A migraine is a severe, painful headache that can be preceded or accompanied by sensory warning signs such as flashes of light, blind spots, tingling in the arms and legs, nausea, vomiting, and increased sensitivity to light and sound.
The excruciating pain that migraines bring can last for hours or even days. Migraine is a common problem affecting 36 million Americans, about 12% of the population.1
Contents of this article:
At the end of some sections you may also see introductions to any recent developments that MNT has covered.
Fast facts on migraines
Here are some key points about migraines. More detail and supporting information is in the main article.
- The cause of migraines is still largely unknown.
- Migraines can be preceded by an aura of sensory disturbances followed by a severe one-sided headache.
- Approximately 12% of Americans get migraine headaches.
- Migraine tends to affect people between 15-55 years of age.
- Some people who suffer from migraines can clearly identify triggers or factors that cause the headaches such as allergies, light and stress.
- Some people get a warning prodrome, preceding the onset of a migraine headache.
- Many migraine sufferers can prevent a full-blown attack by recognizing and acting upon the warning signs.
- Over-the-counter medications can eliminate or reduce pain.
- Specific medications can help some sufferers.
- People who suffer from severe attacks can take preventative medicines.
What are migraine headaches?
The exact cause of migraine headaches is unknown; it is thought to be due to abnormal brain activity causing a temporary alteration in the nerve signals, chemicals and blood flow in the brain.
Migraine headaches can be very debilitating.
Migraine headaches can be very debilitating affecting 1 in 4 households in America. They are more common in women than men, and 3% of people have chronic migraines where they experience symptoms for half the month for six months.1
How common are migraines?
The prevalence of migraine headaches is high, affecting roughly 1 out of every 7 Americans annually, and has remained relatively stable over the last 8 years.
Migraine and headache are leading causes of outpatient and ED visits and remains an important public health problem, particularly among women during their reproductive years.2
The National Headache Foundation states that health care providers have properly diagnosed fewer than half of all migraine sufferers.3
Migraine is commonly misdiagnosed as tension-type headache or sinus headache.
What triggers migraine headaches?
Some people who suffer from migraines can clearly identify triggers or factors that cause the headaches, but many cannot. Potential migraine triggers include:
- Allergies and allergic reactions
- Bright lights, loud noises, flickering lights, smoky rooms, temperature changes, strong smells and certain odors or perfumes
- Physical or emotional stress, tension, anxiety, depression, excitement
- Physical triggers such as tiredness, jet lag, exercise
- Changes in sleep patterns or irregular sleep
- Smoking or exposure to smoke
- Skipping meals or fasting causing low blood sugar
- Hormonal triggers such as menstrual cycle fluctuations, birth control pills, menopause
- Tension headaches
- Foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs and salami)
- Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products and fermented or pickled foods
- Medication such as sleeping tablets, the contraceptive pill, hormone replacement therapy.
Triggers do not always cause migraines and avoiding triggers does not always prevent migraines.
Recent developments on the possible causes of migraine headaches from MNT news
A higher percentage of obese people have episodic (occasional) migraines compared to individuals with a healthy body weight, researchers at the Johns Hopkins University School of Medicine reported in the journal Neurology.
A team of scientists, including Emily A. Bates, PhD, from the University of California, San Francisco (UCSF) and Brigham Young University, who has been plagued by migraines since her teens, have identified a gene mutation that increases a person's susceptibility to migraines. They published their findings in Science Translational Medicine (May 2013 issue).
Symptoms of migraines
Symptoms of migraine can occur a while before the headache, immediately before the headache, during the headache and after the headache. Although not all migraines are the same, typical symptoms include:
- Moderate to severe pain, usually confined to one side of the head during an attack, but can occur on either side of the head
- The pain is usually a severe, throbbing, pulsing pain
- Increasing pain during physical activity
- Inability to perform regular activities due to pain
- Feeling sick and physically being sick
- Increased sensitivity to light and sound, relieved by lying quietly in a darkened room
- Some people experience other symptoms such as sweating, temperature changes, tummy ache and diarrhea.
Migraines with aura
Many people experience migraines with auras or warning signs just before or during the head pain, but many do not. Auras are perceptual disturbances such as:
- Confusing thoughts or experiences
- The perception of strange lights, sparkling or flashing lights
- Zigzag lines in the visual field
- Blind spots or blank patches in the vision
- Pins and needles in an arm or leg
- Difficulty speaking
- Stiffness in the shoulders, neck or limbs
- Unpleasant smells.
If any migraine sufferer experiences unusual or worrying features that they do not normally have, then they should seek medical help rather than blaming the migraine.
Symptoms such as unusual severe headache, visual disturbance, loss of sensation or power, difficulties with speech are all important features, which, if unusual for the sufferer, should not be ignored.
According to the National Health Service in the UK, about one-third of people who get migraines also have auras.4
When migraines with aura affect vision, the patient may see things that are not there, such as transparent strings of objects, not see parts of the object in front of them, or even feel as if part of their field of vision appears, disappears and then comes back again.
It is common for patients to describe the visual disturbance as similar to the sensation one has after being photographed with a very bright camera flash, especially if one walks into a darker room straight away.
For many migraine sufferers, the auras act as a warning, telling them that the headache is soon to come.
The Migraine Trust says that in adults auras usually occur before the headache, but in children they may happen at the same time.5
Migraine sufferers also may have premonitions know as a prodrome that can occur several hours or a day or so before the headache. These premonitions may consist of feelings of elation or intense energy, cravings for sweets, thirst, drowsiness, irritability, or depression.
On the next page we look at the diagnosis of migraines and treatment options for migraines.