Migraine is a condition associated with severe, recurring headaches and other symptoms. A migraine episode is a type of pain that occurs in the head and an episode usually comes in spurts and can last for several days. Severe cases can affect a person’s daily life, including their ability to work or study.
Migraines can affect people in different ways, and the triggers, severity, symptoms, and frequency of doing it can vary. Some people have more than one episode per week, while others have them only occasionally. Although a severe, debilitating headache is a common feature, additional symptoms can include:
- Nausea
- Vomiting
- Difficulty Not Speaking
- Numbness Or Tingling
- Sensitivity To Light and Sound
Such a condition is common and runs in families and can affect all age groups. Women are more likely to be diagnosed with migraines than men. A diagnosis of migraine is determined based on the clinical history and reported symptoms and other factors. The most common categories of migraine headaches (or attacks) are episodic versus chronic, and then there are ones without aura and others with aura.
How Does a Migraine Feel?
People describe migraine pain as:
- Throbbing
- Palpitations
- Perforation
- Throbbing
- Debilitating
It may also feel like a stabbing, dull, constant pain. The pain may start out as a mild one. Without treatment, they can become moderate to severe. Migraine pain most commonly affects the forehead area. It’s usually on one side of the head, but it can occur or alternate on both sides.
Most migraine attacks last about 4 hours. If people suffering from migraine don’t receive treatment or don’t respond to treatment, the attack can last anywhere from 72 hours to a week. In migraines with aura, the pain may overlap with an aura or not occur at all.
Symptoms
Migraine symptoms usually occur in several stages:
Pre The Headache
At this stage, a person may experience a “prodrome” that may involve emotional changes, particularly depression and irritability. A prodrome can also include yawning, dizziness, thirst, frequent urination, and sensitivity to light and sound. Sometimes an aura can occur. This includes physical or sensory symptoms such as flashing lights in the field of vision.
During The Headache
In addition to a mild to throbbing or severe throbbing headache, symptoms may include nausea, vomiting, neck pain, dizziness, and stuffy nose.
Common Features
Now the headache, fatigue, and irritability may persist for another 2 days. This is sometimes referred to as a “migraine hangover”.
Other common characteristics of migraines include:
- Headaches that spread during physical exertion and aggravate activity or exertion.
- Inability to perform regular activities due to pain.
- Increased sensitivity to light and sound, which can sometimes occur relaxed from lying quietly in a darkened room.
Other symptoms may include sweating, feeling unusually hot or cold, abdominal pain, and diarrhoea.
Migraine vs. Headache
A migraine episode differs from a typical headache. Experiences vary, and they can have different causes. Writing down the symptoms as and when they occur can help a person and their doctor identify migraine attacks. Keep this diary for at least 8 weeks and note the occurrence and when symptoms start possible triggers such as
- Stress Or Menstruation
- Type Of Headache
- Other Symptoms
- Any Recognizable Signs of Migraines, Such as Aura
- All Drugs and Their Effects
Types of Migraines
There are two main types of migraines – with or without an aura. Migraine with aura is further divided into four subtypes- typical migraine aura, migraine with brainstem aura, hemiplegic migraine, and retinal migraine. Some of these subtypes have their own sub-subtypes. A person can have more than one type of migraine at the same time, as well as other types of headaches.
Migraines are also classified as chronic or episodic based on the number of days per month per year. Chronic migraine is defined as migraine pain that occurs for 15 or more days per month for at least three months. Episodic migraines are defined as migraine symptoms on fewer than 15 days per month.
Determining what type of migraine, you have can help you and your doctor determine the right treatment for you.
Migraine With Aura
Migraine with aura formerly called Migraine Classic occurs in up to 30 percent of people who have migraines. Usually, this migraine causes the same symptoms as a migraine without aura, except that the headache phase of the migraine attack is preceded by neurological disorders, which may include visual, speech, or sensory changes.
Examples of visual auras are seeing stars, zigzag lines, or flashing lights; blurred vision; temporary blind or coloured spots; and tunnel vision. Sensory disturbances may include tingling or numbness in any part of the body, face, or tongue. In some cases, the aura symptoms occur without an accompanying or subsequent headache.
Migraine Without Aura
Migraine without aura, formerly known as common migraine, is characterized by a headache that usually occurs on one side of the head, has a throbbing, that worsens with physical activity, and is accompanied by nausea or sensitivity to light and sound. Migraines without aura may have a prodrome, or warning phase, in which a person experiences symptoms such as depression, food cravings, difficulty concentrating, uncontrollable yawning, and others.
You may also have a postdrome phase when the headache has subsided, but the person feels tired and aches and has difficulty concentrating. Alternatively, a person may feel exhilarated and even euphoric after overcoming the headache phase of a migraine.
Migraine With Brainstem Aura
This type of migraine, formerly known as the basilar type, is a rare type of migraine with aura. It often includes neurological symptoms such as double vision, speech and hearing problems, dizziness, and loss of balance and coordination
Chronic Migraine
Chronic migraine is defined as a headache that occurs for 15 or more days per month for at least three months and has migraine-like features on at least eight of those days. Given the frequency of chronic migraine symptoms, it can be impossible to tell when one migraine attack ends, and another begins.
It can also be difficult to determine whether a person has chronic migraines or other conditions, such as medication overuse headaches that are likely to cause daily or almost daily headaches.
