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Healthcare

Migraine

About

A migraine is a type of headache. It may occur with symptoms such as nausea, vomiting, or sensitivity to light and sound. In many people, a throbbing pain is felt only on one side of the head.

Causes

Causes

A migraine headache is caused by abnormal brain activity. This activity can be triggered by many things. But the exact chain of events remains unclear. Most medical experts believe the attack begins in the brain and involves nerve pathways and chemicals. The changes affect blood flow in the brain and surrounding tissues.

Migraine headaches tend to first appear between the ages of 10 and 45. Sometimes, they begin earlier or later. Migraines may run in families. Migraines occur more often in women than men. Some women, but not all, have fewer migraines when they are pregnant.

Migraine attacks may be triggered by any of the following:

  • Caffeine withdrawal
  • Changes in hormone levels during a woman's menstrual cycle or with the use of birth control pills
  • Changes in sleep patterns, such as not getting enough sleep
  • Drinking alcohol
  • Exercise or other physical stress
  • Loud noises or bright lights
  • Missed meals
  • Odors or perfumes
  • Smoking or exposure to smoke
  • Stress and anxiety

Migraines can also be triggered by certain foods. Most common are:

  • Chocolate
  • Dairy foods, especially certain cheeses
  • Foods with monosodium glutamate (MSG)
  • Foods with tyramine, which includes red wine, aged cheese, smoked fish, chicken livers, figs, and certain beans
  • Fruits (avocado, banana, citrus fruit)
  • Meats containing nitrates (bacon, hot dogs, salami, cured meats)
  • Onions
  • Peanuts and other nuts and seeds
  • Processed, fermented, pickled, or marinated foods

True migraine headaches are not a result of a brain tumor or other serious medical problem. Only a health care provider who specializes in headaches can determine if your symptoms are due to a migraine or other condition.

Symptoms

Symptoms

There are two main types of migraines:

  • Migraine with aura (classic migraine)
  • Migraine without aura (common migraine)

An aura is a group of nervous system (neurologic) symptoms. These symptoms are considered a warning sign that a migraine is coming. Most often, the vision is affected and can include any or all of the following:

  • Temporary blind spots or colored spots
  • Blurred vision
  • Eye pain
  • Seeing stars, zigzag lines, or flashing lights
  • Tunnel vision (only able to see objects close to the center of the field of view)

Other nervous system symptoms include yawning, difficulty concentrating, nausea, trouble finding the right words, dizziness, weakness, numbness, and tingling. Some of these symptoms are much less common with migraine headaches. If you have any of these symptoms, your provider will likely order tests to find the cause.

An aura often occurs 10 to 15 minutes before the headache, but can occur just a few minutes to 24 hours beforehand. A headache does not always follow an aura.

The headaches usually:

  • Start as a dull ache and get worse within minutes to hours
  • Are throbbing, pounding, or pulsating
  • Are worse on one side of the head with pain behind the eye or in the back of the head and neck
  • Last 6 to 48 hours

Other symptoms that may occur with the headache include:

  • Chills
  • Increased urination
  • Fatigue
  • Loss of appetite
  • Nausea and vomiting
  • Sensitivity to light or sound
  • Sweating

Symptoms may linger, even after the migraine goes away. This is called a migraine hangover. Symptoms can include:

  • Feeling mentally dull, like your thinking is not clear or sharp
  • Needing more sleep
  • Neck pain
Prognosis

Prognosis

Each person responds differently to treatment. Some people have migraines only rarely and need little to no treatment. Others need to take several medicines or even go to the hospital sometimes.

Migraine headache is a risk factor for stroke. Risk is higher in people who smoke, more so in women who have migraines that occur with aura. In addition to not smoking, people with migraines should avoid other risk factors for stroke. These include:

  • Taking birth control pills
  • Eating unhealthy foods, which can cause high cholesterol or high blood pressure
Doctor

When to Contact a Medical Professional

Call 911 if:

  • You are experiencing "the worst headache of your life."
  • You have speech, vision, or movement problems or loss of balance, especially if you have not had these symptoms with a migraine before.
  • A headache starts suddenly.

Schedule an appointment or call your provider if:

  • Your headache pattern or pain changes.
  • Treatments that once worked no longer help.
  • You have side effects from your medicine.
  • You are taking birth control pills and have migraine headaches.
  • Your headaches are more severe when lying down.

Alternative Names

Headache - migraine; Vascular headache - migraine