Everything You Need to Know About Migraine
This article will further define migraine. It will also discuss the phases, types, symptoms, causes, and treatments of the condition.
Migraine headaches are a primary headache, meaning other medical conditions are not the cause. The migraine happens independently.
It is thought that a chain of events brought on by triggers leads to neuroinflammation. This affects the nerves and causes the release of neuropeptides, which leads to migraine symptoms and pain.
Both children and adults can experience migraine. It is thought genetics may play a role, as most people with migraine have a family history of it.
There are distinct phases of migraine, and understanding them can help you manage your symptoms better.
Also called the premonitory phase or “preheadache,” prodrome phase signals the beginning of a migraine episode. This phase can last a few hours to a few days.
Most people with migraine experience the prodrome phase but not necessarily for each migraine episode. Symptoms vary from person to person and include:
- mood changes
- difficulty focusing
- light sensitivity
- sound sensitivity
- constipation or diarrhea
- neck and shoulder muscle stiffness
Not everyone with migraine experiences aura, but up to one-third do. Symptoms of the aura phase involve the visual field and may include blurry vision or vision loss.
Other symptoms include:
- flashing or shimmering lights
- blind spots
- the appearance of geometric patterns
The duration of the symptoms is typically at least 5 minutes and up to 60 minutes. Not all auras lead to a headache. However, they are a common warning sign of a potential migraine.
There is a throbbing pain that typically begins on one side of your head that lasts for several hours to up to 3 days. Some people with migraine experience mild pain, while others have debilitating pain. The pain sometimes shifts from one side of the head to the other.
Other symptoms include:
- light or sound sensitivity
Some people cannot participate in usual activities during the headache phase because of the pain.
Sometimes called the “migraine hangover,” the postdrome phase usually happens after the headache phase has ended. Not everyone experiences this phase, but approximately 80% of people with migraine do.
Even though the headache phase is over, the postdrome phase is sometimes just as debilitating.
- body aches
- difficulty concentrating
- feeling dizzy
- light sensitivity
There are several types of migraine. The main types are migraine with aura and migraine without aura. Other types include:
- Abdominal migraine: Usually, this type of migraine affects children and involves moderate to severe abdominal pain lasting 1–72 hours. Other symptoms may include loss of appetite, nausea, and vomiting.
- Migraine with brainstem aura (previously Basilar type): Typically, this type of migraine affects children, adolescents, and young adults. However, it can affect anyone. Symptoms include changes in vision such as partial loss, total loss, or double vision. People may also experience feeling dizzy, loss of balance, or poor muscle coordination. A throbbing headache may hit suddenly on both sides at the back of the head.
- Hemiplegic migraine: This is a rare but severe form of migraine. It causes temporary paralysis on one side of the body, which sometimes lasts for days. Other symptoms include vertigo and trouble seeing, speaking, or swallowing.
- Menstrually related migraine: Typically, this type of migraine affects people 2 days before to 3 days after menstruation, though it can also happen at other times of the menstrual cycle. Symptoms include pulsing pain on one side of the head, aura, nausea, vomiting, and light and sound sensitivity.
- Migraine aura without headache: This type of migraine, also called silent migraine, does not typically include head pain but involves other symptoms such as visual problems, aura, nausea, vomiting, and constipation.
- Retinal migraine: This type is also known as ocular migraine. There is visual loss or problems in one eye during the headache phase of this migraine. This type can also have symptoms that are similar to those of migraine with visual aura. However, they tend to be more severe and intrusive.
- Status migrainosus: This is a rare but painful form of acute migraine. Status migrainosus causes disabling pain and nausea lasting for 72 hours or longer. The pain and nausea are often so severe that the person experiencing the migraine requires hospitalization.
The most common migraine symptom is moderate to severe head pain. However, migraine does not always include a headache. In the same way, not all headaches are migraine.
