasting, excessive caffeine, cheese, chocolate, MSG, fermented foods, alcohol
Work stress, anxiety, anger, excitement — and even the relief after stress ("weekend migraine")
Too little sleep, too much sleep, irregular schedule, jet lag
Bright/flickering lights, strong smells, loud noise, weather changes, sun exposure
Taking painkillers too often (>10–15 days/month) can paradoxically CAUSE more headaches!
Menstrual cycle, dehydration, skipping exercise, travel, posture
If you take painkillers more than 10-15 days per month, they can make headaches worse and more frequent. This is called Medication Overuse Headache — one of the most common reasons headaches become daily. Always consult your doctor about frequency of painkiller use.
Treatment is two-armed — like two weapons in your toolkit:
Goal: Reduce frequency of attacks
Needed if ≥4 headache days/month or very disabling attacks
Goal: Stop or reduce current headache
Earlier = more effective. Don't wait for pain to build — a small fire is easy to put out, a large one is not.
Think of a migraine attack like a fire starting in a kitchen. If you grab the extinguisher (your medicine) the moment you smell smoke — at the very first warning signs — a small squirt puts it out completely. Wait until the whole room is burning and no amount of extinguisher will help quickly.
This is why NSAIDs taken within the first 15–30 minutes of an attack work so well for most patients — the fire is still small. Waiting until the headache is severe makes any medicine far less effective.
No, not usually. Preventive medicines are typically taken for 6–12 months. Many patients can then stop or reduce them. Some patients may need intermittent courses. This is not a lifelong disease commitment — think of it as training your brain's alarm system to be less sensitive.
This is a very common myth. Migraine is a brain disorder, not an eye or sinus problem. Many patients are wrongly treated for "sinus headache" for years. If your headache is one-sided, throbbing, with nausea/light sensitivity — it's likely migraine, NOT sinus.
Yes, absolutely! Migraine is a functional (chemical) disorder — not a structural one. Brain scans are typically normal. We do scans mainly to rule out other causes. A normal scan is actually reassuring, not concerning.
Yes. The medicines commonly used (like Flunarizine, Propranolol, Topiramate, Amitriptyline) have been used safely for decades. Your doctor will choose based on your profile and monitor for any side effects. The benefit of fewer, less severe headaches usually far outweighs any risks.
Stress is a major trigger, but interestingly, "let-down" after stress is also a trigger. So headaches on weekends or holidays (after a stressful week) are common. This is why consistent routines (sleep, meals, exercise) are so important — even on weekends.
Yes. Migraine can start as early as 5–7 years of age. In children, headaches may be shorter (1–2 hours), bilateral (both sides), and often accompanied by stomach pain, vomiting, and car sickness. Family history is often found.
While lifestyle modifications from any tradition (yoga, regular sleep, dietary changes) are beneficial, the preventive and abortive medicines with proven efficacy are from modern medicine. We recommend evidence-based treatment. Many "herbal pain relievers" actually contain hidden painkillers which can cause medication overuse headache.
Yes. Newer CGRP-based injectable treatments (anti-CGRP antibodies) are now available for patients with frequent migraines who haven't responded well to standard preventive medicines. These are given monthly or quarterly by injection and have shown excellent results. Ask your neurologist if you qualify — referral to a specialised centre can be arranged if needed.
This is one of the most powerful tools to manage your migraine. Track:
When did it start? How long?
How bad was it? Could you work?
What happened before?
What did you take? Did it help?
For women: period dates
Any other observation
Print it, fill it in, and bring it to your appointment. Helps your doctor find your triggers faster.
Sleep and stress are two of the biggest migraine triggers — these guides work hand-in-hand:
Consult Dr. Kamal Kumar Jain — DM Neurology, Consultant Neurophysician
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Ballari Neuro Centre