A migraine is much more than a bad headache. This neurological disease can cause debilitating throbbing pain that can leave you in bed for days! Movement, light, sound and other triggers may cause symptoms like pain, tiredness, nausea, visual disturbances, numbness and tingling, irritability, difficulty speaking, temporary loss of vision and many more.
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.
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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.
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:
There are several types of migraines, and the same type may go by different names:
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:
It can take about eight to 72 hours to go through the four stages.
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.
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:
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.
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.
Yes, but pediatric migraines are often shorter and there are more stomach symptoms.
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.
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.
The primary symptom of migraine is a headache. Pain is sometimes described as pounding or throbbing. It can begin as a dull ache that develops into pulsing pain that is mild, moderate or severe. If left untreated, your headache pain will become moderate to severe. Pain can shift from one side of your head to the other, or it can affect the front of your head, the back of your head or feel like it’s affecting your whole head. Some people feel pain around their eye or temple, and sometimes in their face, sinuses, jaw or neck.
Other symptoms of migraine headaches include:
Most migraines last about four hours, although severe ones can last much longer.
Each phase of the migraine attack can come with different symptoms:
The cause of migraine headaches is complicated and not fully understood. When you have a headache it’s because specific nerves in your blood vessels send pain signals to your brain. This releases inflammatory substances into the nerves and blood vessels of your head. It’s unclear why your nerves do that.
Migraine attacks can be triggered by a variety of factors. Common triggers include:
Other possible triggers include:
There are some smartphone apps you can use to keep a migraine journal if you don’t want to use pen and paper.
To diagnose a migraine, your healthcare provider will get a thorough medical history, not just your history of headaches but your family’s, too. Also, they'll want to establish a history of your migraine-related symptoms, likely asking you to:
Your healthcare provider may also order blood tests and imaging tests (such as a CT scan or a MRI) to make sure there are no other causes for your headache. An electroencephalogram (EEG) may be ordered to rule out seizures.
Migraine with aura (complicated migraine). This is a headache, plus:
Migraine without aura (common migraine). A common migraine is a headache and:
Plus, you’ve experienced at least one of the following:
Sometimes you or your healthcare provider may assume that the pain you’re feeling is a sinus headache or a tension-type headache. Show your healthcare provider your migraine journal so that they can learn about your unique situation.
Migraine headaches are chronic. They can’t be cured, but they can be managed and possibly improved. There are two main treatment approaches that use medications: abortive and preventive.
Over-the-counter medications are effective for some people with mild to moderate migraines. The main ingredients in pain relieving medications are ibuprofen, aspirin, acetaminophen, naproxen and caffeine.
Three over-the-counter products approved by the Food and Drug Administration for migraine headaches are:
Be cautious when taking over-the-counter pain relieving medications. Sometimes overusing them can cause analgesic-rebound headaches or a dependency problem. If you're taking any over-the-counter pain medications more than two to three times a week, report that to your healthcare provider. They may suggest prescription medications that may be more effective.
Prescription drugs for migraine headaches include:
Triptan class of drugs (these are abortives):
Calcium channel blockers:
Calcitonin gene-related (CGRP) monoclonal antibodies:
Your healthcare provider might recommend vitamins, minerals, or herbs, including:
Drugs to relieve migraine pain come in a variety of formulations including pills, tablets, injections, suppositories and nasal sprays. You and your healthcare provider will discuss the specific medication, combination of medications and formulations to best meet your unique headache pain.
Drugs to relieve nausea are also prescribed, if needed.
All medications should be used under the direction of a headache specialist or healthcare provider familiar with migraine therapy. As with any medication, it's important to carefully follow the label instructions and your healthcare provider’s advice.
Alternative migraine management methods, also known as home remedies, include:
Biofeedback is the use of special equipment strapped to your head. The equipment measures the physical tension in your body and alerts you when you need to control your stress, which changes the physical processes related to stress. You won’t have to use the equipment forever because you’ll learn how to detect the tension on your own. The device works on children as well as adults.
Surgical treatments are not generally recommended for migraine headaches.
Avoid medications for migraines when you’re pregnant, or if you think you may be pregnant. They can negatively affect your baby. With your healthcare provider’s permission, you may be able to take a mild pain reliever like acetaminophen.
There is no cure for migraine headaches, but you can take an active role in managing them, maybe reducing how often you get them and possibly controlling how severe they are by following these tips:
Migraines are unique to each individual. Likewise, how migraines are managed is also unique. The best outcomes are usually achieved by learning and avoiding personal migraine triggers, managing symptoms, practicing preventive methods, following the advice of your healthcare provider and reporting any significant changes as soon as they occur.
Although there isn’t a cure, there are treatments that may help you manage the symptoms.
You may experience migraine headaches for the rest of your life. If your migraines are caused by your period, you may stop having them when menopause starts.
Call 911 or go to an emergency department right away if:
Schedule a visit with your healthcare provider if:
A note from Cleveland Clinic
Migraine headaches can be devastating and make it impossible to go to work, school or experience other daily activities. Fortunately, there are some ways to possibly prevent a migraine and other ways to help you manage and endure the symptoms. Work with your healthcare provider to keep migraines from ruling your life.
Last reviewed by a Cleveland Clinic medical professional on 03/03/2021.
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