The Migraine Clinic has been established to help people with headaches diagnose and manage their symptoms.
The clinic is run by our experienced neurologists at Northern Beaches Neurology and operates in our Dee Why and Frenchs Forest locations.
Our neurologists are experts in the assessment and management of patients with headache and migraine, and are experienced with the latest advances in migraine treatment.
Migraine is very common, affecting about 5 million Australians. Migraine imposes a huge cost on Australian society with direct and indirect costs estimated at about $35.7 billion annually (Migraine in Australia, Deloitte Access Economics Report, 2018). Improving treatment of migraine should be a priority to improve the lives of people with migraine and to reduce these costs to society.
Our neurologists at Northern Beaches Neurology are experts in the treatment of migraine and can help with your migraine symptoms.
SYMPTOMS OF MIGRAINE
A lot of people seen by our neurologists with headache often believe that only severe headaches with vomiting count as a “migraine.”
The truth is that migraine has many faces. A “classical migraine” is a throbbing or pounding headache that usually involves half the head and is associated with light and sound sensitivity, nausea and vomiting.
Headache in migraine can take a number of other forms such as:
- Headache behind the eye
- Headache at the back of the head or neck
- Headache all over the head
- Pain in the face or sinuses
People with migraine often experience several different types of headaches and are more likely than others to get tension headaches.
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Some people with migraine experience an “aura.” An aura means a warning before a migraine strikes that consists of various neurological symptoms. Someone with a migraine may feel irritable or hungry for several hours before a migraine hits.
The most common “aura” described by migraine sufferers is a change in vision. This could be with blotches, sparkles or zig zags in the vision, blurring of vision or double vision. Other aura symptoms include numbness or tingling in the face, arms or legs, difficulty speaking or thinking, and unsteadiness or dizziness.
Some people experience the migraine aura without much of a headache afterwards.
Besides the aura symptoms described above, some patients experience symptoms with the headache such as a droopy eyelid, blocked nose or watery eye. Migraine is often associated with light and sound sensitivity. Some people feel nausea (upset stomach) or may vomit.
It is important to see a doctor quickly if you experience any of these symptoms for the first time as these symptoms can also be experienced in serious conditions such as stroke or a torn neck artery.
Many people report specific things that trigger a migraine. Again triggers can vary dramatically and can consist of some of the following:
- Various foods (commonly citrus, chocolate, cheese)
- Fatigue and sleep deprivation
- Strong smells
- Visual effort (eg prolonged screen time or bright light)
- Change in the weather
Some people with migraine do not know what triggers their headache.
TREATMENT OF MIGRAINE
The migraine specialists at The Migraine Clinic will advise you about the most appropriate treatment and medications tailored to your migraine condition. This will include advice about what medication to take when you develop a migraine as well as treatments to prevent migraines from developing. This may include tablet medication, injections of ‘anti-wrinkle’ toxin and recently approved treatments
MIGRAINE MANAGEMENT FACTORS TO CONSIDER
How to manage migraine depends on a few things:
How often do migraines occur?
- Occasional migraine (less than once a fortnight)
- Frequent migraine (more than once a fortnight)
- Chronic migraine (headaches at least 15 days a month)
What time of the day do migraines occur?
- No pattern
- Always at the same time of the day
- Causing the person to wake up
Do migraines relate to the menstrual cycle?
Are there any avoidable migraine triggers?
Is there a clear warning prior to the migraine?
Is the migraine associated with nausea or vomiting?
MANAGEMENT OF MIGRAINE WITHOUT MEDICATION
There are a number of things that can help patients with any sort of migraine. Below are recommendations of things that can be tried to help treat migraine:
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- Keep a headache diary
A headache diary is a very helpful way to look for patterns in how you experience your migraine including the time of the day you get migraines, how often you get migraines, where migraines occur in the menstrual cycle and the symptoms you get with you migraines.
Please click here for a printable monthly headache diary. or email firstname.lastname@example.org for an excel version.
- Try to identify and eliminate any migraine triggers
Keeping a record of foods eaten and their relationship to food can help. Some patients choose to undertake an elimination diet to see if this helps, although proper nutrition must be maintained.
Regular exercise can help control migraine. We recommend relaxing low-intensity exercise such as swimming, walking and jogging. Improving core muscle strength is useful (for example Pilates and lower-intensity forms of yoga). We recommend avoiding high-intensity workouts for people with migraine, especially when headaches are present.
- Physical neck treatments
Some people with migraine find that physical treatment of the neck can improve their symptoms. This may include massage, physiotherapy or osteopathy.
Some patients temporarily respond to acupuncture treatment.
Migraine can disturb sleep and poor sleep is associated with higher pain levels. We recommend attention to good sleep habits for people with migraine.
MIGRAINE AND CONTRACEPTION
Migraine occurs most commonly in women between puberty and menopause. As such, migraine can pose specific issues with contraception, in particular the pill.
Your neurologist can discuss the issues regarding migraine, migraine treatment and contraception.
MIGRAINE AND PREGNANCY
Pregnancy is a time of a lot of hormonal and body changes and this can impact on migraine. Some patients will develop migraine in pregnancy for the first time, some patients will experience worsening of their migraine and some will find their migraine less severe. It is not always predictable.
Migraine is challenging to manage during pregnancy as a lot of the commonly used medications should be avoided. It is important to speak with your neurologist or GP regarding your migraine treatment if you are planning to become pregnant. Migraine in pregnancy is best managed in consultation with your neurologist and obstetrician.
Your first appointment at The Migraine Clinic will be a 45-minute initial consult, where we can discuss your medical and migraine history. If you come with a completed migraine diary (a month will give us a good overview), this will help your Neurologist with your first consult plan a course of treatment. Click here for a copy of a migraine diary.
For the cost of your initial appointment please click here.