A migraine is more than just a terrible headache. Instead, it is a neurological disorder characterized by severe recurring head pain often preceded, accompanied, or followed by various neurological symptoms.
According to the World Health Organization (WHO), migraine is the sixth most disabling disease globally. (1) Indeed, more than 90% of sufferers cannot function during a migraine attack. (2)
Chronic migraine, characterized by 15 or more migraine days per month, affects an estimated three to five percent of the U.S. population. However, a small percentage of those who suffer from episodic migraines may go on to develop chronic migraines. (2a)
Two Classifications of Migraines
There are two basic types of migraines: those without aura and those with aura. An aura is a sensory disturbance that occurs before or during headache pain. It can even happen without headache pain, called “silent migraine.”
Migraine without aura is the most common type, accounting for 75% of migraines.
What Does Migraine Headache Pain Feel Like?
An intense headache is the primary sign of migraine, but like all migraine symptoms, the type and intensity of headache pain differ between individuals.
Migraine headaches usually occur in the forehead area on just one side of the head, though it can occur on both sides. The pain can also occur in your cheeks, behind both eyes. The latter is often mistaken for a sinus headache. The pain can be mild and then increase in intensity. Finally, it can develop into acute migraine attacks characterized by severe headaches.
The migraine pain itself is often described as:
Though pulsing pain is often a feature of migraines, the pain can also be a dull, steady ache. Along with head pain, sufferers may experience symptoms that include:
- Sensitivity to light and sound
- Dizziness and vertigo (the feeling of spinning even when perfectly still)
Other Migraine Symptoms (Prodrome)
Other symptoms can occur one to two days before the headache begins. This is called the prodrome stage.
Symptoms can include:
- Frequent yawning
- Food cravings
Typical Aura Symptoms
Some migraine sufferers experience sensory disturbances called “auras” before or during their migraine attack.
Typical aura symptoms may include:
- Blurred or double vision
- Sensitivity to light
- Vision anomalies such as seeing flashing lights or wavy lines
- Tunnel vision (loss of peripheral vision)
- Trouble speaking, i.e., inability to find correct words
- Tingling hands or feet
- Numbness on one side of the body
- A feeling of heaviness in limbs
Aura symptoms typically last less than an hour. However, in some rare migraine subtypes, the aura can last for more than two hours and can be exceptionally disabling.
Migraine With Aura Subtypes and Symptoms
Subtypes of Migraine with Aura include:
- Aura without headache (silent migraine)
- Migraine with brainstem aura: Symptoms come from the brain stem or nerves on both sides of the brain. The most common symptoms include dizziness or vertigo, slurred speech, double vision, ringing in the ears, loss of coordination, trouble focusing. They can also have some of the symptoms seen in migraine with typical aura.
- Hemiplegic Migraine: A rare subtype characterized by mild to severe muscle weakness on one side of the body that can last several hours or days. In rare cases, the weakness can persist for weeks. Along with muscle weakness, they can also experience typical migraine aura symptoms.
- Retinal Migraine: Characterized by vision changes in just one eye before headache pain. Vision changes may include tunnel vision, seeing flashing lights or halos, or even temporary blindness.
- Vestibular Migraine: Also called Ocular Migraine, This rare subtype affects the inner ear, causing balance issues. Therefore, the main aura symptoms of vestibular migraine are dizziness and vertigo, i.e., the feeling that your body is moving or the environment is spinning. Nausea may also occur.
Remember that these subtypes may also have typical migraines with or without auras.
A typical migraine attack lasts four to 72 hours. If it lasts longer than that — a condition called status migrainous — you should consult your doctor for help stopping it as this can increase your risk of stroke.
The exact cause of migraine episodes is unknown. However, experts theorize that migraines may stem from temporary changes in the brain, such as a change in the way neurotransmitters operate or blood vessel dilation. In addition, the rise and fall of certain body chemicals like serotonin is thought to play a role. Finally, genetic factors are a common risk factor for migraine.
There is also a growing body of evidence suggesting that migraines result from spreading electrical activity in the brain. For example, researchers at Penn State have identified electrical activity in the brain that causes aura, a precursor to migraine headache in about 20% of sufferers. (3) Using a positive charge, they stopped it from spreading across the brain, thereby ending the migraine episode. (4) This study could lead to better ways to manage migraine episodes.
