Everything You Need to Know About Migraine

Medically Reviewed By Susan W. Lee, DO
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Migraine is a common condition that affects millions of people. It is often debilitating. However, treatments for the condition are available. Migraine is a medical condition affecting approximately 39 million people in the United States. It is the most common form of disabling headaches that impair daily productivity. The pain from a migraine episode is intense throbbing that typically begins on one side of the head. 

This article will further define migraine. It will also discuss the phases, types, symptoms, causes, and treatments of the condition.

What is migraine?

Female sitting and covering her eyes with her hand
Demetr White/Stocksy United

Migraine headaches are a primary headache, meaning other medical conditions are not the cause. The migraine happens independently.

It is thought that a chain of events brought on by triggers leads to neuroinflammation. This affects the nerves and causes the release of neuropeptides, which leads to migraine symptoms and pain.

About 12% of people in the U.S. experience migraine. They report moderate to severe throbbing pain, usually on one side of the head. Some experience light and sound sensitivity and nausea. Some people experience zigzag lines, flashing lights in their vision, or temporary vision loss

Both children and adults can experience migraine. It is thought genetics may play a role, as most people with migraine have a family history of it. 

What are the phases of migraine?

There are distinct phases of migraine, and understanding them can help you manage your symptoms better.

Prodrome phase

Also called the premonitory phase or “preheadache,” prodrome phase signals the beginning of a migraine episode. This phase can last a few hours to a few days. 

Most people with migraine experience the prodrome phase but not necessarily for each migraine episode. Symptoms vary from person to person and include:

Aura phase

Not everyone with migraine experiences aura, but up to one-third do. Symptoms of the aura phase involve the visual field and may include blurry vision or vision loss.

Other symptoms include:

  • flashing or shimmering lights
  • blind spots
  • the appearance of geometric patterns

The duration of the symptoms is typically at least 5 minutes and up to 60 minutes. Not all auras lead to a headache. However, they are a common warning sign of a potential migraine.

Headache phase

There is a throbbing pain that typically begins on one side of your head that lasts for several hours to up to 3 days. Some people with migraine experience mild pain, while others have debilitating pain. The pain sometimes shifts from one side of the head to the other.

Other symptoms include:

  • nausea
  • insomnia
  • anxiety
  • light or sound sensitivity

Some people cannot participate in usual activities during the headache phase because of the pain. 

Postdrome phase

Sometimes called the “migraine hangover,” the postdrome phase usually happens after the headache phase has ended. Not everyone experiences this phase, but approximately 80% of people with migraine do.

Even though the headache phase is over, the postdrome phase is sometimes just as debilitating. 

Symptoms include:

What are the types of migraine?

There are several types of migraine. The main types are migraine with aura and migraine without aura. Other types include:

  • Abdominal migraine: Usually, this type of migraine affects children and involves moderate to severe abdominal pain lasting 1–72 hours. Other symptoms may include loss of appetite, nausea, and vomiting.
  • Migraine with brainstem aura (previously Basilar type): Typically, this type of migraine affects children, adolescents, and young adults. However, it can affect anyone. Symptoms include changes in vision such as partial loss, total loss, or double vision. People may also experience feeling dizzy, loss of balance, or poor muscle coordination. A throbbing headache may hit suddenly on both sides at the back of the head. 
  • Hemiplegic migraine: This is a rare but severe form of migraine. It causes temporary paralysis on one side of the body, which sometimes lasts for days. Other symptoms include vertigo and trouble seeing, speaking, or swallowing. 
  • Menstrually related migraine: Typically, this type of migraine affects people 2 days before to 3 days after menstruation, though it can also happen at other times of the menstrual cycle. Symptoms include pulsing pain on one side of the head, aura, nausea, vomiting, and light and sound sensitivity. 
  • Migraine aura without headache: This type of migraine, also called silent migraine, does not typically include head pain but involves other symptoms such as visual problems, aura, nausea, vomiting, and constipation
  • Retinal migraine: This type is also known as ocular migraine. There is visual loss or problems in one eye during the headache phase of this migraine. This type can also have symptoms that are similar to those of migraine with visual aura. However, they tend to be more severe and intrusive.
  • Status migrainosus: This is a rare but painful form of acute migraine. Status migrainosus causes disabling pain and nausea lasting for 72 hours or longer. The pain and nausea are often so severe that the person experiencing the migraine requires hospitalization. 

Read nine things doctors want you to know about migraine here.

What are the symptoms of migraine?

The most common migraine symptom is moderate to severe head pain. However, migraine does not always include a headache. In the same way, not all headaches are migraine.

Symptoms of migraine vary from person to person but commonly include:

  • neck pain
  • body chills
  • phantom smells
  • brain fog
  • insomnia
  • sinus issues
  • dizziness or vertigo
  • mood changes
  • light or sound sensitivity
  • allodynia, which is an extreme sensitivity to things that do not typically cause pain, such as a light touch

What are the causes and triggers of migraine?

