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Table of contents
OverviewCommon symptoms of migraineCauses and other migraine triggersSeeking medical adviceMigraine in women: Hormonal considerationsPromising research and future directionsSources
Navin Khosla NowPatientGreen tick
Medically reviewed by Navin Khosla, BPharm and written by Rajive Patel, BPharm - Updated on 26 Jan 2024
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A migraine is more than just a type of headache. It is a neurological condition that often presents as a severe and throbbing pain on one side of the head. Many individuals remain undiagnosed or do not receive the appropriate treatment. While the exact cause of migraines is unknown, researchers believe that changes in the brain and genetics play a role. Migraines can be triggered by various factors, including hormonal changes, stress, certain foods, lack of sleep, and environmental factors. In this comprehensive guide, we will explore the symptoms, causes, and treatments of migraines. From understanding the different types of migraines to finding effective ways to manage and prevent attacks, we have you covered.

Common symptoms of migraine

Migraine symptoms can vary from person to person, but there are common indicators that can help identify a migraine. The hallmark of migraine is a moderate to severe head pain that may be throbbing or pulsating. Other symptoms include nausea, sensitivity to light, noise, and smells, as well as worsening of pain with physical activity.

Migraines are often accompanied by various symptoms that can greatly impact an individual’s daily life. It is important to recognize these symptoms to seek appropriate treatment and manage migraines effectively. A migraine attack consists of four distinct phases: prodrome, aura, headache, and postdrome. Not all individuals experience every phase, and the duration of each phase can vary. The prodrome phase may precede the attack by several hours or days and is characterized by changes in mood, food cravings, and fatigue. Aura, experienced by about 20% of individuals, involves neurological symptoms such as visual disturbances or tingling sensations. The headache phase is marked by intense head pain, while the postdrome phase is often referred to as the “migraine hangover,” where individuals may feel fatigued and experience difficulty concentrating.

Prodrome symptoms

Before a migraine attack, individuals may experience prodrome symptoms, which serve as early warning signs. These symptoms can include:

  • Fatigue and excessive yawning
  • Food cravings or changes in appetite
  • Mood changes
  • Increased thirst
  • Gastrointestinal symptoms such as bloating, constipation, or diarrhea

Aura symptoms

Aura symptoms typically occur before or during a migraine attack and can vary from person to person. These symptoms may include:

  • Visual disturbances, such as seeing zigzag lines or flashing lights or bright lights
  • Numbness or tingling sensations, resembling pins and needles
  • Dizziness
  • Difficulty speaking or finding the right words
  • Changes in smell, taste, or touch

Headache Phase symptoms

The headache phase is the most recognizable and debilitating phase of a migraine attack. Common symptoms during this phase include:

  • Intense and throbbing headache, typically on one side of the head
  • Sensitivity to light and sound
  • Nausea and vomiting
  • Pale complexion and feeling clammy
  • Fatigue and difficulty concentrating

Postdrome symptoms

Following a migraine attack, individuals may experience postdrome symptoms, also known as the migraine hangover. These symptoms may include:

  • Feeling tired, fatigued, or irritable
  • Muscle pain or weakness
  • Food cravings or lack of appetite

Causes and other migraine triggers

The exact causes of migraines are still not fully understood, but both genetic and environmental factors play a role. Migraine often runs in families, suggesting a hereditary link. While some individuals experience spontaneous attacks, others may have identifiable triggers such as stress, certain foods, hormonal changes, or changes in the environment.

Risk factors and demographics

Migraines can affect anyone, but certain risk factors and demographics increase the likelihood of experiencing them. Women are three times more likely than men to have migraines, and hormonal changes, such as those occurring during menstruation, can influence the frequency and severity of attacks. Additionally, individuals with a family history of migraines or other medical conditions like depression, anxiety, or epilepsy may be more prone to developing migraines.

Diagnosing migraine

Diagnosing migraines relies on a thorough assessment of symptoms and medical history. There are no specific tests to confirm a migraine, so doctors rely on patient reports and physical examinations to make an accurate diagnosis. It is important to rule out other underlying causes of headaches through additional tests like brain imaging or blood tests.

