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About Migraine

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Migraine About

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What is Migraine?

Migraine headaches are recurring attacks of moderate to severe throbbing and pulsating pain that usually occurs on one side of the head. Untreated, a migraine attack can last from 4 to 72 hours. 1

A migraine can occur any time of day, but most often they start in the morning. For some, migraines can happen at predictable times, such as before a woman has her period or on weekends following a stressful week at work. A migraine can interfere with your dayto-day activities and may leave you feeling exhausted or weak following an attack. 1,2

People who experience migraines usually have no symptoms between attacks. 1

Types of Migraine

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There are many types of migraine. The two most common types are migraine without aura and migraine with aura.

Migraine Without Aura. This is the most frequent type of migraine, and it strikes without the warning an aura can give you. Typical characteristics of migraine without aura may include: 1,3

  • Pain on one side of the head
  • Moderate to severe pain intensity
  • Pulsing sensation
  • Pain that worsens with routine physical activity such as walking or climbing stairs
  • Increased sensitivity to light or sound
  • Nausea and/or vomiting
  • Confusion
  • Fatigue (feeling tired)
  • Blurred vision
  • Mood changes

Migraine With Aura. An aura is a group of symptoms that act like warning signs a migraine is about to begin. The aura usually occurs before headache pain but can also occur after the headache has started or continue during the headache phase. About 15% to 20% of people with migraine experience an aura. Symptoms of an aura may include: 1,4

  • Vision symptoms
  • Seeing bright flashing dots, sparkles, or lights
  • Blind spots in your vision
  • Seeing wavy or zigzag lines
  • Temporary loss of part or all of your vision
  • Tingling or pins and needles in the hands and face
  • Numbness or muscle weakness on one side of the body
  • Changes in smell or taste
  • Confusion or mental fuzziness
  • Trouble speaking

Phases of Migraine

There are 4 phases of migraine. You may have all or some of these phases during an attack. The phases don't always happen right after each other and can overlap if they do occur at all. 1,3,4

  1. Prodrome. The symptoms of this phase may begin hours or 1 to 2 days before the other symptoms of a migraine attack. Symptoms may include fatigue, difficulty concentrating, neck stiffness, sensitivity to light and/ or sound, nausea, blurred vision, yawning, and unusual paleness. You may or may not experience this phase each time you have a migraine.
  2. Aura. The symptoms of an aura can occur with a headache or the aura symptoms are followed within 60 minutes by a headache. Each individual aura symptom typically lasts 5 to 60 minutes. So if you have three aura symptoms, the accepted maximum duration is 3 x 60 minutes. Aura symptoms are reversible. Most people with migraine don't experience an aura and many who have migraine attacks with aura also have attacks without aura. It's also possible to experience an aura without a headache.

Who is More Likely to Experience Migraines? 1,4

  1. Headache. During the headache phase the pain is moderate to severe in intensity and can last 4 to 72 hours. The pain usually occurs on one side of the head but may spread to the other side.
  2. Postdrome. Following the headache you may have postdrome symptoms. Most often they include feeling tired or weary, difficulty concentrating, and neck stiffness. Symptoms may last up to 48 hours and it can be a day or two before you feel back to normal.

Women. Migraines can affect children and adults, though women are 3 times more likely than men to get them. Migraines are likely more common in women because of the influence of hormones.

People with a family history of migraines. Most people affected by migraine have a family history of the disorder.

People with certain medical conditions. Depression, anxiety, bipolar disorder, sleep disorders, and epilepsy are more common in people with migraine than in the general population.

What are Common Migraine Triggers?

A number of factors, called triggers, can increase your risk of having a migraine. Triggers can vary from person to person and from migraine to migraine. Usually a combination of triggers sets off a migraine attack. Some common triggers include: 1,2

  • Changes in the weather
  • Too much or too little sleep
  • Strong odors or fumes
  • Loud noises
  • Bright or flashing lights
  • Motion sickness
  • Head trauma
  • Hormonal changes in women (related to menstrual cycles)
  • Tobacco use
  • Too much alcohol

Understand Your Migraines and What Triggers Them

  • Stress
  • Anxiety and depression
  • Some medicines
  • Low blood sugar
  • Skipped meals
  • Overexertion (too much physical activity)

Understanding your migraines and what triggers them is key to diagnosing, preventing, and treating migraine. To help you learn more, keep a headache journal. Provide as much detail as possible before, during, and after the attack. Write down: 2,4

  • Where you were, and what you were doing, when the migraine started. Include the date and time. Also, do your best to keep track of each phase of your migraine – when each phase started and how long they lasted
  • Any symptoms you experienced (be specific)
  • A description of the type and location of your pain and rate it on a scale of 1 to 10, with 10 being the worst pain you've ever had
  • Your stress level and what may be causing it
  • How much sleep you got the night before your migraine started
  • What you ate or drank 24 hours before your migraine attack. Had you skipped a meal?
  • For women, include each day of your menstrual cycle to help you and your doctor know if migraines occur during your period
  • How you treated your migraine and if it worked. Include what medicines you took, the dosage you took, and what time you took them
  • Other daily medicines you took including prescriptions, supplements, and pain medicine
  • Anything that may have triggered your migraine

How is Migraine Diagnosed?

To diagnose migraine, your doctor will: 4

  • Evaluate your medical history
  • Assess your family history of migraine headaches
  • Establish your history of migraine – your symptoms, how often you have them, possible triggers, and how you relieve the pain. If you've been keeping a migraine journal share it with your doctor

Your doctor may also order blood tests, imaging tests (such as a CT scan and MRI), or an electroencephalogram (EEG) to rule out other medical conditions that may be causing your headaches.

References:

  1. National Institute of Neurological Disorders and Stroke. Migraine. Reviewed January 20, 2023. Accessed February 8, 2023. https://www.ninds.nih.gov/health-information/disorders/migraine
  2. Office on Women's Health. Migraine. Updated February 22, 2021. Accessed February 8, 2023. https://www.womenshealth.gov/a-z-topics/migraine
  3. International Headache Society. The international classification of headache disorders, 3 rd edition. Cephalalgia. 2018;38(1):1-211. doi:10.1177/0333102417738202
  4. Cleveland Clinic. Migraine Headaches. Reviewed March 3, 2021. Accessed February 27, 2023. https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches