What is a migraine headache?
A migraine headache is a type of headache that tends to recur and causes moderate to severe pain. The pain is often described as throbbing or pulsing and usually begins on one side of the head. Migraine headaches are worsened by physical activity, light, sound or physical movement. The pain typically last from 4 hours up to 3 days. You may be sensitive to light, sound and even smell. And you may also experience nausea and/or vomiting.
Who is affected by migraines?
The National Headache Foundation estimates that nearly 12% of the population experience migraine headaches. This means that nearly 40 million people in the United States have migraines. Women are about three times more likely than men to experience migraines.
Are migraines hereditary?
Yes, migraines have a tendency to run in families. As many as four out of five people with migraine have a family history of migraines. If one parent has a history of migraines, the child has a 50% chance of developing migraines. And if both parents have a history of migraines, the risk jumps to 75%.
What causes a migraine?
Migraine headache pain results from signals interacting among your brain, blood vessels and surrounding nerves. During a headache, specific nerves of the blood vessels are activated and send pain signals to the brain. It’s not clear, however, why these signals are activated in the first place.
There is a migraine “pain center,” or generator, in the mid-brain area. A migraine begins when overactive nerve cells send out impulses to your blood vessels. This causes the release of prostaglandins, serotonin and other substances that cause swelling of the blood vessels in the vicinity of the nerve endings, resulting in pain.
What are the symptoms of migraines?
One symptom of migraine is headache pain. Pain is described as a pounding or throbbing. It can begin as a dull ache that develops into throbbing pain. The pain worsens with physical activity. The pain can begin as mild, moderate or severe. If left untreated, the headache will become moderate to severe. The pain can shift from one side of the head to the other, or it can affect the front of the head or feel like it’s affecting the whole head. Most migraines last about 4 hours, although severe ones can last much longer and even become daily. Having two to four migraine headaches per month is common. However, some people have headaches daily; others only get a migraine once or twice a year.
Other symptoms of migraine headaches include:
- Sensitivity to light, noise and odors.
- Nausea and vomiting, stomach upset, abdominal pain.
- Loss of appetite.
- Feeling very warm (sweating) or cold (chills).
- Pale color (pallor).
- Feeling tired.
- Blurred vision.
- Tender scalp.
- Diarrhea (rare).
- Fever (rare).
About 30% of people who have migraines develop symptoms several hours up to 2 days before their headache starts. This early stage of migraine is called a prodrome. During this stage, you can experience vague symptoms including anxiety, mood changes (depression, hyperactivity, irritability, euphoria), tiredness, increased thirst, food cravings and neck stiffness and pain
What triggers a migraine?
Migraine attacks can be triggered by a variety of factors. Common triggers include:
- Emotional stress , worry. Emotional stress is one of the most common triggers of migraine headache. During stressful events, certain chemicals in the brain are released to combat the situation (known as the "flight or fight" response). The release of these chemicals can bring on a migraine. Other emotions like anxiety, worry and excitement can increase muscle tension and dilate blood vessels. That can make the migraine more severe.
- Sensitivity to specific chemicals and preservatives in foods. Certain foods and beverages, such as aged cheese, alcoholic beverages, chocolate and food additives such as nitrates (in pepperoni, hot dogs, luncheon meats) and fermented or pickled foods may be responsible for triggering up to 30% of migraines.
- Caffeine. Having too much caffeine or withdrawal from caffeine can cause headaches when the caffeine level abruptly drops. Your blood vessels seem to become sensitized to caffeine, and when you don't get it, a headache may occur. Caffeine itself is often helpful in treating acute migraine attacks.
- Hormonal changes in women. You might ask, "Is there a link between migraines and hormones?" Migraines in women are more common around the times of their menstrual periods. The abrupt drop in estrogen that triggers menses can also trigger migraines. Hormonal changes can also be brought on by birth control pills and hormone replacement therapy. Migraines are generally worse between puberty and menopause, since these estrogen fluctuations generally do not occur in young girls and post-menopausal women. If your hormones are a strong factor in your migraines, it is possible that you may have fewer headaches after menopause. Hormonal changes do not appear to trigger migraines in men.
There are other mirgraine triggers, including:
- Changing weather conditions such as storm fronts, barometric pressure changes, strong winds or changes in altitude.
- Bright light, fluorescent light, flashing lights, sunlight.
- Tension, anxiety.
- Being overly tired.
- Missing meals, dieting or not drinking enough liquids.
- Changes in normal sleep pattern.
- Loud noises.
- Exposure to smoke, perfumes or other odors.
- Certain medications that cause blood vessels to swell.
- Overuse or daily use of headache-relieving medications.
What is an aura?
An aura is a symptom or “warning signal” that a migraine is about to begin. An aura can also appear during or after the headache pain. Auras can last from 15 to 60 minutes. About 15 to 20% of people who experience migraines have auras. Auras can affect vision, producing symptoms such as:
- Bright flashing dots or lights.
- Blind spots.
- Distorted vision.
- Temporary vision loss.
- Wavy or jagged lines.
Auras can affect your other senses too. Other auras may include ringing in the ears (tinnitus), tingling in the arm or face, speaking difficulties, changes in smell (such as strange odors) or taste, or simply having a “funny feeling.”
Some rare migraines, with specific neurological auras, include:
Hemiplegic migraine. You'll have temporary paralysis (hemiplegia) or neurological or sensory changes on one side of the body. The onset of the headache may be associated with temporary numbness, dizziness or vision changes.
Retinal 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.
Migraine with brainstem aura. With this is migraine, you'll have accompanied 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 severe. Certain medications, or medication withdrawal, can cause you to have this type of migraine syndrome.