By REBECCA WALSH health reporter
It was during an exam when he was dissecting a dogfish that Timothy Steiner suffered his first migraine attack. He was 17.
"I had this intense pounding headache and I couldn't concentrate. It was gone within an hour," he said.
After that the migraines would come once a month, he would vomit and have to go to bed.
Forty years later he is a leading headache specialist based in Britain.
This week he is in New Zealand for a meeting of the World Headache Alliance Council, a body working towards increased recognition, research and treatment of migraines and headache disorders.
Dr Steiner said that in 2001 the World Health Organisation listed migraines as 19th on a list of the top 20 causes of disability in a report looking at the global burden of disease.
Now the WHO is working with the World Headache Alliance and the International Headache Society on a global campaign - "Reducing the Burden of Headache" - to be launched in Copenhagen next month. The aim is to gather more information on the impact of migraine and headache disorders and use that to convince governments that headache disorders should be among their priorities.
Years down the track it is planned to set up a project to try to look at possible solutions.
Dr Steiner, the director of the Princess Margaret Migraine Clinic in London, said headaches were the most common reason people went to see their GP, but most doctors were not well informed about their diagnosis or treatment, and headaches were generally not a priority.
"Almost everybody has episodic tension headaches and at the end of a bad day they either take a stiff drink or a couple of aspirin and they are better," he said.
"Because everybody has that there is a tendency to assume when people complain of a migraine, that's what they are talking about.
"They will say 'take an aspirin and get on with your life'. But a migraine is far more painful and disabling than that."
Migraines affect about 15 per cent of the adult population and are three times more common in women, due to hormonal factors. An estimated 5 per cent to 10 per cent of children also suffer from them.
Generally migraines become less of a problem when sufferers reach their mid-40s, although women may experience them around menopause.
Dr Steiner said a migraine was a severe headache associated with nausea and vomiting. Some people suffered visual disturbances. Some became so ill they were unable to go to work or look after their children.
Migraines were known to be hereditary and triggers such as a lack of sleep or food, and stress could produce a crippling migraine.
"If you want to avoid it, lead a totally boring life, doing the same thing at the same time every day," he said.
"There's something in the brain of a migraine sufferer which sends out signals that generate an attack by causing inflammation around nerves and blood vessels. Where that centre is and what switches it on and off we don't know."
He suggested people troubled by headaches see a doctor for a proper diagnosis.
* Migraine affects about 15 per cent of women and 6 per cent of men in New Zealand.
* Between 40 per cent and 60 per cent of sufferers have a family history of migraine.
* Up to 15 per cent of women suffer migraine during menstruation.
* There is no cure but a range of treatments are available.
* Migraine attacks last between four and 72 hours.
* The cause of migraines is not yet understood.
* Children also suffer from migraine.