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Migraine

Woman holding head

What is a migraine?

A migraine is a very intense headache that is usually felt as a throbbing or pulsing pain on one side of the head and accompanied by a sensitivity to light or sounds.

Some migraines are preceded by an aura, and most people with migraines experience them repeatedly.

What causes a migraine?

Experts are not sure exactly what causes a migraine but suspect it involves changes in a chemical in the brain responsible for regulating pain, called serotonin.

Migraines are more common in women and over two-thirds of people that suffer from migraines have a family history of the disorder.

Several migraine triggers have been identified. These are substances or events that are more likely to provoke a migraine in certain people. Common triggers include:

  • Alcohol
  • Dehydration
  • Foods, such as chocolate, caffeine, cheese, or processed foods
  • Food additives, such as aspartame or monosodium glutamate (MSG)
  • Hormonal changes
  • Intense physical exertion
  • Sensory stimuli, such as bright or flashing lights, sun glare, loud sounds
  • Skipping meals
  • Stress
  • Strong smells, such as perfume, secondhand smoke, chemicals
  • Sleep changes or jet lag
  • Weather changes.

What are the symptoms of a migraine?

The symptoms of a migraine can vary from person to person and even from episode to episode in the same person. Symptoms may include:

  • Severe pain on only one side of the head
  • Sensitivity to any kind of light
  • Sensitivity to any kind of sound
  • Throbbing pain
  • Nausea with or without vomiting
  • Vision changes or blurred vision.

An aura is a feeling, vision or hearing change, unusual smell or taste that typically precedes the migraine by anywhere from 30 minutes to 24 hours. About 20% of migraine sufferers develop an aura.

How is a migraine diagnosed?

See your doctor if you are suffering from regular headaches or you have symptoms of a migraine. It is useful for your doctor if you keep a journal and try to identify any specific event or food that repeatedly precipitates your migraine attack.

Your doctor will evaluate your history and symptoms to determine if your headaches are migraine headaches.

Usually, no special tests are required. If there is any doubt about your diagnosis, your doctor may suggest you see a neurologist, a medical doctor with expertise in illnesses of the nerves and brain.

How is a migraine treated?

There are two types of treatment for migraine:

  • Medications that reduce the symptoms of a current migraine attack
  • Medications that aim to prevent migraines from recurring.

Treatments may include:

  • Pain relievers, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Caffeine
  • Triptans
  • Ergotamine
  • Oral serotonin (5-HT) 1F receptor agonists.

Preventive agents may include beta-blockers, calcium channel blockers, anticonvulsants, antidepressants, and calcitonin gene-related peptide (CGRP) receptor antagonists.