Migraines are much more than your typical headache. For many people, it can significantly impact how they go about their daily lives. According to the American Migraine Association, about 39 million Americans live with migraines. In this article, we will discuss further what a migraine is and how it can impact one’s life.
What is a Migraine?
A migraine is a common and disabling neurological disease that causes a throbbing and/or pulsing headache on one side of the head. This pain is usually accompanied by nausea, vomiting, and sensitivity to light and/or sound. Depending on the situation- a migraine can last for a couple of hours or days. It can also occur in children, teens, adults, and older people.
What Are the Different Types of Migraine?
There are various types of migraines people can experience (each of which comes with its own set of symptoms). The different types of migraines include (but are not limited to):
Migraine with aura (complicated aura):
About one in three people experience this type of migraine. An aura tends to gradually occur over 5 minutes and can last up to an hour. It tends to affect a person’s sight. Afterward, a headache ensues. Symptoms may also include:
- Blind spots (in the eyes)
- Seeing colored spots or lines
- Seeing flashing or flickering lights
- Seeing zig zag patterns
- Temporary blindness
- Numb or tingling sensation in various parts of the body
- Muscle weakness
- Feeling dizzy or off balance
Migraine without aura (noncomplicated aura):
A migraine without aura is the most common type that does not usually come with a warning sign that a migraine attack is about to begin. These tend to last about four hours to three days. Common symptoms include:
- Headache on one side of the head that is generally accompanied with a throbbing pain (can worsen with physical activity)
- Nausea and/or vomiting
- Sensitivity to light, sounds, and/or smells
Migraine without head pain:
This type of migraine is similar to an aura migraine. However, a headache will not follow.
A rare type of migraine that causes temporary weakness on one side of the body. Other symptoms may include:
- Visual disturbances (seeing zig-zags, colored spots, or sparkles)
- Speech difficulties (slurring or speech or unable to speak clearly)
- Communication difficulties (temporary inability to write or understand language)
- Dizziness or vertigo
- Hearing problems or ringing in the ears
This type of migraine also falls under two categories: familial hemiplegic migraine and sporadic hemiplegic migraine. Familial hemiplegic migraine occurs when two or more members within the same family experience weakness on one side of the body as a symptom of their migraine. Various studies have also linked three gene mutations that may cause this type of migraine- CACNA1A, ATP1A2, and SCN1A.
Meanwhile, sporadic hemiplegic migraine is when someone experiences symptoms of a familial hemiplegic migraine- but they have no family history of the condition. People also tend to face similar symptoms as those with aura migraines. The cause of this type of migraine is still unknown.
Retinal Migraine (ocular migraine):
A type of migraine that results in the temporary, partial, or complete loss of vision in one of the eyes. It can also include a dull ache behind the eye that spreads throughout the head. A retinal migraine can last a couple of minutes or for months.
Chronic migraines tend to last for 15 days per month. Symptoms can vary in length and severity. Symptoms may include:
- Frequent headaches
- Increased sensitivity to light, sounds, or smells
- Nausea and/or vomiting
- Dizziness or vertigo
- Symptoms that are also associated with aura migraines
Migraine with brainstem aura:
Common symptoms may include:
- Slurred speech
- Double vision
- Loss of balance
- Ringing in the ears
- Inability to communicate properly
- Ensuing headache
It is a rare and severe type of migraine that may last longer than 72 hours. Headache pain and nausea tend to be debilitating. Specific medications (or medication withdrawal) can trigger this type of migraine.
It is a condition that tends to affect children and some adults. Children tend to stop experiencing abdominal migraines as they grow older. However, they are highly likely to experience headache migraines as adults. Some common symptoms include:
- Regular attacks of moderate/severe stomach pain that tend to last 2-72 hours
- Nausea and/or vomiting during attacks
- No headaches
What Are the Common Symptoms?
Symptoms will vary between individuals. However, the most common symptoms for migraines include:
- Moderate to severe head pain that is difficult or unbearable to handle
- Intense headache on one side of the head or both. It can also occur on the front or back of the head.
- Throbbing, pounding, or pulsing sensation on the head
- Head pain that gets worse with physical activity or movement
- Nausea and/or vomiting
- Sensitivity to light, noise, and/or smells
- Loss of appetite
- Sweat or chills
- Pale skin tone
- Tender scalp
- Dizziness and blurred vision
- Diarrhea (rare)
- Fever (rare)
What Are the 4 Stages of a Migraine?
