Migraine Headache: Everything To Know

Migraine headaches are a are a type of painful and often debilitating headache. The pain goes beyond that of normal headache pain. Migraines usually occur with other symptoms such as nausea, vomiting and light and sound sensitivity. This guide will explore everything to know about migraine headaches including signs and symptoms, triggers, types of migraine medications and treatments, and other important facts.

What Is a Migraine Headache?

Migraines are a neurological condition with varying symptoms. Migraines are characterized by intense and throbbing head pain, but not all types of migraines include head pain. Different terms are often used to describe migraine pain. Some of the ways pain from migraines is described include:

  • Throbbing
  • Pounding
  • Pulsating

Some people experience migraines as more of a dull ache.

For most people, migraine pain affects one side of the head and usually, it’s the forehead. Some people do experience migraines on both sides of the head, or the pain might shift.

Typically migraines last for 4 hours, but some people experience them for much longer. Some migraine attacks may last as long as 72 hours, or even up to an entire week.


What Are the Symptoms of a Migraine Headache?

The specific symptoms of a migraine can vary depending on the type of migraine a person has. Symptoms can start anywhere from two days before the actual headache, and when this happens, it’s known as the prodrome stage.

Symptoms that are often seen during the prodrome stage include:

  • Food cravings
  • Fatigue
  • Low energy levels
  • Depression
  • Irritability
  • Yawning
  • Stiffness in the neck
  • Hyperactivity

If a person has migraine with aura, the aura happens during this stage.

Migraine with aura can cause symptoms such as:

  • Vision problems
  • Difficulty speaking
  • The feeling of tingling or prickling in the face, arms and legs
  • Seeing flashes or bright spots
  • Seeing shapes and other visual disturbances
  • Temporary vision loss

When an actual migraine headache attack occurs, symptoms may include:

  • Head pain
  • Increased light and sound sensitivity
  • Dizziness
  • Nausea
  • Feeling faint
  • Vomiting

Once a migraine attack is over, people may experience symptoms of the postdrome phase.

Postdrome phase symptoms include:

  • Emotional and mood changes
  • Fatigue
  • Apathy
  • A dull, mild headache

Nausea from a Migraine Headache

More than half of people who suffer from migraines experience nausea as a symptom. For some people, this symptom starts when the headache does, but for others, it can take around an hour to experience nausea.

For a lot of people, the symptoms of nausea and vomiting are as difficult to cope with as the actual headache. Vomiting can make it difficult to take oral migraine medications, then worsening the severity of the migraine.

What Causes Migraine Headaches?

People often wonder what causes a migraine headache, and there is typically not one particular answer. As with many neurological conditions, the factors leading to migraine are complex and multi-faceted.

Researchers believe there is a genetic component to people getting a migraine headache along with other factors. Possible factors linked to the development of migraine headache disorders include:

  • Genetics: If you have a family history of migraines you may be more likely to get them as well as compared to someone without a family history of migraines
  • Age: People are most likely to get their first migraine when they’re in their teens. For many migraine sufferers, they peak in their 30s and then as they get older, they start to become less severe.
  • Gender: Women are three times more likely than men to get migraines.
  • Brain Chemicals: There is something called the trigeminal nerve. This nerve is located in the head and operates the eyes and mouth. It is responsible for feeling sensations in the face and it’s a primary pain pathway. When someone’s serotonin levels decline at the beginning of a migraine, the nerve might then release neurotransmitters into the brain that cause pain.
  • Hormones: Changes in certain hormones can trigger migraines and other types of headache and this is one of the reasons they tend to affect women more than men. Estrogen, in particular, can cause migraines or make them worse. Using medications that affect hormones like hormone replacement therapy and birth control pills can make migraines worse for some women.
  • Stress: Anxiety and stress are significant triggers for migraines in many people. When someone is experiencing anxiety, stress or fear, there are brain chemicals released that can either trigger a migraine or make it worse.
  • Diet: Certain foods are known migraine triggers like artificial sweeteners, aged cheeses and process foods among others. If someone regularly skips meals, this can trigger migraines as well because it causes a drop in blood sugar levels. Alcohol and caffeine are common triggers of migraine headaches also as is monosodium glutamate or MSG.
  • Sensory Overload: If you experience sensory overload, it can be a migraine trigger. For example, bright lights, being in a loud place or strong smells can all trigger migraines for some people.
  • Sleep Patterns: Changes in sleep patterns including getting more or less sleep than usual can cause migraines.
  • Physical Strain
  • Changes in weather
  • Too Much Medicine: If you get migraines and take medication to treat them for more than ten days a month, you may be at risk for medication overuse headaches, also called rebound headaches.

