Migraine is a type of recurring headache. It involves nerves and brain chemicals. Other sensations (eg, auras) may come before a migraine headache.
There are two types of migraines:
Migraine may happen several times a week or once every couple of years. They can be so severe that they interfere with the ability to work and carry on normal activities.
While the precise cause is not known, many potential triggers have been identified. Common triggers include:
A trigger sets the process in motion. It is possible that the nervous system reacts to the trigger by conducting electrical activity. This spreads across the brain. It leads to the release of brain chemicals, which help regulate pain.
Migraines are more common in women and before the age of 40. Other factors that increase your chance for migraines may include:
Migraines occur in phases that may include:
A warning may come before a migraine. In the hours or days before the headache, symptoms may include:
The most common aura is visual. The aura lasts about 15-30 minutes. It may produce the following sensations:
Migraine pain starts within an hour of the aura ending. Symptoms include:
Migraines usually last from 4-72 hours. They often go away with sleep. After the headache, you may experience:
The doctor will ask about your symptoms and medical history. A physical exam will be done. You may also be given a neurological exam.
To rule out other conditions your doctor may order tests, such as:
CT Scan of the Head
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Migraine therapy aims to:
Treatment options include:
Pain medications are often needed to ease or stop the pain. Over-the-counter pain pills may ease mild symptoms.
Warning: Regular use of some over-the-counter medications may cause a rebound headache.
Some prescription medications act directly to stop the cause of the migraine headache. These include drugs that:
These drugs can be taken by mouth. They may act more quickly in forms that dissolve in the mouth, are inhaled through the nose, or injected. They are more likely to be helpful if taken as soon as possible at the start of a migraine. Your doctor can help you choose the medication best for you.
Medications that can help stop a migraine once it has begun include:
Other drugs can help prevent migraines for people with frequent migraines. Preventive drugs are taken every day. Classes of preventative medications include:
Therapy may also be used to reduce the length and frequency of migraine headaches. It may be used with or without medication and may include cognitive behavioral therapy, biofeedback, or relaxation methods.
Botulinum toxin injections may be used as a way to prevent migraines and to reduce the duration and intensity of the headaches in people who have headaches often.
In some people, migraines are triggered when a nerve in the head is stimulated. With this type of surgery, the doctor finds the nerve trigger point in the head and deactivates it. This surgery may reduce the number of migraines or completely eliminate them in sufferers who do not respond to conventional treatments. Most migraines are not treated with surgery.
Transcranial magnetic stimulation surgery may also be used in patients with migraine with aura who have not responded to other treatments.
If you are diagnosed with a migraine, follow your doctor's instructions.
Methods for preventing migraine include:
Healthy lifestyle habits that may help prevent migraines include:
Therapy that may decrease migraine or migraine pain include:
Foods are not proven to trigger migraine. But consider keeping a diary of migraine and diet to identify foods that may trigger migraines for you. Foods suspected to trigger migraine include:
American Headache Society
The National Migraine Association
The College of Family Physicians of Canada
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Last reviewed December 2013 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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