• Migraines
• Cluster Headaches

Everything You Need to Know About Migraines

If you’ve ever experienced a migraine, you know how painful (and sometimes even debilitating) they can be. 

Understanding what a migraine is and how it differs from other types of headaches is crucial for proper treatment and management. By recognizing the symptoms and knowing the potential causes, individuals can take proactive steps to reduce the frequency and severity of migraine attacks.

This can ultimately improve quality of life, lessen the impact on daily activities, and help prevent migraines from becoming a chronic condition.

What is a Migraine?

A migraine is a recurring headache that causes moderate to severe throbbing or pulsating pain, usually on one side of the head. It often comes with other symptoms like nausea, sensitivity to light and sound, or visual disturbances called aura. 

Migraines are considered neurological disorders because they involve changes in brain activity that affect nerve pathways and chemicals. These changes trigger a variety of symptoms beyond just head pain, making migraines much more than a typical headache and showing their impact on the brain and nervous system.

There is no cure for migraines, but they are extremely common and affect millions of people worldwide. In fact, approximately 12% of the population experiences migraines – with women being more likely to suffer from them due to hormonal factors. Migraines are the third most prevalent illness globally and the leading cause of disability among people under 50. This can severely impact personal and professional life, making it difficult to work, engage in social activities, or even carry out everyday tasks during an attack.

Symptoms of Migraines

Migraine pain is usually described as intense, throbbing, or pulsating, often located on one side of the head. This pain can escalate over time, becoming debilitating. In addition to the pain, many people experience a variety of accompanying symptoms that can make the condition even more challenging to deal with.

Common migraine symptoms include:

• Throbbing or pulsating pain

• Nausea and vomiting

• Sensitivity to light (photophobia)

• Sensitivity to sound (phonophobia)

• Visual disturbances (aura)

• Fatigue

• Difficulty concentrating

Stages of a Migraine Attack

Migraines don’t just happen out of nowhere – they typically progress through distinct stages, each with its own set of symptoms. Understanding these stages can help individuals recognize and manage migraines more effectively.

Prodrome

The prodrome stage serves as an early warning sign, often beginning hours or even days before the headache. Common signs include mood changes, fatigue, neck stiffness, or food cravings.

Aura

Next is the aura phase, which some people may experience. This stage involves visual disturbances like flashing lights or blind spots, as well as other sensory changes, such as tingling or numbness in the face or limbs.

Headache

The headache phase follows, characterized by intense, throbbing pain, usually on one side of the head. This stage often brings additional symptoms like nausea, vomiting, and sensitivity to light and sound, making it the most debilitating part of the attack.

Postdrome

Finally, the postdrome phase – often referred to as a migraine “hangover” – sets in after the headache subsides. Many people feel drained, foggy, or irritable during this recovery period, which can last for a day or more.

Types of Migraines

Migraines come in various forms, each with unique characteristics and triggers. Each type of migraine presents differently, and recognizing their variations is essential for effective management and treatment.

Migraine with aura 

Also known as classic migraine, the migraine with aura includes visual disturbances like flashing lights or zigzag patterns, as well as other sensory changes. These may include tingling or numbness, which occur before the headache begins. The aura typically acts as a warning sign, providing a window of time to recognize and potentially treat the migraine before it fully develops. 

Some individuals experience difficulty speaking, confusion, or dizziness during this phase, which can be unsettling and mimic symptoms of more severe conditions, such as a stroke. The aura phase typically lasts between 20 minutes and an hour, and in some cases, it may not be followed by the headache phase at all, which is known as a silent migraine.

While the exact cause of aura is not fully understood, it’s believed to result from a temporary disruption in electrical and chemical activity in the brain, known as cortical spreading depression. This wave of activity can trigger the sensory changes experienced during an aura. Identifying the early signs of aura can help individuals take quick action, such as using prescribed medications, to potentially reduce the severity or duration of the migraine.

Migraine without aura

Unlike migraines with aura, this type does not include the sensory or visual disturbances that act as a warning sign. Instead, it typically begins with moderate to severe throbbing or pulsating pain – often localized on one side of the head. This pain can last anywhere from a few hours to several days if untreated, significantly impacting daily activities.

In addition to head pain, migraines without aura frequently come with other debilitating symptoms. These may include nausea, vomiting, and a heightened sensitivity to light, sound, or even smells, making it difficult to be in bright or noisy environments. Physical activity often worsens the symptoms, leading many people to seek a dark, quiet room to find relief.

Because there are no early warning signs like those seen in migraines with aura, this type of migraine can strike unexpectedly. This being said, some common triggers include stress, lack of sleep, dehydration, and certain foods.

Chronic migraines

Chronic migraines are a particularly challenging form of migraine characterized by their frequency and persistence. To be classified as chronic, migraines must occur at least 15 days per month, with at least eight of those days involving migraine-specific symptoms like moderate to severe head pain, sensitivity to light and sound, or nausea. This condition often develops over time, with occasional migraines becoming more frequent until they transition into a chronic pattern.

The symptoms of chronic migraines can vary in severity, but their ongoing nature often makes them more disabling than episodic migraines. People with chronic migraines may experience a mix of full-blown migraine attacks and milder, headache-like pain on non-migraine days. The unpredictable nature of these migraines can interfere with work, social activities, and overall quality of life. In addition to the physical symptoms, chronic migraines can lead to emotional and mental health challenges, such as anxiety or depression, due to the constant struggle of managing the condition.