Researchers do not know the exact cause of migraine but believe it is due to changes in the levels of chemicals produced in the brain.

Genetics may link to migraine, as most people who experience migraine have a family history of the condition. 

There are many factors that can trigger migraine. The triggers typically vary from person to person.

Physical migraine triggers

Physical migraine triggers include:

  • lack of sleep or too much sleep
  • skipping meals
  • stress
  • anxiety
  • hormonal changes during the menstrual cycle

Environmental migraine triggers

Environmental triggers include:

  • loud noises
  • strong odors
  • bright lights
  • changes in weather

Food-related migraine triggers

Eating and drinking habits that can trigger a migraine include:

  • drinking red wine and other alcohol
  • drinking too much caffeine
  • withdrawing from caffeine
  • eating food that has nitrates
  • eating foods with monosodium glutamate
  • eating foods that contain tyramine
  • consuming foods or drinks with the sweetener aspartame

What are the risk factors for migraine?

Migraine has possible strong genetic factors. It may have more than one genetic source. 

Having a menstrual cycle also puts you at higher risk. After menopause, your risk typically decreases. 

Migraine is more common in females than in males. Around 3 out of 4 people who experience migraine are female.

How do doctors diagnose migraine?

Your doctor will ask you questions about your medical history and what current medications, vitamins, and supplements you are taking. They may also ask about your family history of migraine.

They will need to know about your symptoms and may ask questions such as:

  • When did your headaches start?
  • Where does it hurt?
  • Can you rate your headache pain on a scale of 1–10?
  • What are the characteristics of the pain?
  • How long does the pain last?
  • Have your headaches changed over time?
  • How frequently do you get your headaches?
  • Have you pinpointed any triggers?
  • Do you have other symptoms with your headaches?
  • Is your headache sleep-related?
  • What methods have you tried for relief, and have they worked?

In some situations, your medical team may order a CT scan or MRI scan of your head to aid in diagnosis. 

Benefits of keeping a migraine journal

There are many details your doctor will ask about. To give them the most accurate information, keeping a headache journal is often helpful. When you feel a migraine beginning, ask yourself the following questions:

  • What is your current stress level?
  • How much sleep have you been averaging?
  • What have you recently eaten?
  • Have you skipped any meals?
  • Have you been around strong odors or bright lights?
  • What has your caffeine and alcohol intake been over the past couple of days?

Also, take note of the location of the pain, if any. Record when it starts and how it feels. Keep notes on what you take to try and bring relief and the outcome. 

Jot down any other symptoms you experience before, during, and after your headache.

These details will help your doctor determine what type of migraine you are experiencing and develop a treatment plan.

Read more about how doctors treat and diagnose migraine.

What are the treatment options for migraine?

Migraine is not curable. However, it is treatable. Typically, a combination of medications and lifestyle changes works best for managing migraine. 

Lifestyle changes to reduce the frequency of migraine

Changing some lifestyle habits may help decrease the frequency of your migraine episodes.

These include the following:

  • Learn and avoid your triggers.
  • Set a sleep schedule.
  • Eat a healthy diet and do not skip meals.
  • Exercise regularly.
  • Limit your caffeine and alcohol intake.
  • Learn stress coping techniques and try to reduce unnecessary stress.

Medications to treat migraine

For some people, over-the-counter medications such as acetaminophen (Tylenol), aspirin, or nonsteroidal anti-inflammatory drugs, including ibuprofen (Advil), can relieve mild headaches. 

If these medications do not help, there are three other classes of medications your medical professional may suggest trying. These are:

  • triptans
  • ergot derivatives
  • CGRP antagonists

Medications for migraine typically work best when taken as soon as symptoms first start. Always have your migraine medication with you.

Work with your doctor to find the right treatment plan for you.

Other frequently asked questions

These are some more questions people have asked about migraine. The answers have been reviewed by Susan W. Lee, D.O.

What happens during a migraine episode?

Researchers believe that specific triggers cause chemical changes in the brain, leading to inflammation and a migraine episode. During the migraine episode, you may experience an aura along with mild or severe throbbing pain that starts on one side of the head. You may also have other symptoms, such as sensitivity to light and noise, nausea, and vomiting.

What causes migraine aura?

Researchers are not sure what causes migraine to have auras and why some migraine types do not have them. They are often a signal that a migraine episode is beginning. 

Summary

Migraine is a common and debilitating medical condition that many people experience.

There are several different types of migraine headaches, each with its own unique symptoms. Although there is currently no cure, your doctor can help you develop a treatment plan that works for you.

If you are experiencing migraine, contact your doctor.

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Medical Reviewer: Susan W. Lee, DO
Last Review Date: 2022 May 30
View All Migraine and Headache Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.