What causes a migraine?

A migraine can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities. For some people, a warning symptom known as an aura occurs before or with a headache. An aura can include visual disturbances, such as flashes of light or blind spots, or other disturbances, such as tingling on one side of the face or in an arm or leg and difficulty speaking. Medications can help prevent some migraines and make them less painful. The right medicines, combined with self-help remedies and lifestyle changes, might help.

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Symptoms: Migraines, which often begin in childhood, adolescence, or early adulthood, can progress through four stages: prodrome, aura, attack, and post-drome. Not everyone who has migraines goes through all stages.

Prodrome: One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including:

• Constipation

• Mood changes, from depression to euphoria

• Food cravings

• Neck stiffness

• Increased thirst and urination

• Frequent yawning

For some people, aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They're usually visual but can also include other disturbances. Each symptom usually begins gradually, builds up over several minutes, and lasts for 20 to 60 minutes.

Examples of migraine aura include:

• Visual phenomena, such as seeing various shapes, bright spots, or flashes of light

• Vision loss

• Pins and needles sensations in an arm or leg

• Weakness or numbness in the face or one side of the body

• Difficulty speaking

• Hearing noises or music

• Uncontrollable jerking or other movements

Attack: A migraine usually lasts from four to 72 hours if untreated. How often migraines occur varies from person to person. Migraines might occur rarely or strike several times a month.

During a migraine, you might have:

• The pain usually on one side of your head, but often on both sides

• Pain that throbs or pulses

• Sensitivity to light, sound, and sometimes smell and touch

• Nausea and vomiting

Post-drome

After a migraine attack, you might feel drained, confused, and washed out for up to a day. Some people report feeling elated. The sudden head movement might bring on the pain again briefly.

When to see a doctor Migraines are often undiagnosed and untreated. If you regularly have signs and symptoms of migraines, keep a record of your attacks and how you treated them. Then make an appointment with your doctor to discuss your headaches. Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different. See your doctor immediately or go to the emergency room if you have any of the following signs and symptoms, which could indicate a more serious medical problem:

• An abrupt, severe headache like a thunderclap

• Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or trouble speaking

• Headache after a head injury, especially if the headache worsens

• A chronic headache that is worse after coughing, exertion, straining, or a sudden movement

• New headache pain after age 50

Though migraine causes aren't fully understood, genetics and environmental factors appear to play a role. Changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway, might be involved. So might imbalances in brain chemicals including serotonin, which helps regulate pain in your nervous system. Researchers are studying the role of serotonin in migraines. Other neurotransmitters play a role in the pain of migraine, including calcitonin gene-related peptide (CGRP).

Risk factors: Several factors make you more prone to having migraines, including:

· Family history. If you have a family member with migraines, then you have a good chance of developing them too.

· Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s and gradually become less severe and less frequent in the following decades.

· Sex. Women are three times more likely to have migraines.

· Hormonal changes. For women who have migraines, headaches might begin just before or shortly after the onset of menstruation. They might also change during pregnancy or menopause. Migraines generally improve after menopause.

Complications: Taking combination painkillers, such as Excedrin Migraine for more than 10 days a month for three months or in higher doses can trigger serious medication-overuse headaches. The same is true if you take aspirin or ibuprofen (Advil, Motrin IB, others) for more than 15 days a month or triptans, sumatriptan (Imitrex, Tosyma) or rizatriptan (Maxalt), for more than nine days a month.

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 ice pick 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.

Check out the following resources to help you with migraines:

Hat for Migraine Relief Ice Pack Head Wrap for Cold Therapy: https://amzn.to/2YXfRnX

Fighting The Migraine Epidemic: https://amzn.to/3oZv8z1