Today we’re going to be talking about something that affects 15% of the global population

and is not only one of the most common causes of disability but the most costly neurological

disorder in the Europe:

- maybe the rest of the world too but only the European Union gave me figues for it…

Migraines!

The thing that leaves me feeling for a large part of the month like:

Oh my god, the world is ending...

So fun (!)

Many people misunderstand migraines as being ‘just a bad headache’ but there are actually

a range of side affects and at least seven different types of migraine. And believe me,

they’re all much worse than ‘just a headache’:

[groans]

- subscribe if you haven’t already!

In this video I’m going to explain more about what a migraine actually is and why

it really, really sucks. There won’t be coping tips per se as I’m going to make

a follow up video gathering those together so if you have any tips and tricks for making

it through a migraine please leave them in the comments.

No weird fake cures like ‘sniff a rock and spin around three times on one spot under

a full moon’ please.

I’ll do it! I’ll try anything!

- exactly, Migraine!Me, that’s why I’m here to protect you.

The underlying causes of migraines are unknown, however, they are believed to be related to

a mix of environmental and genetic factors- running in families in two-thirds of cases.

It affects two to three times more women than men and most often starts at puberty, becoming

worse during middle age.

I’m not even there yet.

Oh and FYI: while migraines were once believed to be more common in those of high intelligence,

this does not appear to be true… sorry chaps, I know we’re all disappointed by that.

But what makes ME qualified to talk about migraines? Well…

In a 30 day month I have 20 days of painful migraines.

[ding]

I also got discharged from the migraine clinic because I had a migraine.

[ding]

Oh yeah, and I recently went to the neuro-otologist to have my hearing looked into because no

one really knows why I can’t hear because my ear bones are fine and my cochlear is fine

and the nerves from my ears to my brain seem to be fine but then they realised it’s because

I’ve actually had an ongoing migraine for the last 14 years and it’d destroyed the

part of my brain that works out what sounds are and what they mean and I don’t know

how to feel about that news so I’m burying it in this video.

Am I going to loose more bits of my brain? Who knows! Can’t tell you! But I’m quietly

freaking out about it!

- yes, this is the Jessica version of freaking out. It’s very mellow. Of course my inside

voice is more:

Oh my God, my brain is liquifying and pouring out of my nose!

- it’s not, that’s just how a migraine feels.

Someone is literally poking me in the eye with a hot poker!

- that’s really not the right use of ‘literally’

Stop being so blase about this!

- well, it’s either that or panic, which is not very productive so…

Let’s talk about what a migraine actually is!

[Title: What is a Migraine?]

Migraines are believed to be a neurovascular disorder- that means it’s a problem with

the blood vessels that supply the brain and spinal cord with freshly oxygenated blood.

Since our nervous system depends on a constant supply of oxygen and other nutrients from

this network of blood vessels… it’s not great when things go wrong!

However, researchers aren’t yet sure whether migraines are caused by neuronal mechanisms

or blood vessels are setting things off… maybe it’s both!

Spoiler: no one really knows what causes migraines.

I could give you a whole medical schpeal about different nerves and maybe serotonin and triggers

and smells and fatigue but really no one knows why I end up like this for a large part of

the month:

[more groaning]

- But if I can’t tell you what starts a migraine, I can at least tell you what MAKES

a migraine and thus answer that age old question: ‘what’s the difference between a migraine

and a headache?’

So, there are four possible phases to a migraine:

The prodrome, which occurs before the headache and is the sign it’s coming…

The aura, which immediately precedes the headache The pain, also known as ‘headache’

The postdrome, effects experienced following the headache.

A headache is a pain in your head, a migraine is so much more! Since your nervous system

is affected you’ll be feeling symptoms like: irritability, constipation, fatigue, sensitivity

to smells, blurs and lights in your vision, pins and needles in your hands and face, vomiting

and a blocked nose.

Interestingly, you don’t have to have all four of the phases to make a migraine. I often

have all of the symptoms of a migraine but without the actual pain in my head. So I have

visual disturbances, feel very lightheaded and spacy, nauseas, and like my entire body

is made of fresh scar tissue but my head doesn’t hurt so I can’t work out why I can no longer

put words in the right order.

[sight] We classically think of a migraine and assume

someone has to lie down in a dark room but that isn’t always the case. Personally,

it’s rare for me that light makes my pain worse or that looking at a screen affects

my migraine. I can happily read something on my phone whilst feeling like I’m dying

and not feel... more like I’m dying…?

- that’s not a great way to explain that.

actually it’s really helpful because I feel less alone.

To break down those four migraine stages:

1. Prodromal or premonitory symptoms occur in about 60% of those with migraines and they’re

the ones I hate the most because they’re so darn confusing and… awful. You don’t

yet know the migraine is coming so there is seemingly no reason for you to be feeling

like this, and then once you twig there is the awful realisation that you’re going

to get hit with the migraine! Symptoms can include: altered mood, irritability, depression,

euphoria, fatigue, stiff muscles, sensitivity to smells or noise and food craving.

Personally, I get very restless and full of dread. I’ll try and watch something and

only be able to make it 2 minutes in before I have to switch to something else, and then

something else, and then something else… That’s very rare for me. I’m the subscriber

who pulls up people’s watch time averages. I’ve recently become obsessed with Plumbella

and I watch until the end screen on every single video.

The dread is also… overwhelming.

- and I’m naturally a ray of sunshine!

2. An aura is a transient perceptual neurological phenomenon that occurs before or during the

headache. What the hell does that mean? Basically your vision looks like both [turn effect on]

the fancy bokeh filter on final cut pro.

