What is a migraine headache?

A migraine is usually an intense pounding headache that can last for

hours or even days. The pounding or pulsing pain usually begins in the
forehead, the side of the head, or around the eyes. The headache
gradually gets worse. Just about any movement, activity, bright light, or
loud noise seems to make it hurt more. Nausea and vomiting are common
during a migraine.

Migraines may happen only once or twice a year, or as often as daily.

Women are more likely to have migraines than men.

There are different types of migraine headaches. The most common types
of migraines are classic migraines and common migraines.

Classic migraines (also called complicated migraines) start with a warning

sign called an aura. These types of migraines are sometimes also called
“migraines with aura.” The aura often involves changes in the way you see.
You may see flashing lights, colors, a pattern of lines, or shadows. You
may temporarily lose some of your vision, such as your side vision.

You may also feel a strange prickly or burning sensation, or have muscle
weakness on one side of your body. You may have trouble
communicating. You may also feel depressed, irritable, and restless.

Auras last about 15 to 30 minutes. Auras may occur before or after your
head pain. Sometimes the pain and aura overlap, or the pain never
occurs. The head pain of classic migraines may occur on one side of your
head or on both sides.

Common migraines don’t start with an aura. For this reason, these types
of migraines are also called “migraines without aura.” Common migraines
may start more slowly than classic migraines, last longer, and interfere
more with daily activities. The pain of common migraines may be on only
one side of your head. Most people who have migraines have common
migraines (they don’t have an aura).

Migraines without head pain, sometimes called “silent migraines,” may

cause you to feel other migraine symptoms, but not pain. At least not the
usual migraine pain around your eyes and temples. This type of migraine
may even include an aura phase. You may also feel the same sensitivity to
light and sound as with a typical migraine.

Hemiplegic migraines cause one side of your body to become weak,

similar to having a stroke. These symptoms are only temporary. They are
a part of the migraine attack. Areas of the body affected by the weakness
may include your face, arm, or leg. The weakness may last from an hour to
even days. It most often goes away within 24 hours. For this type of
migraine, the head pain can come before or after the weakness. This type
of migraine is rare.

Retinal migraines (also called ocular migraines) cause changes in vision

that are not related to aura vision changes. For retinal migraines,
symptoms involve diminished vision or even blindness in one eye. These
symptoms do not last long. They can occur before or after head pain. If
you experience this type of migraine, it is important to contact your
doctor.

Icepick headaches are not migraine headaches. They produce a stabbing

pain around your eyes and temples. These stabbing pains may occur
repeatedly in the same place or jump around to different areas each time.
This type of headache can occur at any time and without warning. If you
are a person who has migraine headaches, you are more likely to than
others to get icepick headaches, too.

Cluster headaches are not migraine headaches. They are rare headaches

that occur in patterns, known as cluster periods. These periods can mean
having a headache at the same time every day for a week or even a
month. Cluster headaches can be extremely painful. They usually cause
pain on one side of your head. This pain can be so severe that it makes
your eyelid droop and your nose to get stuffy.

Cervicogenic headaches are not migraine headaches. They are

headaches caused by another illness or physical condition, usually a
problem in your neck. Many times, this type of headache can be brought
on by a sudden movement of your neck. You might also get a cervicogenic
headache after keeping your neck in the same position for too long. The
pain can last for hours or days. It may be limited to one side of your head
or face.

What does a migraine feel like?

 The pain of a migraine headache can be intense. It can get in the way of
your daily activities. Migraines aren’t the same for all people. Possible
symptoms of migraines are listed below. You may have a “premonition”
several hours to a day before your headache starts. Premonitions are
feelings you get that can signal a migraine is coming. These feelings can
include intense energy, fatigue, food cravings, thirst, and mood changes.

Symptoms of migraines
Possible symptoms of migraines include:

 Intense throbbing or dull aching pain on one side of your head or both
sides.
 Pain that worsens with physical activity.
 Nausea or vomiting.
 Changes in how you see, including blurred vision or blind spots.
 Being bothered by light, noise, or odors.
 Feeling tired and/or confused.
 Stopped-up nose.
 Feeling cold or sweaty.
 Stiff or tender neck.
 Lightheadedness.
 Tender scalp.

RELATED TOPICS

Read Article >>

Headaches

Read Article >>

Botulinum Toxin Injections: A Treatment for Muscle Spasms

Read Article >>

Teenagers and Headaches

What causes migraines?