How Are Migraines Diagnosed?

As with other medical conditions, a health care professional follows a set of certain criteria and guidelines to diagnose migraines.

International Headache Society (HIS) criteria for Diagnosing a Migraine

The International Headache Center publishes what’s called the “International Classification of Headache Disorders 3rd Edition,” or the ICHD-3.

The following are some excerpts from the ICHD-3 as far as migraines and how they’re diagnosed.

  • Migraine is a disabling primary headache disorder
  • Migraine is ranked as the third-highest cause of disability worldwide in males and females under the age of 50
  • There are two major types of migraine which are migraine without aura and migraine with aura

When a health care provider makes a diagnosis, it can help you rule out the potential that your headaches related to serious underlying conditions. Seeking a diagnosis can also help you learn more about the right treatment options for you, and you may be prescribed certain medications for migraines.

What Do Doctors Use to Diagnose a Migraine Headache?

There’s not one specific test that’s used to diagnose a migraine headache disorder. Instead, a doctor will usually start by taking a patient’s medical history into account, and they will do certain tests to rule out other conditions.

The healthcare provider will likely want to see a detailed history of the migraine headaches and the symptoms that may occur with an attack.

When making a diagnosis, a doctor will want to hear about the specific features of the headache such as how often they occur and how severe the pain is. They will also want to know the effect of the headaches on activities and functionality, and whether or not there is a family history of migraines or headaches.

A neurological assessment will also be completed. Sometimes a CAT or MRI scan might be done to take pictures of the brain. This isn’t to diagnose migraines—instead, these are tests done to rule out the potential for other underlying conditions that could be causing the migraines.

Because of the process used to diagnose migraines, it is extremely helpful to keep a migraine diary for at least a month before visiting a health care provider.


What Treatments Are Available for Migraines?

As far as migraine treatments, there are different options available. There are OTC migraine medications that are pain relievers, prescription migraine medications, natural remedies and lifestyle changes that someone can make to reduce the frequency and severity of attacks.

OTC Migraine Medications

Some of the over-the-counter medications that are used to treat migraines include:

  • Ibuprofen (Brand names Advil and Motrin)
  • Aspirin, acetaminophen, caffeine combination (Brand names Excedrin, Goody’s)
  • Acetaminophen (Brand names Excedrin Tension Headache and Tylenol)
  • Naproxen (Brand names Aleve)

Prescription Migraine Medications

Some of the prescription medications used to treat migraines include:

  • Ergo (Brand names DHE-45 injection, Ergomar, Migranal)
  • Triptans (Brand names Imitrex injection and oral, Zembrace injection)
  • Zolmitriptan (Brand name Zomig)
  • Rizatriptan (Brand name Maxalt)
  • Naratriptan (Brand name Amerge)
  • Almotriptan (Brand name Axert)
  • Eletriptan (Brand name Relpax)
  • Triptans with NSAID (Brand name Treximet)

All of the above prescription migraine medicines are abortive. This means they’re taken as soon as someone feels a migraine attack coming on to stop the symptoms or make it less severe. These are as-needed medications.

Preventative Prescription Migraine Medications

Along with abortive medications for migraines, there are preventative migraine treatments available. Typically preventative migraine medicines are prescribed to someone who has four or more migraine days a month.

Preventative migraine medicines are supposed to help reduce the frequency and severity of attacks.

Prescription preventative migraine medications include:

  • Tricyclic antidepressants
  • SNRI antidepressants such as Effexor and Cymbalta
  • Beta blockers like Inderal and Lopressor
  • Anticonvulsants like Topamax
  • CGRP inhibitors such as brand-name Acimovic
  • Botox

What Happens When Migraine Medicines Don’t Work?

For a lot of people, many migraine medicines both prescription and OTC don’t ultimately work. However, there are different things that can be done.

