Migraine is a condition that causes severe, recurring headaches and other symptoms. It is more than just a source of headaches; it is a neurological condition that can pose a variety of symptoms as well. The headaches are often debilitating, but there may also be other symptoms:
- Having trouble speaking
- Tingling or numbness
- Sensitivity to lights and sounds
The condition can occur at any age and is often inherited. Migraines are more common in women than in men who are assigned female at birth.
An accurate migraine diagnosis can only be made by looking at the clinical history, examining the symptoms, and ruling out other causes. There are three main types of migraine headaches (or attacks): episodic, chronic and aural.
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Different migraine types exist. The most distinguishing characteristic is whether the migraine is accompanied by sensory changes – aura.
Migraine with aura
An aura is a sensory disturbance that occurs in early migraine episodes.
An aura can be caused by:
- Thinking or experiencing things that are confusing
- Seeing strange lights or sparkling lights that don’t exist
- Seeing zigzag lines of light
- Being blind or seeing blank spots
- Feeling pins and needles in arms or legs
- Trouble speaking
- Having problems with your neck, shoulders or limbs
- The act of seeing things out of one eye that are not there, such as transparent strings of objects
- Unable to see a section clearly
- Disappearing sections of one’s field of vision
A visual aura can be felt like the aftermath of a bright camera flash, and the visual changes can last anywhere from a few minutes to an hour. First-time aura patients need to consult a physician to rule out serious neurological illnesses such as strokes or brain tumors.
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Migraine without aura
Migraine without aura usually occurs without any sensory disturbance prior to the attack. Approximately 70–90% of episodes of migraine occur without aura, according to the Migraine Trust.
There are several types of migraine, including:
- Chronic migraine: People with chronic migraine have episodes more than 15 times a month.
- Menstrual migraine: It occurs around the time of the menstruation cycle.
- Hemiplegic migraine: Temporary weakness occurs on one side of the body due to this condition, and it is extremely rare.
- Abdominal migraine: Migraines that involve the stomach and abdominal pain, often accompanied by nausea or vomiting, fall into this category. The condition is most prevalent among children younger than 14 years of age.
- Vestibular migraine: People with this condition often experience severe vertigo.
- Basilar migraine: It is also known as “migraine with brain stem aura.” This rare type can affect speech and neurological functions.
It is recommended that those experiencing neurological symptoms seek medical help. People suffering from migraines are advised to consult a doctor.
Migraine symptoms vary from person to person. Many people experience them in stages. Some of these stages are:
Approximately 60% of people with migraines notice one or more of these symptoms hours or days before they get a headache:
- Light sensitivity, sound sensitivity or a strong smell
- No appetite or food cravings
- Mood changes
- Severe thirst
- Diarrhea or constipation
Symptoms associated with your nervous system, often affect your vision. It usually starts slowly, over a period of five to twenty minutes, and lasts less than an hour. Possible symptoms include:
- Seeing wavy lines, black dots, or things you don’t see (hallucinations)
- Having tunnel vision
- Not seeing anything at all
- Numbness or tingling on one side of your body
- Trouble speaking clearly
- Legs and arms feel heavy
- Ears feel ringing
- Smells, tastes, and textures change
Sometimes migraine headaches start out as a dull ache and become throbbing. Physical activity tends to aggravate migraine headaches. Pain can affect your whole head, change from side to side or feel as though it’s spreading throughout your head.
It is estimated that about 80% of people experience nausea, headaches and vomiting. Other symptoms may include paleness and faintness.
Chronic migraine headaches can last for up to 3 days, but most of them last about 4 hours. The average person suffers two to four headaches every month. People who suffer from migraine headaches on a regular basis receive them less often.
Headaches sometimes last for a few days after they occur. The following symptoms may occur:
- Feeling tired, drained or irritable
- An unusual feeling of happiness or rejuvenation
- Muscle aches or weakness
- Cravings for food or no appetite
What does migraine feel like?
Most people say it feels like:
Sometimes it feels like a dull ache. Sometimes it starts out mild. If left untreated, it can become more serious.
Forehead pain is the most common type of migraine. They usually affect one side of the head, but they can also affect both sides at the same time.
Migraine attacks usually last between four and eight hours. It’s possible for them to last for up to a week if they’re not treated. The pain may occur along with or independently of an aura in migraine with aura.
What causes migraine attacks?
It is not known what causes migraine attacks. The condition is still thought to be associated with abnormal brain activity, which leads to abnormal nerve signaling, chemical changes, and blood vessel changes.
The following triggers are regularly reported to cause migraines:
- Bright lights
- Extreme heat
- Barometric pressure changes
- Menstruation, pregnancy, menopause, and changes in estrogen and progesterone levels experienced by people assigned female at birth
- High stress levels
- Loud sounds
- Intense physical activity
- Skipping meals
- Sleep disturbances
- Certain medications, including oral contraceptives and nitroglycerin, can cause these side effects
- Unusual smells
- Certain foods
- Alcohol use
Keep a headache journal if you experience a migraine attack. By identifying your migraine triggers, you can reduce the likelihood of recurring migraine attacks.
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It is recommended by the International Headache Society that migraines without aura be diagnosed using the “5, 4, 3, 2, 1” criteria. Each number represents one of the following:
- Five or more episodes lasting between four hours and three days each
- Two or more of these symptoms at one time:
- Occurring on one side
- Induces moderate-to-severe pain when activity is performed
- Also includes 1 of the following symptoms:
- Sensitivity to light
- Sensitivity to sound
If the symptoms are not caused by a tumor, meningitis, or stroke, the doctor may recommend imaging or other tests to rule those out.