Migraine Risk Factors
Researchers have identified a few factors that may increase your risk of migraine disorder, including:
Women are much more likely to suffer from migraines than men. Indeed, research shows that 85% of chronic migraine sufferers are adult females. (4)
According to the Migraine Research Foundation, “Of the more than 39 million American sufferers, 28 million are women. Migraine is one of the leading serious health problems affecting women.” (5)
Experts think that the hormone estrogen may play a role because, during puberty, the risk of migraine and its severity significantly increases in girls. Before puberty, boys are more affected by migraines than girls. (6)
Migraine symptoms are most common between the ages of 18 and 44. (7) However, young children and senior citizens can also be affected. (8)
Generally, the risk of migraine headaches decreases with age. For example, research shows that only 10% of women and 5% of people aged 70 and older experience migraine headaches. (9)
The majority of migraine sufferers have a family history of migraine (10) due in part to genetic mutations. In a study published in Science Translation Medicine, a UC San Francisco-led research team identified a genetic mutation known as casein kinase I delta (CKIdelta) that appears to cause a typical form of migraine. (11)
Other studies show a link between genetic mutations and various migraine subtypes, such as Hemiplegic migraine. (12)
Other Medical Issues
Various medical issues — such as anxiety, sleep disorders, epilepsy, and depression — may also increase your risk of migraines due to their effects on the brain.
Certain factors can trigger migraine episodes. Common migraine triggers include:
- A lack of sleep
- Hormonal changes, i.e., menopause
- Loud noise
- Flickering lights
- Certain smells
- Temperature changes
- Changes in barometric pressure
- Bright lights
- Low blood sugar
- Certain foods, i.e., caffeine, cheese, chocolate, nitrates in processed meats, alcohol
There is, unfortunately, no cure for migraines. However, there are many treatments for this condition.
Here are just a few of them.
Numerous medications can reduce the pain of a migraine, helping you feel better.
Over-the-Counter Pain Relievers
OTC pain relief medications are best used for mild to moderate headache pain. These medications include:
- Naproxen sodium (Aleve, Anaprox)
- Ibuprofen (Advil, Motrin)
- Acetaminophen (Tylenol)
- Excedrin Migraine (contains acetaminophen, buffered aspirin, and caffeine)
Experts recommend that you take these medications as soon as the headache begins.
There are also a variety of prescription medications that reduce pain and other migraine systems. If you suffer chronic or particularly disabling migraine attacks, however, preventing the attack from occurring may be the way to go. If that’s the case, please speak to your doctor about prescribing a preventive medication that you take daily. Here are a few commonly prescribed medications for migraine.
- Triptans: A class of drugs designed to stop acute migraine attack after it begins. By using triptans, you may be able to avoid not only headache pain but also sensitivity to light and sound, nausea, and other migraine symptoms. Common Triptans include Imitrex® and Zomig®.
- Antiemetics: These medications help control nausea.
- Anti-convulsants: Certain anti-seizure medications are often used prophylactically to prevent migraine attacks. The ones most commonly used to avoid migraines are sodium valproate (Depakote® and Depakote® ER) and topiramate (Topamax®)
- Antihypertensives: Beta-blockers and other antihypertensive drugs help lower blood pressure, helping to prevent migraines.
Antidepressants: A few antidepressant medications, such as venlafaxine, may also help prevent migraine attacks.
Migraine Prevention Techniques
Avoid Migraine Triggers
If you suffer from migraine, you’ll need to learn your triggers. Your doctor will probably have you record your diet, exercise routine, sleep schedule, smells, and other events to identify your triggers. (Please see the section regarding migraine triggers earlier in this article.)
Once you’ve discovered your triggers, you have a good chance of reducing your number of migraine attacks. For example, if your triggers are certain foods, you can try to avoid them as much as possible. Or, if you notice you have bad migraines after a sleepless night, you can try to get more shut-eye.
More Natural Migraine Treatment/Prevention Strategies
Generally, any steps you take to improve your physical, mental, and emotional health will help prevent migraines. These include:
- Eat a balanced diet while avoiding your trigger foods
- Avoid skipping meals, as hunger can trigger a migraine
- Go to a quiet, darkened room as soon as you feel a migraine staring
- Get at least 8-9 hours of uninterrupted sleep each night
- Quit smoking
- Practice de-stressing techniques like meditation and deep breathing exercises
- Exercise regularly, as this can reduce stress
- Spend quality time with loved ones, as this can have a soothing effect on the brain
Migraine Fast Facts
Here are a few migraine statistics from the Migraine Research Foundation: (13)
- Migraine affects 39 million people in the U.S., including children. That’s 12% of the population.
- More than four million people suffer from chronic migraines, i.e., 15 or more migraine days a month.
- Over 20% of chronic migraine sufferers are disabled.
- Around 10% of school-age children suffer from migraine.
- Migraine takes an economic toll. For instance, “Healthcare and lost productivity costs associated with migraine are estimated to be as high as $36 billion annually in the U.S.” (14)
“More than 157 million workdays are lost each year in the US due to migraine.” (15)
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