"It feels like my head is going to explode, all of a sudden. It's like someone is hitting me on the head with a hammer. The pain starts when I least expect it, and I can't work when it happens."
The pain, which gets worse when the patient is standing up, is often accompanied by visual disturbance, nausea, vomiting and depression. Resting in bed in a dark room normally provides some relief, and apart from that patients should follow the treatment recommended by their doctor. This intense head pain is more common in people aged between 20 and 50, and the crisis can last from four hours to three days.
"Migraine is much worse than a headache; it is an incapacitating neurological illness which is very common and greatly impacts the lives of the patients, but despite that it is still under-diagnosed and not sufficiently treated and recognised," said Sonia Santos, the coordinator of the Headache Study Group at the Spanish Neurology Society (SEN).
Women suffer more
In Spain, more than five million people suffer from migraine and 80 per cent of them are women. The problem is acute because in 75 per cent of cases it takes more than two years for patients to be diagnosed and given the treatment which is best suited to them.
One cause of the delay in diagnosis is that the people affected often do not consult a doctor until the pain becomes chronic. Also, many primary headaches share similar clinical symptoms, and the symptoms of a migraine can vary considerably among sufferers so it is not easy to diagnose, explained Dr Santos.
"Migraine is a difficult illness to manage because the treatment often has to be adjusted, and it can sometimes be difficult to obtain satisfactory results in the short term," she said.
However, these days there are different therapies to treat and prevent migraine attacks. The choice of one treatment or another needs to be individualised and will depend on the characteristics of each patient.
Dr Santos stressed that patients with chronic or occasional migraines should receive preventive treatment. This usually consists of medication combined with recommendations on lifestyle and routines, such as improving sleep quality, avoiding obesity and taking exercise.
Tension headaches are also common. They are not as disabling as migraines but are also very painful. The pain, which is localised in the back and lower part of the head, is continual, although more tolerable than migraine, and is not usually accompanied by vomiting. It can last for several days. Tension headaches are associated with nervousness, irritability and stress, and are also more common among women.