What is a migraine?
Migraine is a neurological disorder that can be very distressing and disabling. It is generally a one-sided throbbing or pulsating headache of at least moderately intense. It is very often associated with nausea and vomiting, as well as increased sensitivity to light, sound and even some types of smell.
It is estimated to affects over 3 million Australians. It can begin from childhood but generally starts in ones 20s or 30s and becomes less common after the age of 40. The frequency of episodes may vary greatly in the same person over time, from a few a year up to several a week.
The exact cause is not known. Genetics is thought to play a part. It is more common in women than men which is thought to be due to hormones. There can be triggers such as certain foods, stress, lack of sleep, alcohol, and bright lights to name a few. Triggers are different in different people and migraines can occur in the absence of specific triggers.
The International Headache Society has a classifies a headache as a migraine when; it lasts between four and 72 hours, has at least two of the following – one sided, moderate to severe, throbbing and aggravated by movement plus one these symptoms - nausea, vomiting, sensitivity to light or sensitivity to noise
Other symptoms that may be experienced include osmophobia (sensitivity to smell), an aura (visual disturbances such as bright zigzag lines, flashing lights, lasting 20-45 minutes), difficulty in concentrating, confusion, and a feeling of being generally extremely unwell.
There are no direct health complications from migraines. However, whilst no causative mechanism has been found, studies show a higher rate of depression, panic disorder, epilepsy, stroke, anxiety disorders, and glaucoma in persons with migraine and severe headache than control groups.
It is certainly the case that migraines adversely affect quality of life.
These divide into three main types – lifestyle measures, medications used to treat migraines and prophylactic medications used to prevent migraines.
Avoidance, where possible of known triggers is helpful as is maintaining good hydration, getting adequate sleep and managing stress. A number of alternative treatments such as acupuncture, hypnotherapy and meditation are popular although supporting evidnec is sketchy.
Analgesics such as aspirin, paracetamol and ibuprofen can be used for acute migraines although stronger combinations with codeine may be needed. A group of medications called triptans are specifically for migraine headaches. Anti-nausea medications may also be needed.
A number of medications are used to try to reduce the frequency and severity of migraine headaches. There is not one which has been found superior to others. A new group of monoclonal antibody medications are coming to market for prevention of migraines.
Treatment with Medicinal Cannabis
Medicinal cannabis for the treatment of migraines
Medicinal cannabis has been shown to assist with recurrent migraines. It can be prescribed by a doctor when other treatments have failed or have caused unacceptable side effects. Studies suggest that a formulation of pure CBD or high in CBD may be the most useful although individual response varies, and some may do better with a formulation equal in THC and CBD.