migraine & headaches

Headaches are such a common symptom that not a day goes by at work without them being discussed.

For doctors in training, they can be one of the most difficult symptoms to gain confidence in managing as they may be the sign of a catastrophic life-changing event, a terminal diagnosis or simply the result of a stressful day in front of the computer.

Whatever the cause the symptom is unpleasant.

“Headache” by Cruikshank who branded illnesses as the work of the devil. First published 12 February 1819, Image in the Public Domain

Headache is usually one of the unpleasant symptoms of migraine. Migraine is complicated as its aetiology is not yet fully understood, there are different triggers and so management requires a person-centred approach. 

The word migraine originates from the Greek – hemikrania- pain on one side of the head.

If you have not suffered from migraines it can be hard to understand the disabling nature of the symptoms. 

It’s postulated that Van Gogh’s suffered from migraine and this is why the stars and moon in this picture have aura.

Atonement Ian McEwan (2001) Published by Vintage

This book is probably not the first place you might think of looking in to find out more about migraine. At the beginning of chapter 6, there is a vivid description of the incapacitating effects of migraine

Emily is lying in bed anxiously trying to avoid a migraine attack.

‘She was not in pain, not yet, but she was retreating before its threat. There were illuminated points in her vision, little pinpricks, as though the worn fabric of the invisible world was being held up against a far brighter light. She felt in the top right corner of her brain a heaviness, the inert bodyweight of some curled and sleeping animal’…….

She lay rigidly apprehensive, held at knife- point, knowing that fear would not let her sleep and that her only hope was in keeping still. ……

The fear of pain kept her in place. At worst, unrestrained, a matching set of sharpened kitchen knives would be drawn across the optic nerve, and then again, with the greater downward pressure and she would be entirely shut-in and alone’.

Another great storyteller is  Oliver Sacks. His book Migraine draws on his work as a neurologist and is a really helpful collection of stories to help you better understand the condition. Read more about this and his other books here.

page updated October 2021