Migraine Headaches

Overview

What’s a migraine? What does a migraine feel like?

A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells. It may last at least four hours or even days. About 12% of Americans have this genetic disorder. Research shows that it’s the sixth most disabling disease in the world.

What are the types of headaches? What type of headache is a migraine?

There are over 150 types of headaches, divided into two categories: primary headaches and secondary headaches. A migraine is a primary headache, meaning that it isn’t caused by a different medical condition. Primary headache disorders are clinical diagnoses, meaning there’s no blood test or imaging study to diagnose it. A secondary headache is a symptom of another health issue.

What is an aura?

An aura is a group of sensory, motor and speech symptoms that usually act like warning signals that a migraine headache is about to begin. Commonly misinterpreted as a seizure or stroke, it typically happens before the headache pain, but can sometimes appear during or even after. An aura can last from 10 to 60 minutes. About 15% to 20% of people who experience migraines have auras.

Aura symptoms are reversible, meaning that they can be stopped/healed. An aura produces symptoms that may include:

• Seeing bright flashing dots, sparkles, or lights.
• Blind spots in your vision.
• Numb or tingling skin.
• Speech changes.
• Ringing in your ears (tinnitus).
• Temporary vision loss.
• Seeing wavy or jagged lines.
• Changes in smell or taste.
• A “funny” feeling.

What are the types of migraines?

There are several types of migraines, and the same type may go by different names:

• Migraine with aura (complicated migraine): Around 15% to 20% of people with migraine headaches experience an aura.
• Migraine without aura (common migraine): This type of migraine headache strikes without the warning an aura may give you. The symptoms are the same, but that phase doesn’t happen.
• Migraine without head pain: “Silent migraine” or “acephalgic migraine,” as this type is also known as, includes the aura symptom but not the headache that typically follows.
• Hemiplegic migraine: You'll have temporary paralysis (hemiplegia) or neurological or sensory changes on one side of your body. The onset of the headache may be associated with temporary numbness, extreme weakness on one side of your body, a tingling sensation, a loss of sensation and dizziness or vision changes. Sometimes it includes head pain and sometimes it doesn’t.
• Retinal migraine (ocular migraine): You may notice temporary, partial or complete loss of vision in one of your eyes, along with a dull ache behind the eye that may spread to the rest of your head. That vision loss may last a minute, or as long as months. You should always report a retinal migraine to a healthcare provider because it could be a sign of a more serious issue.
• Chronic migraine: A chronic migraine is when a migraine occurs at least 15 days per month. The symptoms may change frequently, and so may the severity of the pain. Those who get chronic migraines might be using headache pain medications more than 10 to 15 days a month and that, unfortunately, can lead to headaches that happen even more frequently.
• Migraine with brainstem aura. With this migraine, you'll have vertigo, slurred speech, double vision or loss of balance, which occur before the headache. The headache pain may affect the back of your head. These symptoms usually occur suddenly and can be associated with the inability to speak properly, ringing in the ears and vomiting.
• Status migrainosus. This is a rare and severe type of migraine that can last longer than 72 hours. The headache pain and nausea can be extremely bad. Certain medications, or medication withdrawal, can cause you to have this type of migraine.

What are the four stages or phases of a migraine? What’s the timeline?

The four stages in chronological order are the prodrome (pre-monitory), aura, headache and postdrome. About 30% of people experience symptoms before their headache starts.

The phases are:

1. Prodrome: The first stage lasts a few hours, or it can last days. You may or may not experience it as it may not happen every time. Some know it as the “preheadache” or “premonitory” phase.
2. Aura: The aura phase can last as long as 60 minutes or as little as five. Most people don’t experience an aura, and some have both the aura and the headache at the same time.
3. Headache: About four hours to 72 hours is how long the headache lasts. The word “ache” doesn’t do the pain justice because sometimes it’s mild, but usually, it’s described as drilling, throbbing or you may feel the sensation of an icepick in your head. Typically it starts on one side of your head and then spreads to the other side.
4. Postdrome: The postdrome stage goes on for a day or two. It’s often called a migraine “hangover” and 80% of those who have migraines experience it.

It can take about eight to 72 hours to go through the four stages.

How common are migraine headaches?

Experts estimate that nearly half of the adult population experiences headaches and 12% of Americans get migraine headaches. Women are about three times more likely than men to experience migraines.

Who gets migraines? What are the risk factors?

It’s difficult to predict who may get a migraine and who may not, but there are risk factors that may make you more vulnerable. These risk factors include:

• Genetics: Up to 80% of people who get migraine headaches have a first-degree relative with the disease.
• Gender. Migraine headaches happen to women more than men, especially women between the ages of 15 and 55. It’s likely more common in women because of the influence of hormones.
• Stress level. You may get migraines more often if you’re high-stress. Stress can trigger a migraine.
• Smoking.

How often do migraines happen?

The frequency of a migraine could be once a year, once a week or any amount of time in between. Having two to four migraine headaches per month is the most common.

Are migraines hereditary?

Migraines tend to run in families. As many as four out of five people with migraines have a family history. If one parent has a history of migraines, their child has a 50% chance of having them. If both parents have a history of migraines, the risk jumps to 75%. Again, up to 80% of people with migraines have a first-degree relative with the disease.

Can children get migraines?

Yes, but pediatric migraines are often shorter and there are more stomach symptoms.

Who should I see about my migraine pain?

Discuss your symptoms with your primary care provider first. They can diagnose migraine headaches and start treatment. You may require a referral to a headache specialist.

Do migraines cause permanent brain damage? If I have migraines, does that mean I’ll get another disease?

No. Migraines don’t cause brain damage.

There is a tiny risk of stroke in people who get migraines with aura – 1 or 2 people out of 100,000.