Doctors don’t know exactly what causes migraines. It appears that
migraine headaches may be caused in part by changes in the level of a
body chemical called serotonin. Serotonin plays many roles in the body,
and it can have an effect on the blood vessels. When serotonin levels are
high, blood vessels constrict (shrink). When serotonin levels fall, the blood
vessels dilate (swell). This swelling can cause pain or other problems.
Another aspect that is being studied is that migraine headaches go along
with a spreading pattern of electrical activity in the brain.

Some research suggests there could be a heredity factor for migraines,

meaning they may run in families. Researchers have identified some
genes associated with migraines. They are unsure, though, why these
genes seem to impact some people more than others. The American
Migraine Foundation reports that if one of your parents has migraines,
there is a 50% chance that you will, too. If both of your parents have
 migraines, your chances jump up to 75%. Ultimately, migraines seem to
be caused by a combination of factors: genetic, environmental, and
lifestyle.

Women are more likely to have chronic migraines (migraines that occur 15
days a month or more). This is likely linked to hormones. Hormones
fluctuate each month around the time of your period. They can also
fluctuate if you are pregnant or going through menopause.

What are some migraine risk factors and

triggers?
Some things make you more likely to get migraine headaches (these are
called “risk factors”). Other things may bring on a migraine (these are
called “triggers”).

Common migraine risk factors include the following:

 Family history: You are much more likely to have migraines if one or both
of your parents had migraines.
 Sex: Women are more likely than men to have migraines.
 Age: Most people have their first migraine during adolescence, but
migraines can start at any age, usually before age 40.

Common migraine triggers include the following:

 Food and drink: Certain food and drink (see list below) may cause
migraines. Dehydration and dieting or skipping meals may also trigger
migraines.
 Hormone changes: Women may experience migraines related to their
menstrual cycles, to menopause, or to using hormonal birth control or
hormone replacement therapy.
 Stress: Stress may trigger migraines. Stress includes feeling overwhelmed
at home or work, but your body can also be stressed if you exercise too
much or don’t get enough sleep.
 Senses: Loud sounds, bright lights (such as flashing lights or sunlight), or
strong smells (such as paint fumes or some perfumes) may trigger
migraines.
 Medicines: Certain medicines may trigger migraines. If you think your
migraines might be related to your medicine, talk to your doctor. Your
doctor may be able to prescribe a different medicine.
 Illness: Infections, such as the cold or the flu, may trigger migraines,
especially in children.

Foods that may trigger migraines:

 aged, canned, cured, or processed meat (including bologna, game, ham,

herring, hot dogs, pepperoni, and sausage)
 aged cheese
 alcoholic beverages (especially red wine)
 aspartame
 avocados
 beans (including pole, broad, lima, Italian, navy, pinto, and garbanzo)
 brewer’s yeast (including fresh yeast coffee cake, donuts, and sourdough
bread)
 caffeine (in excess)
 canned soup or bouillon cubes
 chocolate, cocoa, and carob
 cultured dairy products (such as buttermilk and sour cream)
 figs
 lentils
 meat tenderizer
 monosodium glutamate (MSG)
 nuts and peanut butter
 onions (except small amounts for flavoring)
 papaya
 passion fruit
 pea pods
 pickled, preserved or marinated foods (such as olives and pickles, and
some snack foods)
 raisins
 red plums
 sauerkraut
 seasoned salt
 snow peas
 soy sauce

How are migraines diagnosed?

Your doctor can diagnose migraines by the symptoms you describe. If the
diagnosis is not clear, your doctor will perform a physical exam. Your
doctor might want to do blood tests or imaging tests, such as an MRI or
CAT scan of the brain. These tests can help ensure there are no other
causes for the headache. You may also be asked to keep a headache
journal. This can help your doctor identify the things that might cause
your migraines.

If headache pain is getting in the way of your daily activities, it’s time to
see your family doctor.  Read More
by Dr. Jennifer Hanna

Can migraines be prevented or

avoided?
Medicine to prevent migraines may be helpful if your headaches happen
more than 2 times a month. You may want to consider this medicine if
your headaches make it hard for you to work and function. These
medicines are taken every day, whether you have a headache or not.

