What is a Migraine?
A migraine is a severe headache, usually on one side of the head, accompanied by other sensory symptoms.
This condition is the third most widespread illness in the world. It accounts for about 1.2 million visits to the emergency room in the US annually. It is more prevalent in women and children in America, affecting 18 percent of women, 10 percent of children and six percent of men. (1)
The exact cause of a migraine is unknown. However, it is thought to be the temporary result of changes in nerves, chemicals and blood vessels in the brain.
Symptoms
A migraine is not like a normal day to day headache which some people suffer from occasionally. It is a severe pain, generally affecting one side of the head, which begins suddenly.
There are certain triggers or risk factors which can lead to a migraine. Keeping a diary of when migraines happen might help an individual to identify triggers. Some of the most common include:
Lifestyle Risk Factors
Changes in a person’s sleeping patterns, over exertion, stress and exercise can all trigger migraines for some. Other factors are: skipping meals, fasting, not drinking enough water leading to dehydration, and drinking alcohol.
Environmental Risk Factors
Motion sickness caused by travel on trains, boats or in cars, or the altitude and air pressure associated with flying, are triggers for some people. Environments such as flickering or bright lights, strong smells, smoke or air pollution might also set off a migraine.
Weather Related Risk Factors
Some people might experience a migraine as a result of sudden or major changes in temperature. High and low humidity, changes in barometric pressure and bright sunlight can also contribute.
Hormonal Risk Factors
Changes in hormone levels can be affected by a number of factors, including menstruation, pregnancy and menopause. Using oral contraceptives, or using hormone replacement therapy, also affect hormone levels. These can be triggers for the onset of a migraine.
Medication Risk Factors
While non-prescription painkillers can be taken to deal with a migraine, their overuse might make it worse. There are also other medications which could induce a migraine.
Migraine Symptoms
The main symptom of this condition is a severe headache which can be unbearable. It is typically throbbing in nature and can be made worse when a person moves. It might be described as a tightening or pressing pain.
While it generally affects one side of the head, the pain can be felt in both sides of the head or across the forehead. It doesn’t usually involve the back of the head.
Some people might experience warning signs that a migraine is imminent. These include a craving for sweet foods, tiredness, thirst, yawning, mood swings and stiffness in the neck.
There are neurological symptoms, referred to as an aura, which happen for up to an hour prior to a migraine. Some people might experience this aura without actually feeling any pain.
Changes in the brain can affect a person’s sight and they might experience dark or colored spots before the eyes. They might also see zig zag patterns, flashing lights or sparkles.
Dizziness or vertigo could also be present. A person may feel off balance or that the world is spinning.
Speech and hearing disturbances as well as changes in memory, and feelings of confusion and fear, are further symptoms. Some people feel weak and experience tingling, beginning in the hand and moving along the arm to the face and mouth.
Very rarely, a person might experience partial paralysis, or faint and lose consciousness.
Accompanying the pain, some people will experience nausea or even vomit. An increased sensitivity to sound and light is not uncommon.
Other occasional symptoms include sweating, feeling very cold or very hot, poor concentration, abdominal pain and diarrhea. (2, 3)
Stages
Migraines can differ from person to person. There are, however, five stages attributed to a migraine.
Stage #1 Prodrome
This is a warning stage which might alert a sufferer that a migraine attack is imminent. Over time, an individual may begin to recognize the symptoms and be able to prevent a full blown migraine. The symptoms can include yawning, tiredness or excess energy, sweet cravings or feeling run down. These can happen up to 48 hours before the onset of a migraine.
Stage #2 Aura
This stage usually takes place between 30 minutes and an hour before a migraine. Around 20 to 30 percent of children and adults may experience this disturbance.
Symptoms associated with aura include: blurred vision, blind spots or flashing lights. Speech impairment, like slurring or mixing up words, can also be present.
Stage #3 Main Migraine Attack
This is the stage when the main headache manifests. It may be accompanied by nausea and a sensitivity to light, smell or sounds. The chances are this stage will be debilitating and the sufferer will want to be left alone or to sleep.
