Migraine is a neurological disorder characterized by recurrent episodes of headaches, usually unilateral and pulsating, accompanied by other symptoms such as nausea, vomiting, photophobia, and phonophobia. It affects approximately 1 in 7 people globally, with women being more likely to experience it than men. Migraine can significantly affect a person’s quality of life, including their ability to work and participate in daily activities.
Symptoms of migraine
Migraine headaches can be severe and disabling, lasting from a few hours to several days. The pain is usually pulsating or throbbing and can be felt on one side or both sides of the head. Other symptoms that may accompany migraine headaches include:
- Nausea and vomiting: Many people experience nausea and vomiting during a migraine attack, which can worsen the pain and make it difficult to keep food down.
- Photophobia: Sensitivity to light is a common symptom of migraine, and bright lights can make the pain worse.
- Phonophobia: Similarly, sensitivity to sound can also occur during a migraine attack, and loud noises can exacerbate the pain.
- Aura: Some people experience aura, which are visual or sensory disturbances that can occur before or during a migraine attack. These can include flashing lights, blind spots, tingling or numbness in the limbs, or difficulty speaking.
- Dizziness or vertigo: Migraine can cause feelings of dizziness or vertigo, which can affect balance and coordination.
- Fatigue and weakness: Migraine can cause feelings of fatigue and weakness, making it difficult to carry out daily activities.
Types of migraine
There are several different types of migraine, including:
- Migraine without aura: This is the most common type of migraine, accounting for about 70-90% of all cases. It is characterized by moderate to severe pulsating or throbbing pain on one side of the head, along with other symptoms like nausea, vomiting, and sensitivity to light and sound.
- Migraine with aura: This type of migraine includes additional neurological symptoms, such as visual disturbances, tingling or numbness in the face or extremities, and difficulty speaking. These symptoms usually last for 20-60 minutes before the headache begins.
- Chronic migraine: This is a type of migraine that occurs on 15 or more days per month for at least 3 months. Chronic migraine can be especially debilitating and may require more aggressive treatment.
- Vestibular migraine: This type of migraine is characterized by vertigo or dizziness, along with other symptoms like nausea, vomiting, and sensitivity to light and sound.
- Menstrual migraine: This type of migraine occurs in relation to the menstrual cycle and is often associated with a drop in estrogen levels.
- Hemiplegic migraine: This is a rare type of migraine that includes temporary paralysis or weakness on one side of the body, along with other neurological symptoms. Hemiplegic migraine can be especially severe and requires prompt medical attention.
- Retinal migraine: This is a rare type of migraine that includes temporary vision loss or blindness in one eye. It is usually temporary and lasts for less than an hour.
It is important to note that there are many individual variations of migraine, and not everyone experiences the same symptoms or types of migraines.
What causes migraine
The exact cause of migraine is not fully understood, but research suggests that a combination of genetic and environmental factors contribute to its development. The following are some common triggers that can lead to a migraine attack:
- Hormonal changes: Fluctuations in estrogen levels, particularly during menstruation, pregnancy, and menopause, can trigger migraines in some women.
- Environmental factors: Bright lights, loud noises, strong smells, and changes in weather or altitude can trigger a migraine attack in some people.
- Dietary factors: Consuming certain foods or drinks, such as alcohol, caffeine, aged cheese, chocolate, and processed meats, can trigger a migraine attack in some people.
- Stress and anxiety: Emotional stress, anxiety, and tension can trigger migraines in some people.
- Sleep disturbances: Irregular sleep patterns, insufficient sleep, or oversleeping can trigger a migraine attack in some people.
- Physical factors: Intense physical exertion or overexertion, such as heavy lifting, can trigger a migraine attack in some people.
- Genetics: Family history of migraines increases the risk of developing the condition.
Migraine can affect people of all ages, but it is most common in people between the ages of 15 and 55. Women are more likely to experience migraines than men, with a prevalence of 18% among women and 6% among men. Migraine can also be more prevalent among those who have a family history of the condition. People who have other medical conditions, such as depression, anxiety, epilepsy, or sleep disorders, may also be more likely to experience migraines.
Diagnosing migraine can be challenging, as there is no definitive test for the condition. A doctor may diagnose migraine based on a patient’s medical history, symptoms, and a physical examination. The doctor may also recommend imaging tests, such as an MRI or CT scan, to rule out other underlying conditions that could be causing the headaches. In some cases, the doctor may refer the patient to a neurologist, a specialist who focuses on disorders of the nervous system.
To diagnose migraine, the doctor may ask the patient questions about their symptoms, such as when they occur, how often they occur, and what triggers them. They may also ask about the patient’s medical history, including any past injuries, surgeries, or medical conditions, as well as any medications they are currently taking. Additionally, the doctor may perform a physical examination, which may include checking the patient’s reflexes, coordination, and balance.
In some cases, the doctor may recommend additional tests to rule out other potential causes of the patient’s headaches, such as a blood test, EEG, or spinal tap. However, if the patient’s symptoms are consistent with migraine and there are no signs of other underlying conditions, a formal diagnosis may not be necessary.
Migraine treatment usually involves a combination of medication and lifestyle changes. The following are some common treatments for migraine:
- Pain relief medications: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help relieve migraine pain in some cases. For more severe or frequent migraines, prescription medications, such as triptans or ergotamines, may be needed.