Preventive medications for migraines can include prescription drugs often

used to treat other ailments. Anti-seizure medicines, antidepressants,
medicines to lower blood pressure, and even Botox injections are some of
 the preventive medications your doctor may prescribe. Calcitonin gene-
related peptide (CGRP) inhibitors can also help prevent migraines. They do
so by blocking a gene-related peptide in your sensory nerves. This peptide
is known to increase during a migraine attack, so blocking it can help
prevent migraines.

There are also a number of non-medical treatments designed to help

minimize migraine pain and frequency. One is an electrical stimulation
device, which has been approved by the FDA. It is a headband that you
wear once a day for 20 minutes to stimulate the nerve linked to migraines.
Another non-medical treatment is counseling aimed at helping you feel in
more control of your migraines. This counseling works best when paired
with medical prevention of migraines, as well.

What else can I do to prevent migraines?

While there are no sure ways to keep from having migraine headaches,
here are some things that may help:

Eat regularly and do not skip meals.

 Keep a regular sleep schedule.

 Exercise regularly. Aerobic exercise can help reduce tension as well as
keep your weight in check. Obesity can contribute to migraines.
 Keep a migraine journal to help you learn what triggers your migraines
and what treatments are most helpful.
 Migraine treatment
There are 2 types of medicines for migraine treatments. One type, called
“abortive,” focuses on stopping the headache from becoming severe and
relieving the headache pain. You should start this type of treatment as
soon as you think you’re getting a migraine. The other type, called
“prophylactic or preventive” includes medicines that are taken every day
to reduce how often headaches occur (outlined in the section above).

Talk to your doctor about which of these two types of medicine is best for
you. Some people use both types. Nonprescription and prescription
medicines that are used often or in large doses may cause other
problems.

What medicines help relieve migraine

pain?
For mild to moderate migraines, over-the-counter medicines that may
help relieve migraine pain include:

 aspirin
 acetaminophen (one brand name: Tylenol)
 an acetaminophen, aspirin, and caffeine combination (one brand name:
Excedrin Migraine)
 ibuprofen (one brand name: Motrin)
 naproxen (brand name: Aleve)
 ketoprofen (brand name: Orudis KT)
 People who have more severe migraines may need to try “abortive”
prescription medicines. A medicine called ergotamine can be effective
alone or combined with other medicines. Dihydroergotamine is related to
ergotamine and can be helpful. Other prescription medicines for
migraines include sumatriptan, zolmitriptan, naratriptan, rizatriptan,
almotriptan, eletriptan, and frovatriptan.

If the pain won’t go away, stronger pain medicine may be needed, such as
a narcotic, or medicines that contain a barbiturate (sleep-inducing
medicine). These medicines can be habit-forming and should be used
cautiously. Your doctor may prescribe these only if they are needed and
only for a short period of time.

What else can I do?

To help manage your migraine pain, try the following:

 Lie down in a dark, quiet room.

 Put a cold compress or cloth over your forehead or behind your neck.
 Massage your scalp using a lot of pressure.
 Put pressure on your temples.
 Have some caffeine.

Living with migraines

Migraines can come on quickly, many times without warning. They can
ruin your day—or even several days at a time. They can make you miss
 work, miss important events, miss out on fun. If you have recurring
migraines, you probably feel like you don’t have total control of your life.

Work with your doctor to take back control. Keep a migraine journal.
Document when you get migraines and what you were doing and eating.
Keep a record of what the weather was like and if you were exposed to
unusual smells or environments. Knowing your triggers can help you
prevent migraines. You doctor also may prescribe different medicines or
combinations of medicines. Doing this helps sort out which will be most
effective for preventing migraines or stopping them when they start.

Discussion on migraines with Dr. Duren

Michael Ready and Nick Haines
Talking about migraine symptoms, prevention strategies, and treatment
options.

Questions to ask your doctor

 How can I prevent a migraine? Are there lifestyle habits I can change?
 What about medicine? Can migraines be cured?
 What are some possible side effects of migraine medicine?
 What should I be writing in my migraine journal?
 Will my child grow out of having migraines?

Resources
American Migraine Foundation

Migraine Research Foundation

National Headache Foundation

Funding and support for this material have been provided by The Allergan
Foundation.

Last Updated: September 3, 2019

This article was contributed by: familydoctor.org editorial staff
Categories: Family Health, Women
Tags: adults, almotriptan, children, classic migraine, common
migraine, eletriptan, frovatriptan, Inderal, naratriptan, photosensitivity, prodrome, propr
anolol, rizatriptan, sumatriptan, teens, vascular headache, zolmitriptan, Zomig