Being absent with a migraine is something of an office joke. Sufferers often wrongly assume no treatment is available, and they are all too readily labelled malingerers. A knowledge of the facts will help OH practitioners deal with the problem, by Helen Healy
For their awareness campaign this year, The Migraine Trust chose the theme 'One in six', to highlight that recent research has shown the number of people who have migraine in the UK has increased to one in six.
This makes the incidence of migraine more common than many other conditions. But despite this, there remain misconceptions about migraine and what it is like to be a migraine sufferer.
Migraine can affect any person of any age, sex or ethnicity but it is predominantly the working age group that seems to suffer the most frequently and the most severely.
Surely then it is important for occupational health practitioners to have some of the myths dispelled and the facts set out so they know how best to advise and assist the sufferers.
What is migraine?
Migraine is defined as "an episodic primary headache disorder" - episodic because it comes and goes, with complete freedom from symptoms between attacks, and primary because there is no underlying disease causing the problem.
Far from being "a bad headache" as is often assumed, a migraine attack can include a wide range of symptoms and the attack itself typically consists of a series of five stages:
- Prodromal or premonitory stage. This first stage is comprised of certain physical and mental changes such as hyperactivity or fatigue, loss of appetite or craving for specific foods, mood change, fluid retention, thirst, yawning.
These symptoms may last for several hours, up to a day. They may be vague, particularly at first, and therefore may be mistaken for migraine attack 'triggers'. For example, fatigue felt at this stage might lead migraineurs (those who suffer from migraines) to think that getting overtired prompts or triggers an attack or a craving for chocolate may suggest that chocolate is a trigger.
- The aura stage. This second stage can last between five and 30 minutes. It may occur before a headache or may accompany a headache.
Aura, meaning additional neurological symptoms, may include visual disturbances - the most common being flickering zig-zag lines, gaps in the visual field, blurring