One of the best things to do is keep a very detailed headache diary. This is important because it can help identify patterns and hopefully triggers. Once you identify these triggers, you can avoid them and make the necessary lifestyle changes.

Visiting a headache specialist can also be helpful. Plus, with migraine medication, it can take time and experimentation to find what’s going to be most effective for you.

Including natural migraine remedies along with doctor-recommended treatments may prove useful also.


Migraine Headache Complications

Migraine headaches can be debilitating and extremely difficult to live with, but they’re not usually indicative of more severe underlying conditions. Sometimes, in rare cases, they can be, however.

Some of the possible migraine headache complications that can occur or underlying severe conditions that can be associated with migraines include:

  • A status migrainosus is a rare, severe form of a migraine attack with an aura that goes on for more than 72 hours. With status migrainosus, hospitalization may be required to treat the pain.
  • Migrainous infarction is a condition where a migraine is associated with a stroke. This may be the case if someone has a migraine headache with an aura lasting more than an hour. An aura that lasts longer than an hour can signify bleeding in the brain, and if you have an aura for more than an hour, seek medical attention immediately.
  • There is a condition called persistent aura without infarction. This is a complication of a migraine where an aura lasts for more than a week after the migraine attack. This isn’t indicative of bleeding in the brain but does require medical attention.
  • Migralepsy is a condition where an epileptic seizure is triggered by a migraine attack and the seizure usually occurs within an hour of a migraine. This is rare.
  • People who have migraines have around twice the risk of having a stroke. Women with migraines who also take an oral contraceptive are at an even greater risk of having a stroke.

Migraines and Mental Health Issues

People with migraines may be at a greater risk of having co-occurring mental health disorders. The increased risk is small but does exist. The mental health conditions that are more frequently associated with migraines include:

  • Major depression
  • Generalized anxiety disorder
  • Bipolar disorder
  • Panic disorder
  • Substance abuse disorders
  • Agoraphobia
  • Post-traumatic stress disorder (PTSD)

Migraines in Children

While most people don’t start struggling with migraines until adulthood, it is possible for children to have migraines. Most kids get tension headaches but around five percent of children may get migraines, and some get them as young as four years old.

Doctors aren’t sure what causes migraines in children, but believe it could be linked to various chemical changes in the brain and genetic components. For example, a parent who gets migraines might be more likely to have a child who also has migraines. It’s estimated that 7 out of 10 children with migraines have a close relative who has a history of migraine headache as well.

Migraine Facts and Statistics

The following are some interesting facts and statistics about migraine headaches:

  • In the United States, more than 38 million people are believed to suffer from migraines
  • There are some studies that estimate around 13 percent of adults in the U.S. have migraines
  • Anywhere from 2 to 3 million adults may have chronic migraines in the U.S.
  • Nearly 5 million people in the U.S. have at least one migraine attack a month
  • Migraines are the reason for moderate to severe disability for more than 11 million individuals
  • 18 percent of women have migraines and six percent of men do
  • Migraines most often affect people between the ages of 35 and 55
  • 91 percent of people who experience them say migraine attacks cause them to miss work or impair their functionality
  • A Canadian study showed 70 percent of responding migraine sufferers felt it caused relationship problems for them
  • 51 percent of migraine sufferers say they have halved their productivity at school or work

Finally, the most common symptoms experienced with a migraine headache beyond throbbing, pulsating pain are light sensitivity, sound sensitivity and nausea. To learn more about the different types of headaches that can occur such as a hemiplegic migraine, or a common migraine, read our post about the different categories of migraines and headaches.

Sources

WebMD. “Common Migraine Headache Symptoms.” Accessed February 27, 2019.

WebMD. “What To Do When Headache Treatments Don’t Work.” Accessed February 27, 2019.

Excedrin.com. “How Does a Doctor Diagnose a Migraine?” Accessed February 27, 2019.

ICHD-3.org. “The International Classification of Headache Disorders 3rd Edition.” Accessed February 27, 2019.

Healthline Editorial Team. “Migraine Complications.” Healthline. March 4, 2016. Accessed February 27, 2019.

Migraine.com. “Migraine Statistics.” Accessed February 27, 2019.

 

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