Are you suffering from headaches? You are not alone! Headache is a widespread disease. It occurs in different types and strengths and can impair the quality of living substantially. It is possible to do something against it. But before a therapy can be started it has to be found out what the reason is and a correct diagnosis has to be made.

There are many types of headaches. The most common are the primary headaches like migraine, tension headache or cluster headache or an analgetic headache. Your neurologist has to know how your headache feels like, where it starts; whether there are accompanying symptoms, how long it lasts and how often it occurs. Then he will do different medical examinations. After he knows the diagnosis he can give you an advice for the right treatment.  Treatment is possible!

Migraine – more than only headache

Migraine is one of the most frequent neurological diseases. Around the world about 10 percent of the adults are suffering of migraine, more women than men. The difference between the genders has most likely hormonal and genetic reasons. Typically it starts in adolescence. After the 50th year the frequency declines again.

It is a temporary dysfunction of the brain. During a migraine attack the blood vessels of the cerebral membrane are widened and infected. The nerve fibres around the vessels are irritated so heavily that they send pain signals.

The duration of a pain attack is between 4 to 72 hours. The frequency varies between once a year up to twice a week.  The pain is moderate up to very violent. The characteristic is mostly pulsating and only on one side of the skull; but in some patients also on both sides. One side is more affected than the other. Very often people are having accompanying symptoms like nausea, vomiting, visual problems and are very sensitive against light, noise and odour. By physical exercises the pain increases.

There are different migraine triggers like stress, menstruation, alcohol, especially red wine, disturbances in the sleep-awake-cycle, irregular meals, weather changes, light stimulus, odour or pain in the neck. These triggers are very individual and vary even in one individual from time to time.  But these triggers are not the causes of the disease they just stimulate it.

A typical migraine attack proceeds in 4 phases. During the lead time there exist no pains yet. There could be depressive reactions, irritability and agitation. Concentration might get reduced; people feel tired and have to yawn a lot. Oedema, constipation or a craving for sweet or greasy food may occur. The second phase might be an aura. Quite often there are visual problems with scintillating scotomas or double vision. But it also can be sensibility disturbances or movement and speech problems. An aura keeps from a few minutes up to one hour.

The third phase is the headache phase. The pulsating pain starts very often in the neck, spreads over the back of the head and settles behind the eye or at the temple. Most attacks are accompanied by vegetative symptoms. The whole body is affected. Some people are not able to continue their work. They have to lie down. They seek quietness and darkness, don`t want to hear or see anything or anybody. The duration of the headache might be up to 3 days if the attack is not interrupted by medication.

Hours or 1-2 days after a migraine attack (4th phase) people feel tired and exhausted, concentration is still reduced, mood might be swinging.

What can you do to ameliorate the migraine?  Be active, you can do something.

Migraine prevention without medication:


  • Reduce stress factors as much as possible.

  • Learn good time management: plan your day schedule. Don`t forget enough time for brakes.
  • Learn to say “No”.
  • Don`t spread yourself too thin. Not everything has to be done right away.
  • Think: “nobody is perfect!”
  • Take life easier, enjoy it.
  • Relaxation: Proceedings for recreation as Yoga, autogenic training or progressive muscle relaxation techniques help, but have to be done regularly

  • Endurance sports like cycling, walking, jogging or swimming are good. But it is important to exercise regularly, at least three times a week for about 30 minutes.

  • Try to have e very constant sleep-awake cycle, also during the weekend. And eat and drink with regularity.

  • Avoid your personnel migraine triggers.


Migraine prevention with medication:


  • Migraine Medical prophylaxis

In severe cases it is useful to take special medication every day to reduce the number of attacks, the length of the single attack or to improve the effect of the acute medication. This medication has to be taken for at least three quarters of a year, sometimes longer. Your neurologist will find out which medication will be the best for you and will supervise you through the therapy.

  • Therapy of the acute migraine attack:

There are different types of medication to treat the acute attack. In easier cases a painkiller like Panadol or Ibuprofen can be enough. A combination with a medication against nausea can be given. But mostly stronger medication is required. The triptans, a group of special migraine drugs, ameliorates the attack within 2 hours in most patients. The medication has to be taken as soon as possible. Then it helps the best.   But be careful. You should not take any painkiller or any triptan more often than 10-12 times a month. Otherwise there is the danger to develop an analgetic headache, which means headache by the medication itself!