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Treatment for migraines
There is no cure for migraines, but your doctor can provide you with the tools you need to manage migraine attacks when they occur, which may lead to fewer attacks in general. You can also reduce migraine symptoms with treatment.
There are several factors that determine your treatment plan:
- Age of the patient
- How frequently do you experience migraine attacks?
- How severe the migraines are?
- The severity of your migraines depends on how long they last, how much pain you experience, and how often they prevent you from going to work or school
- It also depends on whether they cause nausea or vomiting
- It also depends on whether or not you take other medications
You might need to take a combination of the following:
- Making lifestyle adjustments, avoiding migraine triggers and managing stress
- NSAIDs and acetaminophen (Tylenol) are OTC pain relievers or migraine medications
- Take prescription migraine medications every day to reduce your migraine headache frequency and prevent migraines
- Medications prescribed by your doctor to ease migraine symptoms and prevent attacks from becoming severe
- Medications prescribed for nausea and vomiting
- If migraines happen during your menstrual cycle, you may benefit from hormone therapy.
- A complementary or alternative treatment, such as mediation, acupressure or acupuncture
You can use medications to prevent migraine attacks from occurring as well as treat them once they occur. There are OTC medications that can provide relief. If over-the-counter medications fail to work, your doctor may prescribe another medication.
If you suffer from migraines or any other ailment, the best treatment for you will depend on its severity.
Migraines can be treated acutely by taking these medications:
- NSAIDs: In the case of mild-to-moderate attacks without nausea or vomiting, medications like ibuprofen or aspirin are often prescribed.
- Triptans: Patients with nerve pain as a symptom of migraine attacks typically turn to medications like sumatriptan, eletriptan, and rizatriptan for relief.
- Antiemetics: As NSAIDs typically help decrease nausea, nausea-reducing medications like metoclopramide, chlorpromazine, and prochlorperazine may be used in conjunction with them.
- Ergot alkaloids: Migranal and Ergomar, which act as narcotics, aren’t prescribed that frequently and are usually used only when triptans or analgesics don’t work.
Preventative medications – People who suffer debilitating migraine attacks more than four times a month can take these medications once a day or through injection every three months. This medication includes:
- Antihypertensives: Patients with high blood pressure are prescribed these medications, as well as migraine sufferers. A few examples of antihypertensive medications used to treat migraines include beta-blockers and angiotensin receptor blockers (candesartan).
- Anticonvulsants: Migraines can also be prevented by certain anti-seizure medications.
- Antidepressants: There is also some evidence that certain antidepressants, including amitriptyline and venlafaxine, can prevent migraines.
- Botox: It is administered every three months to inject Botox into the head and neck muscles.
- Calcitonin gene-related peptide treatments: They are administered either as injections or via intravenous access and prevent migraines in the first place.
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Some foods or food ingredients may trigger migraine attacks more than others. However, triggers can vary greatly based on individual characteristics. Some of these include:
- Drinking alcohol or caffeine
- The use of preservatives such as nitrates (used to preserve meat), aspartame (an artificial sweetener), or monosodium glutamate (MSG)
- Tyramine is a naturally occurring substance found in some foods
It is also produced during the fermentation or aging process. You can find them in foods such as aged cheeses, sauerkraut and soy sauce. Tyramine is under investigation as a trigger, but it may not be as strong as believed previously.
Migraine can be caused by a number of factors:
- Hormonal triggers in people born female
- Insufficient sleep
- Hard exercise (not often)
- Bright lights
- Climate changes
- Hormone replacement therapy drugs
You can identify your specific migraine triggers by keeping a journal.
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How to prevent migraine episodes
There may not be a way to completely prevent migraine attacks, but there are ways to reduce their severity and frequency.
People who suffer from severe migraines may find relief from their symptoms with the following prescription medications:
- Trokendi XR (topiramate), an antiseizure drug
- Propanolol (Inderal), used to treat high blood pressure
- Antidepressant medications
- Gepants and CGRP inhibitors
This procedure may take a couple of weeks to work.
Children and adolescents may need a different treatment from adults. They can be helped by a healthcare professional.
Recognizing and avoiding triggers
Migraine attacks can sometimes be precipitated by a trigger. Someone may keep a diary to keep track of how they feel as well as what they did, ate, and drank before symptoms appeared.
The following should be avoided:
- Low blood sugar
- Physical overexertion
- Especially chocolate and foods containing tyramine or MSG
- HRT and some kinds of birth control pills
- Lighting that flickers
Here are some strategies that may help to reduce migraine frequency:
- Get enough sleep
- Reduce your stress level
- Drink plenty of water
- Maintain a healthy posture
- Food triggers such as alcohol, caffeine, and cheese should be avoided
- Exercising regularly is also recommended
It may be necessary to consider medication or other options if making these changes does not reduce migraine severity or frequency.
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When to visit the doctor
People with migraines should seek medical attention if they experience:
- Symptoms of a migraine for the first time
- Symptoms that worsen or are unusual
- Severe symptoms
Seek medical attention if you experience any of the following symptoms:
- Headaches that seem to be getting worse
- Visual disturbances
- Sensory loss
- Speech difficulty
Other health problems, like a stroke, could indicate the need for immediate medical attention.
Migraines are medical conditions that cause headaches and other symptoms. The problems are not limited to headaches and can affect your daily life significantly, making it difficult to work and do everyday things.
It is often possible to reduce the frequency and severity of episodes by identifying and avoiding triggers, but this is not always possible.
Patients with migraines may find relief from the symptoms through medications and other treatments. People with concerns should speak with their healthcare provider.