Migraine – Symptoms and Causes

Understanding Migraines

Migraines are more than just headaches. They’re a genetic neurological disease that affects millions of people worldwide. This condition varies widely in severity.

Some individuals experience occasional attacks while others face frequent, debilitating episodes that significantly impact their quality of life.

Who Experiences Migraines?

Migraines are surprisingly common, affecting:

• 1 in 5 women
• 1 in 16 men
• 1 in 11 children

Women are three times more likely to experience migraines than men. This is likely due to hormonal differences. The condition has strong genetic links. Children of migraine sufferers have approximately a 50% chance of developing the condition themselves.

Common Migraine Triggers:

• Hormonal fluctuations (menstruation, pregnancy, perimenopause)
• Certain medications
• Alcohol consumption (especially red wine)
• Caffeine intake
• Stress
• Sensory stimuli (bright lights, strong smells)
• Sleep pattern changes
• Weather changes
• Missed meals
• Specific foods (aged cheeses, processed foods)

Recognizing Migraine Symptoms

Migraines present differently from person to person, but typical symptoms include:

Primary Symptoms

• Intense, throbbing head pain (often on one side)
• Nausea and vomiting
• Sensitivity to light and sound
• Significant interference with daily activities

Prodrome Phase (Early Warning Signs)

Many people experience subtle warning signs hours or days before the actual headache begins:

• Constipation
• Mood changes
• Food cravings
• Neck stiffness
• Increased urination
• Frequent yawning

Aura Phase

About one-third of migraine sufferers experience aura symptoms before or during an attack. These temporary neurological symptoms typically develop gradually over several minutes and can last up to an hour:

• Visual phenomena (geometric shapes, bright spots, flashing lights, vision loss)
• Numbness or tingling sensations on one side of the face or body
• Speech difficulties

Post-Drome Phase

After the headache subsides, many people feel:

• Drained
• Confused
• Washed out

These feelings can persist for up to a day following an attack.

Diagnosing Migraines

Migraines are diagnosed based on clinical symptoms reported by the patient. There are no specific laboratory tests or imaging studies that can definitively confirm or rule out migraines.

A healthcare provider may use screening criteria based on these key symptoms:

• Headache
• Light sensitivity
• Decreased functional ability
• Nausea

Anyone experiencing these symptoms should consult a healthcare professional for proper diagnosis and treatment.

Treatment Approaches

Treatment plans vary based on the frequency and severity of migraine attacks:

• Acute (Rescue) Treatments: These medications help manage symptoms during an active migraine attack. They work best when taken early in the attack.
• Preventive Treatments:
  • For those with frequent or severe migraines, preventive treatments can reduce both the frequency and severity of attacks. Options include:
  • Daily oral medications
  • Monthly injections
  • Quarterly injections or infusions

The SEEDS Method for Managing Triggers

Lifestyle modifications can significantly help manage migraine triggers:

Letter	Represents	Recommendations
S	Sleep	Maintain a consistent sleep schedule; reduce screen time before bed
E	Exercise	Start with just 5 minutes weekly; gradually increase duration and frequency
E	Eat	Consume balanced meals at least three times daily; stay hydrated
D	Diary	Track migraine days and symptoms using a calendar or app; share with healthcare provider
S	Stress management	Consider therapy, mindfulness, biofeedback, or other relaxation techniques

Moving Forward with Migraine Management

While migraines can be disabling, proper management strategies can significantly improve quality of life:

1. Recognize the reality: Migraines are not “just headaches” but a genuine neurological condition.

2. Communicate honestly: Be forthright with healthcare providers, employers, and loved ones about symptoms and needed support.

3. Prioritize self-care: During attacks, make personal well-being the top priority.

4. Establish consistency: Regular sleep patterns and daily routines can reduce attack frequency.

5. Explore treatment options: Work with healthcare providers to find migraine-specific treatments that work for individual needs.

Signs and Warning Signals

In the day or two before a migraine begins, your body may send early warning signals. You might experience constipation or feel changes in your mood—ranging from feeling sad to unusually happy.

