Introduction
A migraine is a form of severe headache, but differs in many ways from other headaches, with the main difference being that regular headaches generally affect both side of the head, whereas a migraine generally affects only one side.
Migraine is usually accompanied by other symptoms in addition to the severe headache.
Migraine attacks can last for anything from a few hours to 2-3 days.
The World Health Organisation uses a classification system for headaches to differentiate between different types of headache and migraine. Migraines are divided into two broad types - 'migraine with aura' and 'migraine without aura'.
A migraine with aura involves visual disturbance/s, in addition to the symptoms of a migraine without aura. Around 80% of people who experience regular migraines have migraine without aura.
Globally, around 1 in 7 people have regular migraines. People with migraines can suffer them as rarely as once a year, or several times a year.
Causes
Medical science does not fully understand the cause or causes of migraines, although they are believed to be connected with the trigeminal nerve and the brainstem and / or imbalances in levels of certain chemicals in the brain (serotonin for example).
There are a number of commonly recognised 'triggers' for migraines, including…
- Anything that causes hormonal changes in women - for example menstruation or medication containing hormones such as the contraceptive pill and hormone replacement therapy.
- Some foods and drinks - coffee, wine and other alcoholic drinks can trigger migraines in some people, as well as some types of food, notably salty or processed foods or food additives such as monosodium glutamate (MSG) and aspartame.
- Changes in routine - changes in sleeping patterns and altering eating times or fasting.
- Activity levels - high levels of physical activity (including sexual activity).
- Stress.
- Dehydration (even at low levels).
- Prolonged coughing / coughing fits.
- Changes in the weather (or barometric pressure) .
- Loud noises/high sound levels.
- Strong smells e.g. smoke, chemicals, perfume.
There are also some risk factors for developing migraines…
- Gender - women suffer migraines three times more than men.
- Age - migraine attacks tend to affect people aged between 35-45.
- Genetics - migraine can be an inherited trait.
- Head trauma - some injuries to the head can lead to the onset of migraines.
For women, the onset of periods, pregnancy or onset of menopause may also trigger migraine.
Symptoms
Migraines generally occur in four phases, referred to as 'prodrome', 'aura', the attack itself and 'post-drome'.
First phase – prodrome
This phase may include one or more of the following symptoms…
- Mood swings.
- Food craving.
- Stiffness in the neck.
- Thirstiness.
- Increase in urination.
- Bouts of yawning.
- Constipation.
Second phase – aura
(this only applies to people suffering migraines with aura)…
- Seeing sparkles / stars / coloured spots / flashing light.
- Tunnel vision and / or blind spots.
- Temporary loss of vision.
- Numbness, tingling and/or pins and needles in the arms and / or legs.
- Involuntary movement / jerking.
- Weakness on one side of the body.
- Vertigo / dizziness.
- Speech / hearing problems.
- Memory changes.
- Fainting/partial paralysis (rare) .
Third phase - attack
- Pain, most often to one side of the head (although it can affect both sides) .
- Throbbing / pulsing type of pain.
- Heightened sensitivity to light and sound, and sometimes touch and smell.
- Nausea / vomiting.
Fourth phase - post-drome
(after the attack has subsided)…
- Fatigue for up to 24 hours afterwards (although some people can feel elation during this period) .
- Sudden head movement may cause brief pain.
Tests / Diagnosis
There is no test which diagnoses migraine, although your doctor may recommend a range of other tests to exclude other possible causes.