Bengaluru, July 17: Women and people in rural areas are the worst affected by migraines, says a new community-based study conducted by National Institute of Mental Health and Neurosciences (Nimhans). The main triggers are unhealthy lifestyle, lack of sleep and stress.
While women are known to be prone to migraine headaches due to higher levels of estrogen, the findings relating to the rural populace has been illuminating for doctors.
"People in villages may have limited access to healthcare hence diagnosis and treatment may not occur at the right time. They spend more time working in direct sunlight and exposure to pesticides and other chemicals can trigger migraine," said Dr PR Krishnan, consultant neurologist at Fortis Hospital. For many, migraines can be debilitating and lead to loss of income, apart from suffering the blinding headaches and accompanying nausea and sensitivity to light and sound.
Viswanath, 48, a farmer, finally consulted a doctor this month after suffering headaches for years. When he was diagnosed with migraine, he was upset when the doctor told him that he needs to stay away from pesticides and sunlight, which trigger the headaches. "I have to work in the fields to earn a livelihood. How can I stay away from the sun and pesticides?" he asked. The study by Nimhans covered 1,000 people in both rural and urban areas, and was supported by World Health Organization, World Headache Alliance, International Headache Society and European Headache Federation.
"The result showed that mostly women and the rural population are the worst affected by migraine," said Dr Girish B Kulkarni, assistant professor of neurology at Nimhans and one of the co-investigators of the study.
In another study, covering 330 patients at Nimhans, it was found that only one in six patients were taking appropriate treatment at the right time to prevent recurrence of migraines. "Most of these patients were either unaware of the causes of migraine and did not know how to prevent it or were negligent and did not visit a doctor," said Dr Kulkarni.
Dr Anil R, consultant neurologist at Columbia Asia Hospital, said: "Unhealthy lifestyle including lack of sleep, staying hungry for long periods and stress are some of the major triggers for migraine. In the city, strong smells, loud noises, allergies due to excessive pollution, and flickering lights could cause it." Migraines are caused by an interplay of genetic and environmental factors. "It is thought to be attributable to a hypersensitive central nervous system that has difficulty in properly modulating normal sensory stimuli, which implies that migraine occurs due to a more than-normal sensitive brain," said Dr Krishnan.
Patients with frequent migraine attacks should not self-medicate, but should see a doctor immediately and get appropriate medication. "If anybody gets three or four attacks of headache a month with severe or frightening symptoms (weakness of limbs or blurring of vision), medication prescribed by a qualified doctor should be used," said Dr Krishnan. The correct dosage is helpful in 50%-80% of patients in reducing headaches. "The medicines are started in low doses and gradually increased to get desired effects," he added.
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