WHAT IS MIGRAINE: COMMON MIGRAINE AND MIGRAINOUS NEURALGIA

Common migraine

Only a minority of sufferers has visual aura or other features of vasoconstriction and often the headache is not one-sided. These headaches, which are just as frequent as classical migraine, are called common migraine and are otherwise similar.

There are other types of headache which are also included under the general umbrella term of migraine but which differ from classical or common migraine in several respects.

Migrainous neuralgia (cluster headaches)

Patient E.F., a 35-year-old insurance salesman, described an attack as follows:

I am woken in the early hours of the morning by an intense pain behind my left eye, as if someone was sticking a red hot needle into it. I get out of bed to find my nose feels blocked and the left eye is watering. When I look in the mirror, the eye is red. The attack lasts half an hour and goes as quickly as it came. The extraordinary thing is that the attack occurs every night at 2 or 3 a.m. and this has been going on for nearly three weeks.

This is a typical example of migrainous neuralgia. Men are affected more often than women (in the proportion of about 10:1) and it usually occurs between the ages of 30 and 50 years. The sufferer is often woken at night by a very severe pain behind one eye, described often as crushing, lancing like a 'hot poker', or stabbing. There is often watering of the affected eye, which is reddened, and the nostril on that side becomes stuffy and may even run. The attack may last for half an hour and then go, only to return the following night at the same time. The episodes last several weeks and, for this reason, other names (and there are twenty!) include the term 'cluster headaches'. The cluster may occur two or three times a year or only once in two or three years.