Stage #4 Postdrome or Resolution
During this stage, symptoms become less, or can stop suddenly. Sleep might be beneficial in bringing an attack to an end, as can vomiting in some cases.
Children may find that sleeping for only a few minutes can help end a migraine.
Stage #5 Recovery
Once the main symptoms have resolved, the sufferer may still feel unwell or run down for up to 48 hours.
The symptoms experienced during this stage may be the opposite of those experienced prior to the migraine. For example, if a person was tired they might now have lots of energy, if they lost their appetite they may now be hungry. (4, 5)
Treatment
At present, there is no cure for migraine. Treatment is available which can either prevent a migraine or help relieve the symptoms when one occurs.
Prevention
There are medications available, such as Aimovig, which contains erenumab. This drug helps block a molecule which is involved in migraine attacks. Some drugs which are used to treat conditions such as epilepsy, high blood pressure or depression, might also help migraine sufferers. (6)
Botulinum toxin type A (botox) injections have been shown to be effective in helping prevent migraine. (7)
Therapy for stress management, such as: relaxation techniques, muscle relaxing techniques, biofeedback and deep breathing, can also help. (8)
Keeping a diary of personal triggers and avoiding them, as well as ensuring proper sleep, nutrition and hydration are other prevention methods. Losing weight, if a person is obese, can help prevent migraine.,
If this condition is linked to a woman’s menstrual cycle, hormone therapy is an option which might be considered for prevention. (9)
There are also natural remedies which can be taken, in the form of supplements, which have been shown to help some people. These include: feverfew, coenzyme Q10 and riboflavin.
However, these remedies can have side effects and interact with certain medications. Medical advice should be sought before taking them (10)
Treatment of Symptoms
When a migraine attack takes place, analgesic medications can be used. These include over the counter drugs and prescription medications.
Of the many analgesics available to treat migraine, some will suit each individual better than others. Consultation with a pharmacist or doctor can help decide which is best for a person.
Overuse of pain medications has the potential to make headaches worse. Consult a doctor for advice if you experience these symptoms. (11)
FAQ
What is a migraine? A migraine is a severe headache, usually on one side of the head, accompanied by other sensory symptoms.
What are the signs of a migraine? The main sign of a migraine is a severe headache. This can be preceded by yawning, tiredness, feeling run down, a craving for sweet food or being thirsty. It can be accompanied by nausea and sickness, visual disturbances such as flashing lights, or sensitivity to sound, light and smell.
How do you develop a migraine? The exact cause of a migraine remains unknown. A change in chemicals, nerve signals and blood vessels in the brain are thought to contribute.
How are you diagnosed for a migraine? Diagnosis can sometimes be challenging for doctors. Keeping a migraine diary, noting the symptoms, number and duration of attacks, as well as potential triggers, can help. (12)
What is the best treatment for a migraine? There are treatments available to both prevent and treat migraines. It might take some time to find which treatment will work best for each individual. (13)
What are the long term complications of a migraine? Migraines can be debilitating, especially when they are frequent and chronic. They may interfere with a person’s daily routine and lifestyle.
Is a migraine considered a disability? There are occasions, particularly when dealing with chronic migraines, when disability benefits might be paid. (14)
Is there a cure for a migraine? While there are treatments available to prevent and treat migraine, there is, at the present time, no cure.
Is a migraine life threatening? A migraine is not considered a life threatening condition. However, an unexplained severe and sudden headache could be a sign of a more serious condition, such as a stroke. In this event, emergency medical care is necessary. (15)
Summary
A migraine is a severe headache, usually on one side of the head, accompanied by other sensory symptoms. These include nausea, sickness, visual disturbances and a sensitivity to light, sound and smells.
Chronic migraine can be debilitating and interfere with an individual’s ability to function on a day to day basis.
At present there is no cure for a migraine. Diagnosis can be challenging for medical professionals.
Fortunately, there are treatments available to help prevent and relieve the associated symptoms.