Symptoms of migraine vary from person to person but commonly include:
- neck pain
- body chills
- phantom smells
- brain fog
- sinus issues
- dizziness or vertigo
- mood changes
- light or sound sensitivity
- allodynia, which is an extreme sensitivity to things that do not typically cause pain, such as a light touch
Genetics may link to migraine, as most people who experience migraine have a family history of the condition.
There are many factors that can trigger migraine. The triggers typically vary from person to person.
Physical migraine triggers
Physical migraine triggers include:
- lack of sleep or too much sleep
- skipping meals
- hormonal changes during the menstrual cycle
Environmental migraine triggers
Environmental triggers include:
- loud noises
- strong odors
- bright lights
- changes in weather
Food-related migraine triggers
Eating and drinking habits that can trigger a migraine include:
- drinking red wine and other alcohol
- drinking too much caffeine
- withdrawing from caffeine
- eating food that has nitrates
- eating foods with monosodium glutamate
- eating foods that contain tyramine
- consuming foods or drinks with the sweetener aspartame
Migraine has possible strong genetic factors. It may have more than one genetic source.
Having a menstrual cycle also puts you at
Your doctor will ask you questions about your medical history and what current medications, vitamins, and supplements you are taking. They may also ask about your family history of migraine.
They will need to know about your symptoms and may ask questions such as:
- When did your headaches start?
- Where does it hurt?
- Can you rate your headache pain on a scale of 1–10?
- What are the characteristics of the pain?
- How long does the pain last?
- Have your headaches changed over time?
- How frequently do you get your headaches?
- Have you pinpointed any triggers?
- Do you have other symptoms with your headaches?
- Is your headache sleep-related?
- What methods have you tried for relief, and have they worked?
In some situations, your medical team may order a CT scan or MRI scan of your head to aid in diagnosis.
Benefits of keeping a migraine journal
There are many details your doctor will ask about. To give them the most accurate information, keeping a headache journal is often helpful. When you feel a migraine beginning, ask yourself the following questions:
- What is your current stress level?
- How much sleep have you been averaging?
- What have you recently eaten?
- Have you skipped any meals?
- Have you been around strong odors or bright lights?
- What has your caffeine and alcohol intake been over the past couple of days?
Also, take note of the location of the pain, if any. Record when it starts and how it feels. Keep notes on what you take to try and bring relief and the outcome.
Jot down any other symptoms you experience before, during, and after your headache.
These details will help your doctor determine what type of migraine you are experiencing and develop a treatment plan.
Migraine is not curable. However, it is treatable. Typically, a combination of medications and lifestyle changes works best for managing migraine.
Lifestyle changes to reduce the frequency of migraine
Changing some lifestyle habits may help decrease the frequency of your migraine episodes.
These include the following:
- Learn and avoid your triggers.
- Set a sleep schedule.
- Eat a healthy diet and do not skip meals.
- Exercise regularly.
- Limit your caffeine and alcohol intake.
- Learn stress coping techniques and try to reduce unnecessary stress.
Medications to treat migraine
For some people, over-the-counter medications such as acetaminophen (Tylenol), aspirin, or nonsteroidal anti-inflammatory drugs, including ibuprofen (Advil), can relieve mild headaches.
If these medications do not help, there are three other classes of medications your medical professional may suggest trying. These are:
- ergot derivatives
- CGRP antagonists
Medications for migraine typically work best when taken as soon as symptoms first start. Always have your migraine medication with you.
Work with your doctor to find the right treatment plan for you.
These are some more questions people have asked about migraine. The answers have been reviewed by Susan W. Lee, D.O.
What happens during a migraine episode?
What causes migraine aura?
Researchers are not sure what causes migraine to have auras and why some migraine types do not have them. They are often a signal that a migraine episode is beginning.
Migraine is a common and debilitating medical condition that many people experience.
There are several different types of migraine headaches, each with its own unique symptoms. Although there is currently no cure, your doctor can help you develop a treatment plan that works for you.
If you are experiencing migraine, contact your doctor.