Dr Bernadette Carr answers your questions on migraines and shingles

NOTE: The information contained in this column is not a subsitute for medical advice. Always consult a doctor.

My teenage daughter suffers from migraines. Sometimes they are so bad, she has to miss school. Is there anything she can do?

Migraines are types of headaches which can cause severe attacks of throbbing pain which is sometimes associated with nausea or vomiting or disturbed vision with flashing lights. Migraines can last from a number of hours to up to three days at a time. Sometimes migraines run in families and there are many different triggers which may include stress or foods such as chocolate, cheese, caffeine and alcohol. Dehydration and tiredness as well as bright lights and missing meals can also be triggers and in some women migraine may be brought on at the time of their period.

There are a number of things which can be done to help to improve migraine. Keeping a headache diary can be useful in identifying any possible triggers for the migraines. In this diary you record the times and events surrounding migraine attacks and try to identify a pattern over time. Once a suspected trigger has been identified, it can then be avoided. Medication can be tried to deal with acute attacks and many people find their symptoms are relieved by lying down in a dark, quiet room.

If over-the-counter medications are not sufficient, your GP may prescribe stronger medications to help with the attacks.

If attacks are very severe or recurring frequently or if symptoms of migraine are changing or worsening, it is a good idea to visit your GP to see what can be done to help with the issue.

My friend had shingles recently and it looks like a very serious and painful condition. I have not had chickenpox, so I wonder if I can catch shingles from others?

Shingles is caused by a herpes virus which is the same virus that causes chickenpox. Most people will be infected with the chickenpox virus as children. Chickenpox will often cause a mild fever and an itchy rash on the body which starts as blisters which will scab over and disappear. Once the infection has cleared, the chickenpox virus remains dormant in the nerves of the body. It may never re-activate, however, sometimes it can re appear as shingles. Most often, shingles will occur in middle aged or elderly people or at times of stress to the body or a lowered immune system. However, it may occur in people of all ages.

Shingles will present as a burning or painful patch of skin followed by a blistering rash which will typically only occur across one nerve distribution — so it will appear as a distinct, well defined rash that does not cross the midline of the body.

The most usual areas for shingles to appear are on the face (often around the eye) and on the lower sides of the abdomen. The rash can be extremely painful and may last up to four weeks. Shingles pain may persist in the area even after the rash has cleared.

Shingles cannot be caught from contact with a person who has shingles. However, uncommonly, chickenpox may be caught from someone who has shingles if you have not had chickenpox before. It is advisable for pregnant women and people with a reduced immune system to avoid unnecessary contact with people with shingles.

Antiviral treatment may be used for shingles to reduce the severity of the symptoms and their duration if caught in the early stages (ideally within three days of first symptoms), and pain relief and pain patches may also be used to help with the symptoms.


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