Types of migraine

There are different types of migraines, each with its own set of symptoms. The most common types include:

  • Migraine without aura (common migraine): This type of migraine is characterized by a severe headache without any warning signs or visual disturbances
  • Migraine with aura: Migraine with aura is characterized by the presence of warning signs, called aura, before the onset of a headache. These warning signs can include visual disturbances, such as seeing zigzag lines or flashing lights, numbness or tingling sensations, dizziness, and difficulty speaking
  • Silent migraine: Silent migraines, also known as migraine aura without a headache, present with aura symptoms but without the accompanying headache pain
  • Menstrual migraine: This type of migraine is linked to hormonal changes, typically occurring in women before, during, or after their menstrual periods
  • Vestibular migraine: Vestibular migraines are characterized by balance problems, vertigo, nausea, and vomiting, with or without a headache
  • Abdominal migraine: Abdominal migraines mainly affect children and present with stomach pain, nausea, and vomiting
  • Hemiplegic migraine: These types of migraine may cause temporary paralysis or sensory changes on one side of your body
  • Retinal migraine (ocular migraine): You may experience temporary, partial or complete loss of vision in your eyes, accompanied by a dull ache behind the eye which may spread to other parts of your head
  • Chronic migraine: This is a migraine that occurs for at least 15 days each month. Symptoms and severity of the pain may change frequently
  • Migraine with brainstem aura: Symptoms of migraine may include vertigo, slurred speech, double vision or loss of balance, occurring before the headache
  • Status migrainosus: This type of migraine is more rare and severe and can last longer than 72 hours. Pain and nausea can be especially bad

Seeking medical advice

If migraines are severe, frequent, or significantly impacting daily life, it is advisable to seek medical advice from a healthcare professional. A doctor can provide a comprehensive evaluation, diagnose migraines, and recommend appropriate treatment options based on individual needs.

Migraine treatment options

While there is no cure for migraines, several treatment options can help alleviate symptoms and improve the quality of life for individuals living with migraines. Options, for the treatment of migraine can be classified into acute (immediate relief during an attack) and preventive (reducing the frequency and severity of migraines) methods.

Acute medications

The goal of acute treatment is to alleviate the pain and symptoms during a migraine attack. Over-the-counter pain relievers, prescription medications like triptans or ergotamines, and devices that alleviate pain can be used to manage migraines effectively. Early intervention is crucial in the effectiveness of these treatments. Acute medications, also known as abortive or rescue medications, are taken during a migraine attack to relieve symptoms. Common acute medications include:

  • Pain relievers: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and acetaminophen can help alleviate mild to moderate migraine pain
  • Triptans: Triptans (such as almotriptan, eletriptan, rizatriptan, or sumatriptan) work by narrowing blood vessels and reducing inflammation in the brain. They are available in various forms, including oral tablets, nasal sprays, and injections
  • Anti-nausea medications: Medications such as metoclopramide or prochlorperazine can be used to alleviate nausea and vomiting associated with migraines

Preventive measures for migraine

Preventive treatment aims to reduce the frequency, severity, and duration of migraines by addressing the underlying causes and triggers. Medications such as beta-blockers, antidepressants, or anticonvulsants may be prescribed for long-term use. Additionally, lifestyle changes, stress management techniques, and identifying and avoiding triggers can be effective preventive measures. Preventive medications are taken regularly to reduce the frequency and severity of migraines. These medications are suitable for individuals who experience frequent or severe migraines. Common preventive medications include:

  • Beta-blockers: Medications like propranolol (also used to treat angina and high blood pressure) can help reduce the frequency of migraines by relaxing blood vessels and decreasing the excitability of nerve cells
  • Antidepressants: Certain antidepressants, such as amitriptyline, can be effective in preventing migraines by altering the levels of neurotransmitters in the brain
  • Anti-seizure medications: Medications commonly used to treat epilepsy, such as topiramate and valproate, have shown to be effective in preventing migraines

Calcitonin Gene-Related Peptide (CGRP) monoclonal antibodies

CGRP monoclonal antibodies are a newer class of preventive medications specifically developed to target migraines. These medications work by blocking the action of CGRP, a protein involved in the development of migraines. They are administered as injections once a month or every few months, depending on the medication.

