Migrane
If you experience recurring, throbbing headaches with light or sound sensitivity in Pune, Maharashtra, this guide explains what migraine is, why it happens, and how it’s treated at Dr. Borse's Neuro Clinic.
From understanding triggers to advanced therapies like CGRP inhibitors and nerve blocks, learn when to self-manage and when to see a specialist for the best neurology care in Pune, Maharashtra.
Migraine is a neurological disorder—not just a “bad headache.” Accurate diagnosis, trigger control, and a tailored mix of acute and preventive therapies can dramatically reduce attack frequency and restore quality of life.
Neurology team, Dr. Borse's Neuro Clinic, Pune, Maharashtra
What is Migraine?
Migraine is a primary headache disorder characterized by moderate to severe, throbbing head pain, often on one side, aggravated by routine activity and accompanied by nausea, vomiting, and sensitivity to light and sound. Some people experience an “aura” before or during the attack—transient neurological symptoms such as visual zig-zags, blind spots, numbness, or speech difficulty. Attacks can last 4–72 hours without treatment.
Early, evidence-based care at Dr. Borse's Neuro Clinic can reduce the frequency and intensity of attacks and help prevent medication-overuse headaches.
Causes & Triggers
Migraine arises from genetically mediated brain sensitivity involving the trigeminovascular system and cortical excitability. Common triggers include:
- Sleep disruption (too little, too much, irregular schedules)
- Stress fluctuations and post-stress “let-down” days
- Dehydration, skipped meals, low blood sugar
- Caffeine overuse or withdrawal, alcohol (especially red wine)
- Strong smells, bright or flickering lights, loud noise
- Weather changes, high altitude, heat, humidity
- Hormonal changes (menses, perimenopause)
- Certain foods for some individuals (aged cheese, processed meats, MSG)
- Excess use of painkillers leading to medication-overuse headache
Symptoms to Recognize
- Throbbing or pulsating head pain, usually unilateral
- Nausea, vomiting, sensitivity to light (photophobia) or sound (phonophobia)
- Worsening with routine activity (stairs, bending)
- Aura: visual shimmering, zig-zag lines, blind spots; sensory tingling; difficulty speaking
- Neck stiffness, fatigue, difficulty concentrating
- Prodrome (hours to a day before): yawning, food cravings, mood change
- Postdrome (“migraine hangover”): fatigue, mild head discomfort after pain subsides
Non-Surgical / Lifestyle Care
Non-drug strategies can significantly reduce attacks and enhance the effectiveness of medications.
Daily habits
- Sleep: Aim for consistent 7–8 hours; maintain the same sleep and wake times daily.
- Hydration & nutrition: Regular meals; carry water; avoid skipping breakfast.
- Caffeine: Keep intake stable and moderate; avoid late-day caffeine.
- Exercise: 150 minutes/week moderate aerobic activity; add gentle strength and stretching.
- Stress skills: Practice relaxation training, breathing exercises, or mindfulness 10–15 minutes/day.
- Trigger tracking: Use a migraine diary app to identify and manage personal triggers.
Evidence-informed supplements
- Magnesium citrate/glycinate 400–600 mg/day (may help; watch for diarrhea).
- Riboflavin (vitamin B2) 400 mg/day; CoQ10 100–300 mg/day—benefit for some.
- Discuss with your clinician before starting, especially if pregnant or on other medications.
Treatment & Procedural Options
Acute (abortive) medications
- Simple analgesics: Paracetamol/acetaminophen, ibuprofen, naproxen—best taken early in an attack.
- Triptans: Sumatriptan, rizatriptan, zolmitriptan—migraine-specific; avoid overuse; discuss cardiovascular risks.
- Gepants: Ubrogepant, rimegepant—useful when triptans are not tolerated or contraindicated.
- Ditans: Lasmiditan—non-vasoconstrictive; may cause drowsiness; driving restrictions apply.
- Antiemetics: Metoclopramide or domperidone for nausea; can enhance pain relief.
To prevent medication-overuse headache, limit triptans/combination analgesics to ≤10 days/month and simple analgesics to ≤15 days/month.
Preventive (prophylactic) therapies
- Beta-blockers: Propranolol, metoprolol.
- Antiepileptics: Topiramate, valproate (avoid in pregnancy; discuss risks).
- Antidepressants: Amitriptyline, venlafaxine—helpful if sleep or mood issues coexist.
- CGRP monoclonal antibodies: Erenumab, fremanezumab, galcanezumab, eptinezumab—effective for frequent attacks or chronic migraine.
- OnabotulinumtoxinA (Botox): For chronic migraine (≥15 headache days/month) administered every 12 weeks in trained clinics.
Office procedures and devices
- Nerve blocks: Greater occipital or sphenopalatine ganglion blocks for refractory attacks or as a bridge to prevention.
- Trigger-point injections: For associated myofascial pain.
- Neuromodulation devices: External trigeminal nerve stimulation, noninvasive vagus nerve stimulation, or single-pulse TMS—drug-free options with guidance.
Surgical options
Surgery is rarely indicated. Peripheral nerve decompression may be considered only in highly selected, refractory chronic migraine after comprehensive evaluation and trials of medical, procedural, and behavioral therapies. Evidence is mixed; careful patient selection and counseling are essential.
When to consider prevention: If you have ≥4 migraine days/month, prolonged or disabling attacks, or poor response to acute therapy, preventive medication or Botox/CGRP therapy at Dr. Borse's Neuro Clinic may be appropriate.
When to image (MRI/CT): New or abrupt “thunderclap” headache, new neurological deficits, headaches with fever/neck stiffness, head injury, new headache after age 50, cancer/immunosuppression, or a significant change in pattern.
When to seek urgent care
Call emergency services or go to the nearest hospital if you have a sudden, severe “thunderclap” headache; new weakness, numbness, confusion, or vision loss; fever with neck stiffness; head injury; or a new headache pattern after age 50. These may indicate causes other than migraine and need immediate evaluation.
Consultation & next steps in Pune, Maharashtra
For personalized migraine care—including diagnosis, trigger counseling, acute and preventive treatment planning, and advanced options—book a visit at Dr. Borse's Neuro Clinic in Pune, Maharashtra.
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