Migraine And Headache
A report done by the World Health Organization (WHO) examined more than 55,000 confirmed cases of COVID-19 and found out that headache occurred in 13.6% of the COVID-19 cases. However, the actual occurrence of headache in COVID-19 may be higher in some populations.[1] Besides that, a recent online survey explored the real-world impact of COVID-19 on patients with migraine and showed that about 60% of respondents had an increased episodes of migraine frequency, 16% reported a decrease in migraine frequency, and a little over 10% reported converting from episodic migraine to chronic migraine. [2]
Headache is one of potential symptoms of COVID -19 and it is a common condition that causes pain and discomfort in the head, neck or scalp.[1] However, migraine is often described as recurrent throbbing or pulsating, moderate or severe headache felt on either right or left side of the head.[3]
Headaches are classified into primary and secondary headaches. Primary headaches are the results of underlying process of brain whereas secondary headaches are usually due to underlying medical condition. Examples of primary headaches include tension headache, cluster headache, migraine etc.[1] There are 3 types of migraines such as migraine with aura, migraine without aura and silent migraine. Migraine without aura is the most common type, where the migraine happens without any specific warning signs.[3]
Image 1 : Tension headache, cluster headache and migraine[7]
The exact cause of migraine is unknown but the attacks from migraine are believed as the result of abnormal brain activity temporarily affecting nerve chemicals, blood vessels and signals in the brain. Migraine is initiated by specific triggers like emotional trigger, physical trigger, environmental trigger and dietary trigger as shown in the table 1 below.[3]
| Specific trigger | Examples |
| Emotional trigger | Hormonal changes (3 days before and after period) Stress Depression Anxiety Excitement Shock |
| Physical trigger | Working shift Poor-quality sleep (lack of sleep) Fatigue Jet lag Extreme exercise Low blood sugar Poor posture Neck or shoulder tension |
| Dietary trigger | Dehydration Delayed or irregular meals Caffeine products Alcohol Specific foods; chocolate and citrus fruitTyramine based foods (cured meats, yeast extracts, smoked fish, pickles herrings and certain cheese) |
| Environmental trigger | Bright lightsLoud noisesChanges in climate (very cold temperature)A stuffy atmosphereStrong smells |
Table 1 : List of examples of specific triggers that initiate migraine[3]
There are a few treatments to reduce symptoms of migraine but there is no cure for migraine. The most common classes of drugs prescribed by healthcare professionals to treat headaches include painkillers, analgesics and anti-emetics.[4]
Prevention is better than cure. One of the best ways to prevent headaches or migraines is by avoiding the specific triggers that could possibly trigger an attack. Avoid excess caffeine intake by limiting caffeine to 2 to 3cups, or none of coffee daily can actually help in reducing migraines.[5] Staying in a quiet, dark room may help to ease migraines too. Furthermore, practising a healthy lifestyle such as sufficient sleep, lower stress, stay hydrated and exercise regularly is important to prevent migraines.
Taking supplements and herbs are also highlighted in reducing headaches and migraines.
According to studies by University of Minnesota, taking 200mg of vitamins B12 twice daily and taking 200mg of Magnesium twice daily may help in migraine. In addition, frequency of headache may be reduced by taking150mg of coenzyme Q10 once daily.[5] Taking 60mg-100mg of Ginkgo biloba once daily also aids in reducing headaches and migraines.[6]
Conclusion
Most headaches aren’t symptoms of life-threatening medical conditions. However, please consult the doctor if you have headache for quite some time or headache that happens after any head trauma incidents.
References :
- https://www.healthline.com/health/headache/coronavirus-migraines (medically reviewed by Deena Kuruvilla, MD, written by Jill Seladi-Schulman, Ph.D. on 27Aug2020)
- https://www.medscape.com/viewarticle/950452 (by Deena Kuruvilla, MD on 12 May 2021)
- https://www.nhs.uk/conditions/migraine/
- https://www.who.int/news-room/fact-sheets/detail/headache-disorders (WHO website 8 Apr 2016)
- https://www.healthline.com/health/headache (medically reviewed by Saurabh Sethi, M.D., written by Rachel Nall, MSN, CRNA and Matthew Solan and Verneda Lights on 2 Aug 2018)
- https://pubmed.ncbi.nlm.nih.gov/19415441/ (by Giovanni D’Andrea et al. Neuro Sci. 2009 May)
- Image : https://www.wisemedical.com.au/headache-or-migraine/ (website)
