Many medical conditions have ‘prodromes’, warning signs that something is going to happen, usually something not very nice.
For instance, if you suffer from cold sores, caused by the herpes virus, you’ll be familiar with its classical prodrome – soreness and tingling in the skin over the spot that’s developing on your lip and in nearby gums and teeth.
This prodrome serves a useful purpose because if you act on it immediately by applying an anti-viral cream you can abort the cold sore altogether. The same goes for genital herpes.
Migraine sufferers will identify with the sensations they feel when one of those pounding, disabling headaches is about to strike – flashing lights, halos around lights, loss of part of your vision, coldness of the side of the face where the headache attacks, even dribbling from the side of the mouth on the same side as the headache.
This is the time to swallow your medication and head to a darkened room. People with epilepsy know the particular signs, “the aura”, that heralds a seizure. It can affect any of the senses depending on which part of the brain the seizure originates in.
Sounds and smells are all part of the prodrome and they may appear hours, even days before the attack. They can vary enormously. People report mood changes across a broad spectrum like irritability, agitation, ecstatic feelings, light-headedness, insomnia, headache and difficulty concentrating.
There are also a group of neurological conditions with well-recognised prodromes. Alzheimer’s is one, with confused thinking, spatial awareness and forgetfulness.
Parkinson’s disease may be heralded by a loss of smell and a report in The Lancet last year described that people who go on to develop MS have signs more than five years earlier in the shape of vision problems and difficulties with stiffness.
The Lancet researchers suggested looking out for these prodromal symptoms allowing earlier detection and possible treatment.
A stroke is sometimes preceded by unclear thinking, loss of colour vision called “greying out”, fixation of the eyes and a frozen appearance. And a TIA (transient ischemic attack) is, in effect, a warning mini-stroke that may be the prodrome to a major one.
Many people who have had a heart attack say they knew beforehand one was imminent.
The classical prodrome includes tightness in chest, pain in the jaw and down the left arm and shortness of breath.
In women, however, the prodrome is often different with unusual tiredness, indigestion, sleep disturbance, anxiety, muscle aches, tightness and pressure at the top of the back, weakness, dizziness and cold sweats, for up to a month before.
Women, be prepared.