Maybe this sounds familiar. The zigzag lights start at the edge of your vision during the school run, and you know what is coming. By lunchtime you are in a dark bedroom with a cold cloth, the curtains drawn, hoping the nausea passes before the children need supper. Tomorrow you will feel wrung out, and you will start counting the days until the next one.
A migraine is not just a headache
A migraine is a neurological event that involves the whole nervous system. For years it was explained as blood vessels in the head tightening and then widening. Today, researchers understand it more as a sensitive brain that processes signals differently, with nerves, brain chemicals and blood vessels all taking part.
That sensitivity explains why an attack is so much bigger than pain. A warning phase of yawning, cravings or irritability is common. Some then have an aura, which is a short spell of visual disturbance, tingling or trouble with words. The headache phase often brings throbbing pain, nausea and a strong dislike of light, sound and smell. Afterwards comes a washed-out day that people often call the migraine hangover.
Common triggers include skipped meals, too little or too much sleep, hormonal changes, dehydration, bright light and a let-down after stress. A trigger is not a cause, though. It can be thought of as the last straw for a brain that was already close to its threshold.
See your doctor first
A doctor's diagnosis comes before anything else. Many conditions cause headaches, and a GP or neurologist needs to confirm that yours are migraines and discuss treatment with you. There are effective medicines for both stopping an attack and preventing the next one.
Seek urgent medical attention if you have:
- A sudden, severe headache that peaks very quickly, often described as the worst of your life
- A headache with fever, a stiff neck, a rash or confusion
- New weakness, numbness, slurred speech, a drooping face or loss of vision
- A headache after a head injury
- A new kind of headache later in life, during pregnancy, or one that keeps getting worse
It is also worth telling your doctor how often you take pain tablets. Using them on many days of the month can itself keep headaches going, and your doctor can help you manage that safely.
What HEG actually measures
HEG is short for hemoencephalography. It is one type of neurofeedback that has been studied for migraine, and it tracks blood flow instead of brainwaves. A headband with a small sensor rests on the forehead, over the frontal lobes. This is the part of the brain behind your forehead that is involved in planning and attention.
One type of HEG shines low-level red and infrared light through the skin and measures how much is reflected back, which gives an estimate of how much oxygen-rich blood is in the area. Another type simply measures the gentle warmth the forehead gives off. In both cases the sensor only reads. Nothing is sent into the brain.
When a brain area works, it draws more blood. HEG is designed to show that change on a screen. In a typical HEG session, a person might watch a film that keeps playing only while the signal rises, or a bar that climbs as they settle into calm, steady attention. The aim is to learn, with practice, what that state feels like. Our article on the difference between EEG and HEG compares the two approaches in more detail.
A trigger is only the last straw. The real work is raising the threshold so that fewer straws break the camel's back.
What is known about HEG and migraine
The thinking behind HEG for migraine is fairly simple. The frontal lobes are thought to help keep the brain's more reactive areas in check. The theory is that practising a calm, well-supplied frontal state may leave the nervous system as a whole a little less easily tipped over. It remains a theory.
Here it is important to stay honest. The research on HEG and migraine is still limited and preliminary, and HEG is not an established migraine treatment. Results vary, and nobody can promise that your migraines will stop.
What to expect at our practice
Every client at our Krugersdorp practice starts with a 19-channel brain map, which takes about an hour and a half. The map is a recording of how your brain is functioning at the time. Training sessions are 45 to 60 minutes and open with a short check-in on how you are feeling. The sensors only read brain activity, and nothing is sent into the brain. You can read about the full process on our what to expect page.
A simple headache diary is very useful. Note the date, how long the attack lasted, what you took and what was happening beforehand. Share it with your doctor too. Because sleep and migraine are so closely tied, you may also like our article on chronic insomnia and sleep spindles. If your headaches began after a knock to the head, read about post-concussion syndrome and speak to your doctor.
Common questions
Is HEG neurofeedback safe?
HEG is non-invasive. The sensor on your forehead only reads blood flow or warmth, and nothing is sent into the brain. As with any training that asks for concentration, some tiredness afterwards is possible. If you notice a headache or anything else unusual after any neurofeedback session, mention it to the practitioner and to your doctor.
Can HEG stop a migraine once it has started?
It is not designed for that. Once an attack is under way, follow the plan your doctor has given you, including any prescribed medicine. HEG is a form of training practised between attacks. Its aim is to help the nervous system become steadier over time, but the evidence that this reduces migraines is limited. Results vary.
Can I stop my preventive migraine medication if training helps?
Please do not stop or reduce any medication on your own. Neurofeedback works alongside medical treatment, not in place of it. If your headaches improve and you would like to review your medicine, take your headache diary to the doctor who prescribed it and make that decision together.
Living with migraines means planning your life around something you cannot predict, and that is exhausting in its own right. If you have a diagnosis and a medical plan, and you are curious whether brain training could sit beside it, you are welcome to contact Irine to talk it through.
- migraine
- heg
- hemoencephalography
- headache relief
- neurology