Menstrual migraines

Menstrual migraines are a specific type of migraine closely tied to hormonal fluctuations in women – particularly the drop in estrogen levels that occurs just before menstruation. These migraines typically strike in the days leading up to a period or during the first few days of the cycle, making them predictable for many individuals who experience them. However, their intensity and additional symptoms often set them apart from other types of migraines.

Managing menstrual migraines often requires a targeted approach that considers hormonal triggers. Options include hormonal therapies, such as birth control pills to stabilize estrogen levels, or migraine-specific medications taken at the onset of symptoms. Preventive strategies, like maintaining a consistent sleep schedule, managing stress, and staying hydrated, can also help reduce the frequency and severity of these migraines. By understanding the hormonal connection, women can better anticipate and manage their menstrual migraines, minimizing their impact on daily life.

Hemiplegic migraines

Hemiplegic migraines are a rare and particularly severe type of migraine characterized by temporary weakness or paralysis on one side of the body. This striking symptom mimics those of a stroke – often making hemiplegic migraines a frightening experience. The weakness or paralysis – which may affect the face, arm, or leg – can last from several hours to a few days and is usually accompanied by other migraine symptoms.  

In addition to physical weakness, individuals may experience other neurological symptoms during a hemiplegic migraine attack. These can include slurred speech, confusion, visual disturbances such as flashing lights or blind spots, and in some cases, difficulty understanding or processing language. For many, the aura phase is particularly pronounced in hemiplegic migraines and can include tingling or numbness on the affected side of the body before the onset of paralysis or weakness.  

Hemiplegic migraines are often categorized into two forms: familial hemiplegic migraine (FHM), which is inherited and caused by genetic mutations, and sporadic hemiplegic migraine (SHM), which occurs without a family history. These migraines are believed to result from disruptions in the brain’s electrical activity, particularly in areas that control motor functions and sensory perception.  

Treatment and management of hemiplegic migraines can be complex, as certain medications typically used for other migraines – such as triptans or ergotamines – are often avoided due to the risk of worsening neurological symptoms. Instead, preventive treatments – like calcium channel blockers or anti-seizure medications – may be recommended. Acute management may involve pain relievers and anti-nausea medications, along with rest in a dark, quiet room to alleviate symptoms.  

Because hemiplegic migraines are rare and share symptoms with more serious conditions like stroke, it’s crucial to seek immediate medical attention. A proper diagnosis not only ensures appropriate treatment but also provides peace of mind in distinguishing these migraines from other potentially life-threatening conditions.

Causes and Triggers of Migraines

The causes of migraines are complex and involve a mix of neurological, vascular, genetic, and environmental factors. At their core, migraines are believed to result from abnormal brain activity that affects nerve signaling and blood flow, leading to the throbbing pain and other symptoms. These changes can be influenced by various triggers, making migraines a uniquely personal experience for those who suffer from them.

For females, hormonal fluctuations play a significant role in migraine onset. Estrogen levels, in particular, can impact the frequency and severity of migraines, which is why they often occur around menstruation, pregnancy, or menopause. Hormonal birth control and hormone replacement therapy can also influence migraines, either triggering or alleviating them depending on the individual.

Genetics may increase susceptibility, as migraines tend to run in families, suggesting an inherited component. Environmental factors like changes in weather, stress, certain foods, lack of sleep, or bright lights can also act as triggers. These varied causes and triggers highlight the importance of identifying patterns and working with a healthcare provider to better manage migraines.

Managing Chronic Migraines

Managing chronic migraines often requires a combination of lifestyle adjustments, preventive measures, and medical treatments tailored to each individual’s needs. Simple changes – like maintaining a consistent sleep schedule, managing stress, staying hydrated, and avoiding known triggers – can make a significant difference. Identifying these triggers is key, as chronic migraines are often influenced by a mix of environmental and personal factors.

Treatment options

When it comes to migraine treatment, there are various options to explore. Over-the-counter pain relievers may help with occasional migraines, but prescription medications like triptans or preventive therapies such as beta-blockers, antidepressants, or CGRP inhibitors are often recommended for chronic cases. 

Some individuals also find relief through natural remedies, like magnesium supplements, acupuncture, or relaxation techniques. No matter the approach, consulting a healthcare provider is crucial to developing a safe and effective management plan.

Tracking and understanding your migraines

Tracking migraines is another vital tool in managing their impact. A migraine diary can help identify patterns and triggers, providing valuable insight for both patients and doctors.

Apps and digital tools designed to monitor migraines can make this process easier, offering reminders, tracking symptoms, and creating reports that can guide treatment adjustments. With the right combination of proactive measures and professional support, chronic migraines can become more manageable, improving quality of life.

How LifeMD Can Help

Do you get frequent headaches that just don’t let up no matter what medication you take? You may be one of the millions of Americans affected by migraines. But help is available at LifeMD. 

Schedule a video appointment with a board-certified doctor or nurse practitioner so you can start managing your migraines.

LifeMD makes it easy to stay on top of your health because talking to a doctor, filling your prescriptions, getting your labs done—and more—are all easy and cost-effective. Come discover a healthcare solution built around you and your life.

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