It is important to note that not everyone will experience every stage listed below. However, the phases (in chronological order) are:
- Prodrome: This stage tends to last for a few hours or a few days. Some people may not experience it every time they have a migraine. Some symptoms may include:
- Mood changes, from depression to euphoria
- Food cravings
- Neck stiffness
- Increased urination
- Fluid retention
- Frequent yawning
- Aura: This stage can last anytime between 5 minutes to an hour. Most people don’t experience this stage, or they experience aura and headache simultaneously. Symptoms tend to build gradually over time and may include:
- Disturbances in the vision (such as seeing various shapes, bright spots, or flashes of light)
- Vision loss
- Pins and needles sensations in an arm or leg
- Weakness or numbness in the face or one side of the body
- Difficulty speaking
- Headache/Attack: A migraine can last about 4 to 72 hours during this stage. How often a migraine will occur will vary for every individual. Some symptoms may include:
- Debilitating pain on one side of your head- but can often spread to both sides
- Throbbing or pulsing head pain
- Sensitivity to light, sound, smell, and/or touch
- Nausea and vomiting
- Postdrome: This stage tends to last a day or two after a person experiences a migraine. During this stage, people are recuperating from a migraine attack and tend to feel drained, confused, or exhausted. Sudden head movement can still trigger head pain during this stage.
What Causes Migraines?
Because there are various types of migraines, it’s difficult to determine the direct cause. Some people may know what triggers their migraines, but others may experience an attack out of nowhere. A headache tends to occur when specific nerve cells within one’s blood vessels send pain signals to the brain. As a result, the brain commands the body to release inflammatory substances into the nerve and blood vessels within the head. Other possible contributing factors may include age, sex, gender, environment, specific medical conditions, etc.
How do you Diagnose Migraines?
No definitive scans or laboratory tests allow your doctor to know if you are experiencing a migraine. They may order blood tests or imaging tests (such as a CT scan or MRI) to rule out any possible underlying conditions. Your doctor will likely ask about and assess your symptoms during your appointment. They will also take a closer look into your family history.
What Are Some Risk Factors?
Risk factors may include:
- Anyone can experience migraines. However, people tend to experience their first one during adolescence. Their occurrences peak when one reaches their 30s and gradually become less severe and frequent as one ages.
- Studies have found that women are three times more likely to experience migraines.
- Family history. Having a family history of migraines means you have an increased risk of experiencing migraines at some point in your life.
- Hormonal Changes. Some women may experience migraines/headaches during their period. The frequency and severity of these migraines also tend to change after pregnancy or menopause.
What Can Trigger a Migraine?
Migraine triggers will vary from individual to individual. Some to consider may include:
- Hormonal changes in women. Research has noticed that fluctuations in estrogen can trigger headaches/migraines in women. They tend to worsen during puberty and tend to get better after menopause. Specific hormonal medications can also worsen or help with migraines.
- Drinks such as alcohol or caffeinated beverages may trigger migraines. Having too much caffeine (or withdrawals from caffeine) can trigger headaches.
- Sensory Stimuli. Flashing lights, fluorescent lights, light from technological devices, and sunlight can trigger a migraine. Strong smells and loud sounds can also trigger migraines for some.
- Changes in sleep. Not getting enough sleep (or overexerting yourself) can also be a trigger.
- Physical factors. Engaging in intense physical activity may also provoke a migraine.
- Changes in weather. Weather involving barometric pressure changes, strong winds, or changes in altitudes can also be triggering.
- Specific medications. Some medications may trigger migraines for some people. Overuse of medication may also be a triggering factor.
- Specific foods. Aged cheeses, salty or highly processed foods, fermented or pickled foods, or chocolate can trigger a migraine.
- Food additives. Nitrates (found in foods such as pepperoni, hot dogs, or luncheon meats), sweetener aspartame, and MSG can trigger migraines as well.
- Emotional stress. It is one of the most common triggers of a migraine. Our brain tends to go into fight or flight mode as it releases certain chemicals during stressful events. As a result, this can trigger a migraine. Anxiety, worry, and excitement can also increase muscle tension (which dilates the blood vessels and worsens a migraine).
- Skipping meals. Fasting or going through long periods without eating can trigger a migraine (especially if your blood sugar levels drop).
How Can You Treat Migraines?
The two main types of treatment are acute and preventive. Acute treatment is designed for people to take during an attack to stop a migraine from progressing. Forms of treatment include over-the-counter pain relievers, prescription medications, and specific medical devices. It is most effective when you take them while the pain is mild.
Preventative treatments are designed to reduce the frequency, severity, and duration of migraine attacks before they occur. They are often prescribed to those with debilitating, severe headaches that occur more than four times a month. The forms of treatment can include medications (often taken daily) or procedures. They can also involve devices, lifestyle changes, behavioral therapy, or physical therapy.
Can You Prevent Migraines?
There is no cure for migraines as of now. However, you can take action to help manage or reduce your migraine attacks. These steps may include:
- Keeping a migraine journal to take note of the severity and frequency of your attacks (and find possible triggers)
- Getting a good night’s rest
- Eating at regular intervals and drinking plenty of water
- Exercising regularly
- Taking prescription medications prescribed to you by your doctor
- Hormone therapy if your migraines are linked to your menstrual cycle or estrogen levels
- Get counseling from a therapist to help control your stress
- Creating a calm, dark environment
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Sources: What Is Migraine? | American Migraine Foundation, Migraine – Symptoms and causes – Mayo Clinic, Migraine Headaches: Causes, Treatment & Symptoms (clevelandclinic.org)