Retinal Migraine
Retinal migraine is an extremely rare one and causes temporary vision loss in one eye. It is diagnosed when a person has repeated bouts of unilateral vision problems, including the types of visual symptoms commonly seen with migraine aura or migraine-related blindness. These symptoms typically last five minutes or more, can last up to an hour, and may be accompanied or followed by a headache
Migraine Symptoms
Migraine symptoms can appear 1-2 days before the headache. This is called the prodrome stage. Symptoms at this stage may include:
- Cravings
- Depression
- Fatigue Or Lack of Energy
- Frequent Yawning
- Hyperactivity
- Irritability
- Stiff Neck
In migraine with aura, the aura occurs after the stage. During an aura, you may have trouble seeing, feeling, moving, and speaking. Examples of these problems include:
- Difficulty Speaking Clearly
- Itching Or Tingling of The Face, Arms, Or Legs
- See Shapes, Flashes of Light, Or Bright Spots
- Loss Of Vision Temporarily
- The Next Phase Is Called the Attack Phase.
This is the most acute or severe phase where the actual migraine pain occurs. For some people, this may overlap or occur during an aura. Symptoms of the attack phase can last for hours to days. Migraine symptoms can vary from person to person.
Some symptoms may include:
- Increased Sensitivity to Light and Sound
- Nausea
- Dizziness Or Light-Headedness
- Pain On One Side of The Head, Either Left or Right, Front or Back or In the Temples
- Throbbing Headache
- Vomiting
After the attack phase, the person will often experience the post-phase. There are usually mood swings and feelings at this stage. These can range from feeling high and extremely happy to feeling very tired and listless. A slight, dull headache may persist.
The duration and intensity of these phases can vary in severity in different people. Sometimes a phase is skipped, and a migraine attack can occur without causing a headache.
What Causes Migraine Attacks?
Researchers have not identified a clear cause of migraine headaches. They still believe the condition results from “abnormal” brain activity that affects the nerve signals, chemicals, and blood vessels in the brain.
There are also many triggers, and people have reported such triggering migraine headaches like –
- Bright Lights
- Intense Heat or Other Weather Extremes
- Dehydration
- Changes In Barometric Pressure
- Hormone Changes in People Born Female Such as Estrogen and Progesterone Fluctuations During Menstruation, Pregnancy Or Menopause
- Excessive Stress
- Loud Noises
- Intensive Physical Activity
- Skipping Meals
- Changes In Sleep Patterns
- Taking Certain Medications Such as Oral Contraceptives or Nitroglycerin
- Unusual Smells
- Certain Foods
- Smoking
- Alcohol Consumption
- Travel
If you experience a migraine attack, your doctor may ask you to keep a headache diary. Writing down what you were doing, what foods you ate, and what medications you were taking before your migraine attack began can help you identify your migraine triggers.
Syndromes That May Be Associated With Migraine Headaches
Certain conditions are more common in people with migraine headaches or in people who are usually children, with a stronger migraine risk of developing migraine:
Cyclic Vomiting Syndrome
In the syndrome of cyclic vomiting, a person experiences bouts of severe nausea and vomiting lasting an hour or longer for up to 10 days at a time. Between attacks, which occur in a regular cycle, the person has no
Symptoms of Nausea or Vomiting
Abdominal Migraines
This type of episodic migraine is mainly diagnosed in children. Symptoms include abdominal pain, nausea, and vomiting. Children who suffer from abdominal migraines often do not have headache attacks in adolescence but develop them in adulthood.
Benign Paroxysmal Vertigo
In this syndrome, otherwise healthy children experience recurrent brief attacks of vertigo that come on without warning and resolve spontaneously without loss of consciousness. During the attacks, a child may have nystagmus (uncontrolled horizontal or vertical eye movement), impaired balance or coordination (called ataxia), vomiting, pale skin, and fearfulness.
Benign Paroxysmal Torticollis
Occurring in infants and small children, this syndrome causes the head to tilt to one side, with or without slight rotation, and stay tilted for minutes to days before spontaneously resuming its normal position. During the attack, the infant or child may be pale and irritable, seem uncomfortable or generally unwell, vomit, or in older children, have impaired balance or coordination.
Risk Factors
Anyone can develop migraines, and there is a slightly higher risk for people with:
- Depression
- bipolar disorder
- Fibromyalgia
- Irritable bowel syndrome
- Overactive bladder
- Trouble sleeping
- OCD
- Anxiety
How Is Migraine Diagnosed?
There is no single test that can diagnose a migraine. Rather, your doctor will take your medical and family history of migraine headaches and perform a physical and neurological exam. Your doctor may order certain blood tests and imaging tests to rule out other causes of your headache. Keep a detailed record of your symptoms to aid in diagnosis.
Migraine Prognosis
Migraine has a very variable long-term prognosis. Some people have fewer and less severe migraine attacks over time, while others have more attacks, sometimes progressing from episodic migraine to chronic migraine. Others have long periods of remission with no migraine attacks. Researchers are still studying the natural history of migraines and what may help both progressively resolve long-term migraine attacks.
Migraine Treatment
Migraines cannot be cured, but your doctor can help you manage migraine attacks by providing you with the remedies that exist to treat symptoms when they occur, which can result in fewer attacks overall. Treatment can also help make a migraine less severe.
In addition to being the cause of “really bad headaches,” migraines are also a neurological condition that presents multiple symptoms can cause. It is often characterized by severe, debilitating headaches, but other symptoms can include:
- Nausea
- Vomiting
- Slurred speech
- numbness or tingling
- Sensitivity to light and sound
The condition often runs in families and can affect people of all ages. People who were born a female are more likely to be diagnosed with migraines than those who were born a man.
The diagnosis of migraines is made based on medical history, reported symptoms, and the exclusion of other causes. The most common categories of migraine headaches (or attacks) are episodic versus chronic, and then those without aura and those with aura.
