What is a migraine? A migraine is a specific type of headache that is severe, persistent, and often occurs in conjunction with other symptoms, such as sensitivity to sound and light. It is believed that migraines are the result of abnormal brain activity that leads to constriction and subsequent dilation or widening of the arteries in the brain. This process results in the classic symptoms of migraine that include: Nausea and vomiting Sensory disturbances Severe, throbbing headache that lasts several hours to several days Migraines are often, but not always, triggered by one or more specific substances or situations. These triggers vary greatly from person to person and commonly include: Alcohol Aged foods such as cheese Caffeine Chocolate Red wine Sudden warm weather Patient compliance with a good treatment plan can control symptoms of migraine to a degree that allows a person to live a normal, active life. Treatment plans include medications and avoiding substances and situations that can trigger a migraine. In some cases, migraine headaches can be so severe that they are disabling and result in serious disruption of work, school, relationships, and social activities. Seek prompt medical care if you have symptoms of migraine, such as nausea and vomiting, and a severe, throbbing headache. Symptoms of migraine can also mimic symptoms of more serious conditions, such as a stroke, meningitis, or retinal detachment. Seek immediate medical care (call 911) if you, or someone you are with, have a stiff neck and fever or sensory disturbances, such as numbness or vision changes. What are the symptoms of a migraine? Symptoms of migraines vary between individuals. The length of a migraine can vary greatly, from several hours to several days or more. Some people may only have one migraine in their lifetime, but migraines often recur. Repeat migraines can happen often or there may be years between migraines. Symptoms of migraines are the result of constriction and dilation or widening of arteries in the brain. The symptoms may include: Difficulty concentrating Lightheadedness Mild confusion Nausea Numbness or tingling in different parts of the body Sensitivity to light Sensitivity to sound Severe, throbbing or persistent headache that increases in intensity. The headache generally starts on one side of the head and can spread to the other side. However, migraines can vary greatly in character and intensity. Sudden, overwhelming fatigue and need to lie down in a dark, quiet room to sleep Vomiting Some people with migraines experience an aura, which consists of sensory disturbances that occur just before a migraine headache. Sometimes an aura is described as an inspirational or religious experience. Symptoms of an aura may include: Having a passing blind spot Seeing flashing lights, stars, or a zigzag pattern of distorted colors and lights Surging emotions Serious symptoms that might indicate a life-threatening condition Symptoms of a migraine can mimic symptoms of more serious, even life-threatening conditions, such as a stroke, meningitis, or retinal detachment. Only your health care provider can diagnose whether your symptoms are due to a migraine or other type of headache, such as a cluster headache, or a more serious condition. Seek immediate medical care (call 911) if you have any of the following symptoms: Change in level of consciousness or alertness, such as passing out or unresponsiveness Headache that is extremely severe, or if you have been diagnosed with migraines, a headache that is different in nature from your usual migraine headache Headache that starts very suddenly Severe headache that was preceded by a head injury Stiff neck and fever Symptoms that affect vision, mental functioning, balance, or cause numbness or trouble speaking. If you have been diagnosed with migraine, seek immediate medical care if these symptoms have not happened before with your migraines. What causes a migraine? Current research suggests that migraine headaches may be caused by activation of certain brain chemicals and nerve pathways that lead to changes in blood flow. Specifically, blood flow to the brain is reduced by constriction of the arteries in the brain. This is followed by dilation or widening of these arteries. The exact cause of this process is not known, but migraines are often triggered by one or more specific substances or situations. Triggers can vary greatly from person to person. Migraine triggers Common substances and situations that can trigger migraines include: Aged foods, such as aged cheeses and sausages Alcohol, especially red wine Allergies Bright lights and fluorescent lights Caffeine Certain food additives, such as monosodium glutamate, nitrates, and nitrites Chocolate Emotional stress Extreme changes in weather, especially sudden onset of unusually warm weather Extreme exertion High altitudes Hormonal changes due to the menstrual cycle What are the risk factors for migraine? Health care professionals have identified certain risk factors that can make you more prone to migraines. However, having these risk factors does not mean that you will have migraines. The typical risk factors include: Family history of migraine Female gender Female hormonal changes Younger than 40 years old Reducing your risk of recurring migraine headaches If you have recurring migraines, it is a good idea to keep a migraine log or diary. This involves recording the timing, symptoms, and the types of situations that occurred or substances that were ingested before the migraine occurred. This will help you determine triggers that can be avoided to minimize your migraines. How are migraine headaches treated? The most effective treatment plan for migraine headaches is a multifaceted approach. Treatment plans are also individualized to best address the specific triggers and severity of the migraine, your age, medical history, and other factors. Treatment involves using acute therapies to relieve migraines as they develop, as well as preventative therapies that prevent migraines from occurring as often. These options include: Keeping a migraine log or diary to record the timing, symptoms, and the types of situations that occurred or substances that were ingested before the migraine occurred. This can help you to avoid triggers. You can also record any auras (visual disturbances) that occur just before a migraine. This helps you to recognize an oncoming migraine and begin early treatment. The type of treatment and its effect are also recorded to help pinpoint the most effective treatment for an individual. Many people with migraines report sudden, overwhelming fatigue and need to lie down in a dark, quiet room to sleep. In many people, a nap combined with taking some form of over-the-counter medication might be all it takes to minimize or even completely eliminate a migraine. Medications commonly used to treat migraine include over-the-counter pain medications. These include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), naprosyn (Naproxen, Aleve), and indomethacin (Indocin). All these drugs can cause serious side effects in some people and should be taken only as directed. Vasoconstrictors, which constrict dilated blood vessels in the brain. These include ergot alkaloids and sumatriptan (Imitrex), and other serotonin receptor agonists. Drugs to control nausea and vomiting. If these treatments are not effective, preventive medications that may be prescribed include: Beta blockers (such as propranolol), meant to treat high blood pressure and coronary artery disease. Tricyclic antidepressants (such as amitriptyline), which affect the levels of serotonin and other brain chemicals. CGRP blockers like erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality) that target a molecule thought to instigate and intensify migraines. Narcotics, such as morphine or Dilaudid, are generally not recommended for long-term treatment of migraines because of the potential for dependence. What are the possible complications of migraine headaches? Migraine headaches are generally not a serious health threat. However, if migraine headaches are frequent and severe, it may be difficult for you to function normally or effectively in everyday life. Migraines headaches are also a risk factor for stroke. In severe cases, migraine headaches can result in disability. You can help minimize your risk of recurring migraine headaches and serious complications by following the treatment plan you and your health care professional design specifically for you.