Migraine Headache

What Is It?

Migraine headache is a common type of headache which affects millions of individuals. They are a form of headaches that generally affects an individual in a chronic fashion, occurring repeatedly over their lifetime. Although migraines are called headaches, they often cause symptoms beyond simple head pain (see below).

The cause of migraine headache is not well understood. Both genetic, hormonal and environmental factors may play a role. While some connections have been found to the trigeminal nerve, certain neurotransmitters and the blood vessels around the brain, none of these has been traced back to the actual underlying cause of the headaches.

That being said, there are several risk factors that are known to increase one's risk of having migraines, including a family history of migraines, younger age (most people begin getting them in early adulthood), and female gender (women are 3 times more likely to have them than men).

In addition to these risk factors, there are some triggers which some patients with a tendency toward migraines report increase the chance they will suffer a headache. These include hormonal changes in women (many women report that the occurrence of migraines closely follows their menstrual cycle), certain foods (such as alcohol, chocolate, caffeine, etc.), stress, sleep changes, physical exertion and others.

What Types of Symptoms Are Typical?

Obviously, migraines often present with headache. However, there are many other symptoms which can accompany a migraine attack. The symptoms can last for hours or even days in some cases. Symptoms can include moderate to severe head pain, nausea and/or vomiting, and irritation by bright lights and loud sounds. Some patients even report that the headache is not significant and the other symptoms such as nausea and vomiting predominate. However, the symptoms can be so severe that they are debilitating, requiring the individual to lay still in a dark room for hours to be comfortable.

Some patients with migraines report "auras" that occur just before the onset of the headache. The symptoms of an aura can include visual changes (such as a scotoma, or blind spot in your visual fields, or seeing flashing lights) or sensory changes, such as feeling pins and needles on your skin.

Even without classic auras, some patients have a "prodrome" hours or days before the onset of the headache which can include an increase in energy or mood, cravings for sweet foods, increased thirst, sleepiness or irritability.

For more details, see the Migraine Symptoms page.

How Is The Diagnosis Typically Made?

There are no specific tests that can confirm the diagnosis of migraine headache. Therefore, physicians must base their diagnosis on a close assessment of each patients presenting symptoms and a thorough examination. In addition to looking for the classic findings of migraines, physicians will also try to rule-out other potential causes which could be confused for migraine because they present with similar symptoms. For example, brain tumors, aneurysms, meningitis and other serious disorders can present with headaches with or without nausea and vomiting. Therefore, in cases which are not clear cut, various studies such as MRI, CT scan or a lumbar puncture may be recommended to first rule-out other diagnoses.

What Are Some Common Treatments?

Treatment of migraines both include measures to decrease the frequency of attacks as well as treating the symptoms of a headache once they occur. Some lifestyle changes such as avoiding triggers, exercise and avoiding extra estrogen hormones can help decrease the frequency of headaches for some patients. Additionally, some medications are used to help prevent headaches as well.

Abortive treatments, which aim to stop the symptoms of a headache once it has started, are often prescribed and include everything from simple pain relievers to specialized anti-migraine medications (such as the Triptans) to anti-nausea drugs.

For more treatment details, see the Migraine Headache Treatment page.

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Important Note: This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.

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