- ooh, so fancy

And like someone is shining a bright torch into your eyes.

[ugh, no!]

Fair.

I have this for the aforementioned 20 days of the month and I used to think it was because

I have monolids and no brow-bone to speak of so light just reflected into my eyes in

a funny way. But no. My brain is just…

Exploding!

- It’s really not.

You don’t know that!

- Fair.

Auras vary by individual experience; some people experience lights like me but for others

it’s smells, movements or hallucinations. Many people experience more than one and they’re

meant to last for less than 60 minutes but… well, we’re all special in our own way.

Visual effects occur most frequently in up to 99% of cases and less than half experience

accompanying sensory or motor effects.

I once had a migraine where I lost the vision in my left eye and then… it never came back.

- don’t panic though, I’ve been told that’s incredibly rare.

I wish my migraines were rare!

Same.

Sensory aura are the second most common type, occuring in 30 - 40% of people with auras.

Sometimes this is a pins-and-needles feeling or a numbness that occurs on one side or your

face or your body. Speech and language disturbances get me quite a lot:

What the… with the… elephant… tes. Ish?

[beat] Sure.

These motor symptoms, including world spinning and loss of position sense, indicate that

this is a hemiplegic migraine and weakness often lasts longer than one hour unlike other

auras.

What’s a hemiplegic migraine? It’s when your body paralyses on one side temporarily

and then you panic that you’re having a stroke.

- And while we’re on that cheerful subject:

Migraines do actually increase your chances of having a stroke. Their symptoms are also

very similar but whilst the effects of a migraine are temporary, a stoke’s damage is permanent.

However, as my doctor told me the other day: sometimes migraines can last for years and

mimic the effects of a stroke. So there’s that.

- 14 years and running [cheers]

But no one knows how to stop a migraine.

It’s really tempting to just make this video be me angrily yelling about how little doctors

actually know about migraines and my general helplessness… but that’s not helpful for

you, so on we go:

3. The headache.

Oh god the headache!

Typically the headache is unilateral (one sided), throbbing, and moderate to severe

in intensity. It comes on gradually and is made worse by physical activity. In 40% of

cases the pain is bilateral and then has neck pain associated with it. Pain usually lasts

between 4 to 72 hours- yes, that’s three days.

- Plus side: the frequency of migraine attacks is very variable, from a few in a lifetime

to several a week, so please don’t panic that just because you’ve had one migraine

you’re going to have lots more very soon. It doesn’t have to mean that.

The pain part isn’t just… pain. However.

It’s frequently accompanied by nausea, vomiting, sensitivity to light, sensitivity to sound,

sensitivity to smells, fatigue and irritability. You may feel like the world is spinning, you’ve

lost track of where you are, you’re incredibly nauseous and you’re unable to see through

the pain. From the outside it’s likely someone can see your pallor, sweatiness and swaying.

You’ll want to drag yourself to a dark and quiet room.

We then come to:

4. Postdrome. This is a constellation of symptoms that occur once the acute headache has settled.

Maybe you’ll have a sore head where it was throbbing earlier, you’ll feel like your

entire skin is raw and bleeding, you might not be at your sharpest for the next few days.

You may rely heavily on Diet Coke.

Surprisingly some people feel refreshed or euphoric after an attack. I can promise you

that once my migraine starts and then my medication kicks in I feel like I can do anything!

Can’t wait for that.

- I can’t do a lot actually but… I feel like I can.

As I’ve run you through what a migraine involves I’ve also talked a little about

how varied migraines can be and how every person experiences them differently. And each

person can have different types of migraines! But here are the seven subclasses of migraine:

- The Common Migraine. migraine without aura. It hurts and you feel awful but you don’t

have any weird vision, smell or prickly things. - The Classic Migraine. migraine with aura.

It hurts, you see stuff. Also includes: it doesn’t hurt but someone really needs to

tune the television. And ‘you forget how to talk for a bit whilst writhing in agony’.

- Childhood periodic syndromes. These come before migraines and include cyclical vomiting

(occasional intense periods of vomiting), abdominal migraine (abdominal pain, usually

accompanied by nausea) and benign paroxysmal vertigo of childhood (occasional attacks of

vertigo). - Retinal migraine involves migraine headaches

accompanied by visual disturbances or even temporary blindness in one eye

- ‘Complications of Migraine’ describes migraine headaches and/or auras that are unusually

long or unusually frequent, or associated with a seizure or brain lesion.

- ‘Probable Migraine’ is “I don’t know what just happened in your brain so we’re

going to call it a migraine, come back in 6 months”

- ‘Chronic Migraine’: “Wow, that migraine lasted way longer than expected and also you’re

having loads of them… whoa.”

Some more fun facts about migraines: There is no ‘cure’ as such and the medication

you take- whether that’s simple over the counter stuff like ibuprofen and paracetamol

or specific medication like triptans- can actually lead to Medication Overuse Headache…

which is a vicious cycle as you can imagine.

Don’t tell me my head hurts because I took medication to stop my head hurting- that’s

not fair!

- I know. It makes you pretty defensive, doesn’t it?

Yes! I didn’t do this to myself!

There really isn’t any blame game when it comes to migraines, don’t worry.

For instance, some people find that caffeine really helps and some find that it’s a trigger

which sets off their migraines.

Unfortunately there is no easy step-by-step guide I can give you to make your migraines

go away or not happen. It’s about finding out what works for you, what sets you off

and whether there are any medications that work for you in helping to prevent migraines.

Also, migraines typically do not occur during the second and third trimesters of pregnancy,

so if you can get pregnant… consider staying that way?

- surrogacy: helps build a family, helps stop your migraines [thumbs up]