Managing migraines: prevention and treatment

Written by: Dr Benjamin Wakerley
Published: | Updated: 04/12/2020
Edited by: Robert Smith

A migraine is usually a moderate or severe headache felt as a throbbing pain on one side of the head, however, did you know that sometimes there are other symptoms? We sat down to talk with leading neurologist Dr Benjamin Wakerley, to learn more about some of the other signs of a migraine and how they can be prevented.



What is a migraine?

A migraine is a primary headache disorder, it is characterised by frequent recurrent headaches which are moderately severe in intensity. During attacks, patients are typically sensitive to light sound, smell, and sometimes touch. Often there is nausea and vomiting. Typically symptoms get worse with physical activities. A third of patients experience aura and this is usually visual. Some patients also experience tingling and numbness in their face or down one side of their body.

How can you prevent migraines?

There are two aspects to migraines. Lifestyle is crucial, patients should have regular meals including breakfast. Patients must keep well hydrated, avoid too much caffeine, not drink energy drinks and get a good night’s sleep. Sleep deprivation is a major trigger for migraines. But also, lying in at the weekend and afternoon naps can trigger attacks. Once lifestyle has been adjusted and patients are having more than one attack a week, they may benefit from migraine preventative medications.

These drugs are often used to treat other conditions, including, hypertension, depression and epilepsy. Some of the newer drugs are given as monthly injections, sometimes in the head and sometimes the legs.

What is the most effective way to prevent migraines?

One of the best ways of preventing migraines is by simply recognising what triggers an attack and trying to avoid them. It is crucial to do so before beginning to take preventative medications.

Can diet help with migraine prevention?

Although I do not recommend food diaries, some patients are able to identify particular drinks (e.g. red wine) or food (e.g. chocolate) which trigger their attacks.

If you’re currently suffering from persistent headaches or migraines, we recommend booking an appointment with neurology expert Dr Benjamin Wakerley today. You can check his availability here.

By Dr Benjamin Wakerley

Dr Benjamin Wakerley is a leading neurologist and specialises in diagnosing and treating all kinds of headaches, as well as other general neurological disorders. He is the clinical lead for headache at the Queen Elizabeth Hospital in Birmingham, where he runs the complex headache clinic. Dr Wakerley sees private patients face-to-face at the Winfield Hospital in Gloucester or by videocall.
Dr Wakerley offers extensive diagnostic services and treatment options for all types of headache. He is particularly interested in the treatment of patients with migraine, cluster headacheneck-related headache and can advise on the latest treatment options. For migraine, these include anti-CGRP antibody injection therapy (Aimovig, Ajovy, Emgality) and oral CGRP antiagonists (Rimegepant and Atogepant). He is also very experienced in the administration of botulinum toxin injections (Botox) and greater occipital nerve blocks.
Dr Wakerley qualified in medicine from Imperial College School of Medicine, London, and completed training in neurology in both London and Oxford. He also spent two years in Singapore at the National University Hospital as part of his neurology registrar training. He has a PhD in molecular immunology and is a Fellow of the Royal College of Physicians. He is actively involved in research, having published a number of papers, and is an honorary clinical associate professor at the University of Birmingham.

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