Main symptoms
- •One-sided throbbing headache
- •Moderate to severe intensity
- •Worsened by physical effort
- •Nausea and/or vomiting
- •Photophobia, phonophobia
- •Aura: scotomas, zigzag flashes (20-30%)
- •Duration 4-72h without treatment
Risk factors
- ⚠️ Family history (70% transmission)
- ⚠️ Female sex
- ⚠️ Age 20-50
- ⚠️ Hormonal (menstruation, oestroprogestin contraception)
- ⚠️ Stress / stress let-down
- ⚠️ Irregular sleep
- ⚠️ Dietary triggers
- ⚠️ Fasting (Ramadan)
Management and treatments
**Acute attack**: paracetamol + NSAIDs from onset (ibuprofen, diclofenac), triptans (sumatriptan, rizatriptan) if needed — 50-80% reimbursed. Antiemetics if nausea. **Preventive** (≥ 4 attacks/month): beta-blockers (propranolol), topiramate, amitriptyline. New anti-CGRP drugs (not reimbursed). Keep an attack diary.
Prevention
Regular sleep/meals, hydration 1.5-2 L/day, aerobic exercise 3 times/week, meditation, avoid triggers, suitable contraception if migraine with aura. Preventive treatment if more than 4 attacks/month.
Frequently asked questions
Migraine or tension headache?+
Migraine: one-sided, throbbing, worsened by effort, with nausea. Tension headache: bilateral, helmet-like, not throbbing.
When to worry about a headache?+
Sudden 'thunderclap' headache, fever + neck stiffness, neurological deficit, first headache after age 50 → emergency (141).
Does Ramadan fasting worsen migraine?+
Yes — caffeine withdrawal, dehydration and hypoglycaemia are triggers. Discuss preventive treatment with your doctor.
When to start preventive treatment?+
≥ 4 attacks/month, severe attacks despite acute treatment, or medication overuse (> 10 doses/month).
📖 Detailed article
To learn more about migraine, read our cornerstone medically reviewed article.
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