Some people crave certain foods, feel stiffness in their necks, or need to urinate more often. You might also notice fluid buildup in your body or find yourself yawning frequently.

Visual Disturbances

Some people experience what doctors call an “aura” before or during their migraine. These temporary nervous system symptoms often affect vision but can include other changes too.

Each symptom typically starts slowly, gets stronger over several minutes, and can last up to an hour.

Common aura symptoms include:

• Seeing unusual shapes, bright spots, or flashing lights
• Temporary vision loss
• Tingling feelings in arms or legs
• Weakness or numbness on one side of the face or body
• Trouble speaking

Pain Phase

Without treatment, a migraine attack typically lasts between 4 and 72 hours. How often these attacks happen varies greatly—some people rarely have them while others suffer several times each month.

During the pain phase, you might experience:

Symptom	Description
Head pain	Often on one side but can affect both sides
Pain quality	Throbbing or pulsing sensation
Sensitivities	Discomfort from light, sound, and sometimes smells or touch
Digestive issues	Nausea and vomiting

Recovery Period

After a migraine ends, you may feel exhausted, confused, or drained for up to a day. Some people feel unusually happy during this recovery time. Moving your head suddenly might briefly bring back the pain.

When to Contact a Doctor

If you often have migraine symptoms, keep track of your attacks and treatments. Then talk with your doctor about them.

Seek immediate medical care if you experience:

• A sudden, severe headache that feels like the worst you’ve ever had
• Headache with fever, stiff neck, confusion, seizures, double vision, or weakness
• Headache after hitting your head
• Headache that worsens with coughing or sudden movements
• New headache pain starting after age 50

Even if you’ve had headaches before, see your doctor if your headache pattern changes or your headaches feel different than usual.

What Causes Migraines

Scientists don’t fully understand what causes migraines, but they believe both genetics and environment play important roles. Research suggests changes in the brainstem and how it interacts with the trigeminal nerve (a major pain pathway) might trigger migraines.

Brain chemical imbalances, especially serotonin, which helps control pain signals, may also contribute. Scientists are currently studying serotonin and other chemicals like calcitonin gene-related peptide (CGRP) to better understand their role in migraine pain.

Common Migraine Triggers

Many factors can set off migraines in people who are prone to them:

• Hormones: Women often get migraines due to changes in estrogen levels before or during periods, pregnancy, or menopause. Birth control pills can worsen migraines for some women but improve them for others

• Beverages: Alcohol (especially wine) and too much caffeine can trigger attacks.

• Stress: Tension at work or home is a common trigger.

• Sensory overload: Bright or flashing lights, loud noises, and strong smells like perfume or paint can spark migraines.

• Sleep issues: Both too little and too much sleep can cause problems.

• Physical activity: Intense exercise or even sexual activity might trigger migraines.

• Weather: Changes in weather patterns or barometric pressure can bring on headaches.

• Medication: Some drugs, like birth control pills and heart medications, can make migraines worse.

• Diet factors: Problem foods often include:

  • Aged cheeses
  • Salty or processed foods
  • Skipped meals
  • Food additives like MSG and aspartame

Risk Factors

Several factors can increase your chance of getting migraines:

• Genetics: Having a family member with migraines raises your risk of developing them as well.

• Age: While migraines can start at any point in life, they often begin during teen years. Most people experience their worst migraines in their 30s, with symptoms becoming less severe as they age.

• Gender: Women experience migraines three times more frequently than men.

• Hormone Fluctuations: Women may notice migraine patterns linked to their menstrual cycle. Pregnancy and menopause can also affect migraine frequency and intensity, with many women finding relief after menopause.

Complications

Taking pain medicine too often can lead to medication-overuse headaches. This risk is especially high with combinations of aspirin, acetaminophen (Tylenol), and caffeine.

You might develop these headaches if you use:

• Aspirin or ibuprofen (Advil, Motrin IB) for more than 14 days each month
• Triptans like sumatriptan (Imitrex, Tosymra) or rizatriptan (Maxalt) for more than 9 days monthly

These headaches happen when pain medications stop working and actually start causing headaches themselves. This creates a harmful cycle where people take more medicine to stop the pain, but this only makes the problem worse.