- Preventive medications: If a patient experiences frequent or severe migraines, their doctor may prescribe medications to prevent or reduce the frequency of migraine attacks. These may include beta-blockers, anticonvulsants, or antidepressants.
- Lifestyle changes: Making changes to one’s lifestyle can also help reduce the frequency and severity of migraines. This may include getting regular exercise, maintaining a healthy diet, getting enough sleep, avoiding triggers, and managing stress.
- Alternative therapies: Some people may find relief from migraine symptoms through alternative therapies, such as acupuncture, massage, or biofeedback. However, the effectiveness of these therapies can vary from person to person.
Complications of migraine
Migraine can have a significant impact on a person’s quality of life, including their ability to work, socialize, and carry out daily activities. Additionally, chronic or severe migraines can increase the risk of other complications, such as:
- Medication overuse headaches: Overusing pain relief medications, such as triptans or opioids, can lead to medication overuse headaches, which can be difficult to treat.
- Depression and anxiety: Migraine can increase the risk of developing depression or anxiety, which can further impact a person’s quality of life.
- Chronic migraine: If a person experiences migraines frequently or for long periods of time, they may develop chronic migraine, a condition that can be difficult to treat.
- Stroke: Although rare, people with migraine may be at a slightly increased risk of stroke, particularly if they experience aura.
Preventing migraines involves identifying and avoiding triggers, making lifestyle changes, and sometimes taking medication to prevent attacks. The following are some strategies that can help prevent migraines:
- Identify triggers: Keeping a headache diary can help identify triggers, such as specific foods or environmental factors, that may be causing migraines.
- Manage stress: Stress and anxiety can trigger migraines, so finding ways to manage stress, such as through exercise or relaxation techniques, can help prevent attacks.
- Maintain a regular sleep schedule: Getting enough sleep and maintaining a regular sleep schedule can help prevent migraines.
- Avoid triggers: Once triggers have been identified, avoiding them as much as possible can help prevent migraines.
- Take preventive medication: If migraines are frequent or severe, a doctor may prescribe medication to prevent attacks, such as beta-blockers or anticonvulsants
How long do migraines last?
The duration of migraines can vary widely depending on the individual and the type of migraine. Migraines can last anywhere from a few hours to several days, and the severity and frequency of attacks can also vary.
In general, a typical migraine attack can last between 4 to 72 hours, with most lasting between 4 to 24 hours. However, some people may experience migraines that last longer or shorter than this range.
It is worth noting that migraine attacks often have several phases, including a premonitory phase, an aura phase (in some types of migraine), a headache phase, and a postdrome phase. Each of these phases can vary in duration and intensity, and they can overlap with one another.
It is important to discuss any concerns about the duration or frequency of migraines with a healthcare provider, as they can provide a proper diagnosis and develop an appropriate treatment plan.
What is an aura?
An aura is a neurological symptom that can occur before or during a migraine attack. It is most commonly associated with migraine with aura, but it can also occur in other types of migraine and other conditions.
An aura typically involves a temporary disturbance of vision, such as seeing flashing lights, zigzag lines, or blind spots. However, auras can also involve other neurological symptoms, such as tingling or numbness in the face or extremities, difficulty speaking or understanding speech, and weakness or paralysis on one side of the body.
Auras usually develop gradually over several minutes and last for up to an hour. They are typically followed by the headache phase of the migraine, although in some cases the aura can occur without a subsequent headache.
It is worth noting that not all people with migraine experience auras, and not all auras are the same. Some people may experience different types of auras, or they may experience the same type of aura in different ways.
What does a migraine feel like?
Migraine can feel different for different people and can vary in intensity, duration, and associated symptoms. However, in general, a migraine headache is typically a throbbing or pulsing pain that is often located on one side of the head. The pain can be moderate to severe in intensity, and it can worsen with physical activity. Some people may also experience a sense of pressure or tightness in the head.
In addition to the headache pain, migraines can also be associated with other symptoms, such as:
- Sensitivity to light, noise, or smells
- Nausea and vomiting
- Blurred vision or temporary vision loss
- Dizziness or vertigo
- Tingling or numbness in the face or extremities
- Difficulty speaking or understanding speech
Many people with migraine also experience a premonitory phase, which can involve changes in mood, appetite, or energy levels in the hours or days leading up to the headache. After the headache phase, some people may also experience a postdrome phase, which can involve feelings of fatigue, mood changes, or difficulty concentrating.
What causes ocular migraines?
The exact cause of ocular migraines is not well understood, but it is believed to be related to changes in blood flow to the eye and surrounding tissues. The visual disturbances in ocular migraines are thought to be caused by a temporary reduction in blood flow or constriction of blood vessels in the eye or optic nerve. This can lead to a temporary loss of vision or other visual disturbances, such as flashing lights or blind spots.
In some cases, ocular migraines may be triggered by certain factors, such as:
- Stress or anxiety
- Certain foods or drinks
- Hormonal changes
- Fatigue or lack of sleep
- Bright lights or flickering screens
- Changes in altitude or atmospheric pressure
It is important to note that while ocular migraines are relatively rare, sudden or severe visual changes can be a sign of a more serious condition. If you experience any sudden or severe visual changes, it is important to seek medical attention to rule out any underlying conditions and to receive proper treatment.