Non-medication treatment approaches

In addition to medication and lifestyle changes, complementary therapies can play a role in managing migraines. Techniques such as biofeedback, acupuncture, and cognitive-behavioral therapy have shown promise in reducing the frequency and severity of attacks. It is important to discuss these options with a healthcare professional before incorporating them into your treatment plan. These approaches include:

  • Biofeedback: Biofeedback techniques help individuals gain control over bodily functions, such as heart rate and muscle tension, to reduce migraine symptoms
  • Relaxation techniques: Practices like deep breathing, meditation, and progressive muscle relaxation can promote relaxation and alleviate migraine symptoms
  • Cognitive-behavioral therapy (CBT): CBT helps individuals identify and change negative thought patterns and behaviors that contribute to migraines
  • Medical devices: Various medical devices, such as transcutaneous electrical nerve stimulation (TENS) units or external trigeminal nerve stimulation (eTNS) devices, can provide relief during a migraine attack

Lifestyle modifications for managing migraines

Certain lifestyle changes can help manage migraines and reduce their impact on daily life. Establishing consistent sleep patterns, maintaining a regular meal schedule, managing stress through relaxation techniques or therapy, and avoiding known triggers like specific foods or environmental factors are all essential in managing and preventing migraines. These modifications include:

Identifying triggers

Keeping a migraine diary can help identify triggers that contribute to the onset of migraines. Triggers can vary from person to person but may include hormonal changes, stress, certain foods or beverages, lack of sleep, and environmental factors. By avoiding or minimizing exposure to triggers, individuals can potentially reduce the frequency of migraines.

Establishing a routine

Maintaining a regular sleep schedule, eating balanced meals at regular intervals, and staying hydrated can help stabilize the body’s internal clock and minimize the occurrence of migraines.

Stress management

Stress is a known trigger for migraines. Engaging in stress-reducing activities such as exercise, yoga, meditation, and relaxation techniques can help manage stress levels and reduce the likelihood of migraines.

Dietary considerations

Certain foods and beverages, such as aged cheeses, caffeine, alcohol, and processed foods containing additives like monosodium glutamate (MSG), can trigger migraines in some individuals. It is important to identify and limit the intake of these trigger substances.

Regular exercise

Regular physical exercise, such as walking, swimming, or cycling, can help reduce the frequency and severity of migraines. Exercise promotes the release of endorphins, natural pain-relieving chemicals in the brain, and helps manage stress.

Migraine in women: Hormonal considerations

Hormonal fluctuations can significantly impact migraines in women. Many women experience migraines related to their menstrual cycle, pregnancy or menopause, with attacks occurring before, during, or after menstruation. Understanding these hormonal influences and potentially exploring hormone therapy options can help manage migraines more effectively in women.

Promising research and future directions

Ongoing research aims to deepen our understanding of migraines and improve treatment options. Advances in genetics, neuroimaging, and the development of targeted therapies hold promise for more personalized and effective migraine management in the future. Participating in clinical trials and staying informed about the latest research discoveries can provide valuable insights for individuals living with migraines.

Migraines are a complex neurological condition that can significantly impact an individual’s quality of life. By understanding the causes, symptoms, and treatment options, individuals can take proactive steps to manage migraines effectively. Whether through medication, lifestyle modifications, or a combination of both, individuals can find relief and improve their overall well-being. Remember, each person’s experience with migraines is unique, so it may take time and patience to find the most effective management strategies.

Sources

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NowPatient has taken all reasonable steps to ensure that all material is factually accurate, complete, and current. However, the knowledge and experience of a qualified healthcare professional should always be sought after instead of using the information in this page. Before taking any drug, you should always speak to your doctor or another qualified healthcare provider.

The information provided here about medications is subject to change and is not meant to include all uses, precautions, warnings, directions, drug interactions, allergic reactions, or negative effects. The absence of warnings or other information for a particular medication does not imply that the medication or medication combination is appropriate for all patients or for all possible purposes.

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