Migraines

Migraines are a type of headache that can be intense and at times, debilitating.  They can occur with an aura, a classical migraine, or without an aura, a common migraine.  Common migraines are more common than classical migraines.  The fact that migraines not only involves debilitating pain, but also has classic migraine symptoms differentiate them from other types of headaches.  They are indeed different from a "really bad headache".  Symptoms associated with migraines are:

• nausea
• pain behind one eye or ear
• pain in the temples
• seeing spots or flashing lights
• sensitivity to light and/or sound
• temporary vision loss
• vomiting (Nall, 2015)

It is common for migraines to affect one side of the head.  Another characteristic that differentiates migraines is that the intense pain has a throbbing quality.  A migraine can cause debilitating pain for either hours or days (Mayo, 20).  Without treatment, a migraine can last 72 hours or longer.  As someone who suffers from migraines, I can attest to the fact that they can indeed last this long.  I have had migraines for up to four days.

There are several types of migraines, including:

• Migraine with aura (Classical migraine)
• Migraine without aura (Common Migraine)
• Basilar - Type Migraine:  may include temporary partial or total blindness
• Hemiplegic Migraine:  rare and can cause temporary paralysis
• Migraine without headache:  aura symptoms without a headache
• Status Migrainosus:  rare, severe and can last over 72 hours (NIH, 2023)

Classical migraines occur after an aura which occurs ten to thirty minutes before the migraine.  Common migraines do not have these symptoms beforehand.  Sensations that occur during an aura are:

• feeling less mentally alert or having trouble thinking
• seeing flashing lights or unusual lines
• tingling or numbness in the face or hands
• blurred vision
• unusual sense of smell, taste, or touch (Nall, 2015)

A prodrome may also occur one to two days before a migraine.  Symptoms that can occur during this phase are:

• constipation
• neck stiffness
• increased thirst and urination
• frequent yawning (Nall, 2015)

A postdrome may also occur for approximately 24 hours after the migraine.  Symptoms during this phase include:

• confusion
• moodiness
• dizziness
• weakness
• sensitivity to light and sound (Mayo, 2023) 

There are several theories as to why migraines occur.  Changes in the brainstem and how it interacts with the trigeminal nerve is thought to be involved.  It is also thought that imbalances in brain chemicals, particularly serotonin, also plays a role.  It is thought that when serotonin levels decrease, the trigeminal nerve release neuropeptides which cause the pain associated with migraines by acting on the meninges, the brains outer coverings (Mayo, 2023).

Several things can be done to diagnose migraines.  These include:

• Medical History
• Family History
• Physical Exam
• Including a Neurological examination
• MRI
• CT scan (Mayo. 2023)

There are certain things that may trigger migraines including:

• hormonal changes in women
• foods - salty foods, chocolate
• food additives
• drinks - alcohol and highly caffeinated drinks
• stress
• sensory stimuli - bright lights, loud sounds, strong smells
• changes in wake - sleep patterns
• Intense physical exertion
• changes in environment
• medications (Mayo, 2023)

There are risk factors that make some people more susceptible to migraines.  These individuals who have a family history of migraines are more likely to develop them as well.  Although migraines can occur at any age, they tend to increase during an individual's 30s, then decrease.  Women are three times more likely to be affected by migraines (Mayo, 2023).

There are several treatments for migraines.  

• Pain relievers: ibuprofen or Tylenol
• Triptans: help to block pain pathways. 
• Ergots: block pain messages
• Ubrelvey: relieves both pain and symptoms
• Preventive medications
• Beta blockers
• Calcium channel blockers
• Tricyclic antidepressants
• Anti-seizure medication (NIH, 2023)

To learn more about Migraines, watch our Youtube video.

REVIEWED AND UPDATED 4/7/23

Mayo Clinic. (2023) Migraine.  Mayo Clinic.  Retrieved from http://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/dxc-20202434

Nall, R. (2015) Migraines vs Headache: How to tell them apart.  Healthline.  Retrieved from http://www.healthline.com/health/migraine/migraine-vs-headache#overview1

NIH (2023)  Migraine.  National Institutes of Health.  Retrieved from https://www.ninds.nih.gov/health-information/disorders/migraine#