Migraine: recognising and treating it in Luxembourg

Migraine is a genuine neurological disease, not simply a bad headache you should push through. It comes in attacks of often throbbing pain, typically on one side of the head, with nausea and sensitivity to light or noise, lasting anywhere from a few hours to three days. In Luxembourg, your first port of call is the general practitioner (GP), who can diagnose migraine and start treatment; a neurologist takes over for frequent, unusual or hard-to-treat forms.

Migraine or tension headache? The clues that tell them apart

Many people with migraine spend years assuming they just get headaches "like everyone else". Yet migraine feels nothing like the everyday tension headache, which squeezes both sides of the head like a tight band, stays bearable and rarely stops you from getting on with your day.

A migraine attack has a recognisable signature. The pain pulses in time with your heartbeat, like hammer blows, and usually settles on one side of the head, sometimes behind the eye. It gets worse the moment you move, climb stairs or bend over. And it brings companions that an ordinary headache never does: nausea or even vomiting, an overwhelming need to lie down in a dark, quiet room, and discomfort with light (photophobia) and sound. If you have to stop what you are doing, if your screen suddenly feels blinding, if your family has learned to whisper during your attacks, there is a good chance this is migraine — and it deserves a proper diagnosis, not years of self-medication.

The aura, explained without the fear

Roughly one in four or five people with migraine experiences attacks "with aura". Before the pain, temporary neurological symptoms build up gradually over several minutes: most often visual — shimmering dots, zigzag lines, a blind spot that slowly spreads — sometimes tingling that creeps up one hand or one side of the face, more rarely difficulty finding words. Everything resolves completely within an hour, and then the headache begins.

A first aura can be frightening, because these symptoms mimic more serious conditions. Keep one simple rule in mind: a migraine aura develops gradually and vanishes without a trace. Symptoms that appear suddenly, within seconds, or that persist, are not an aura and need immediate medical attention. Once a doctor has confirmed the diagnosis, the aura remains unpleasant but harmless — many patients learn to read it as the early-warning signal of an attack, and to take their treatment straight away.

Your triggers are personal: keep an attack diary

There is no universal list of causes; every person with migraine has their own triggers, often acting in combination. The most common are too little or too much sleep, stress — and above all the wind-down that follows it, which explains classic weekend migraines — skipped meals, dehydration, hormonal changes in women, certain foods or alcohol, and shifts in the weather.

The best tool for identifying yours fits in a notebook or an app: the attack diary. For each attack, record the date, duration and intensity, what you ate, how you slept, what happened the day before, and whether a medicine helped. After a few weeks, patterns emerge — and the diary is worth its weight in gold at the doctor’s: it confirms the diagnosis, shows the true frequency of your attacks and guides the treatment strategy.

Treating the attack and preventing the next one

Management rests on two complementary pillars. Acute treatment aims to stop the attack: it works best when taken early, at the first signs, using migraine-specific medicines your doctor chooses for your profile. Preventive treatment, offered when attacks become frequent or disabling, is taken daily for several months to make attacks rarer and milder. Several classes of medicines exist, and lifestyle matters just as much: regular sleep, meals at fixed times, physical activity and stress management.

One trap deserves its own story, because it feeds the very pain it claims to relieve: medication-overuse headache. Take painkillers several days a week for long enough and the brain adapts, the pain threshold drops, and a near-daily headache sets in — which people then treat with even more tablets. This vicious circle is common among migraine sufferers who manage alone. If you are using painkillers more than eight to ten days a month, tell your doctor: that is the signal to change strategy, not to increase the dose.

When to see a doctor — and when to call 112

See your GP if attacks keep coming back, if they are becoming more frequent or more intense, if they cost you workdays or family time, or if you find yourself reaching for painkillers ever more often. A neurologist is the next step, particularly beyond several attacks a month or when the diagnosis is in doubt.

Some warning signs fall outside migraine altogether and mean calling 112: a sudden, explosive "thunderclap" headache reaching its peak within seconds; a headache with fever and a stiff neck; slurred speech, weakness down one side of the body or confusion that does not pass; or a first, unusual headache after the age of 50 or following a blow to the head.

How it works in Luxembourg

In Luxembourg you can consult your GP directly — they handle the great majority of migraine care — and be referred to a neurologist when needed; access to specialists is open, with no compulsory referral letter. Consultations and prescribed examinations are covered by the National Health Fund (CNS) under the usual reimbursement conditions. You can find a GP or a neurologist near you and book an appointment directly on Doctipro.