A migraine is usually an intense pounding headache that can last for hours or even days. The pounding or pulsing pain usually begins in the forehead, the side of the head or around the eyes. The headache gradually gets worse. Just about any movement, activity, bright lights or loud noises seem to make it hurt more. Nausea and vomiting are common.
Migraines may happen only once or twice a year, or as often as daily. Women are more likely to have migraines than men.
Yes. The most common are classic migraine and common migraine.
Classic migraines start with a warning sign, called an aura. These types of migraines are also called “migraines with aura." The aura often involves changes in the way you see. You may see flashing lights, colors, a pattern of lines, or shadows. You may temporarily lose some of your vision, such as your side vision.
You may also feel a strange prickly or burning sensation, or have muscle weakness on one side of your body. You may have trouble communicating. You may also feel depressed, irritable and restless.
Auras last about 15 to 30 minutes. Auras may occur before or after your head pain, and sometimes the pain and aura overlap, or the pain never occurs. The head pain of classic migraines may occur on one side of your head or on both sides.
Common migraines don't start with an aura. These types of migraines are also called “migraines without aura.” Common migraines may start more slowly than classic migraines, last longer and interfere more with daily activities. The pain of common migraines may be on only one side of your head. Most people who have migraines have common migraines (they don’t have an aura).
The pain of a migraine headache can be intense. It can get in the way of your daily activities. Migraines aren't the same for all people. Possible symptoms of migraines are listed in the box below.
You may have a "premonition" several hours to a day before your headache starts. Premonitions are feelings you get that can signal a migraine is coming. These feelings can include intense energy, fatigue, food cravings, thirst, and mood changes.
Doctors don’t know exactly what causes migraines. It appears that migraine headaches may be caused in part by changes in the level of a body chemical called serotonin. Serotonin plays many roles in the body, and it can have an effect on the blood vessels. When serotonin levels are high, blood vessels constrict (shrink). When serotonin levels fall, the blood vessels dilate (swell). This swelling can cause pain or other problems. Another aspect that is being studied is that migraine headaches go along with a spreading pattern of electrical activity in the brain.
Some things make you more likely to get migraine headaches (these are called “risk factors”). Other things may bring on a migraine (these are called “triggers”).
Common migraine risk factors include the following:
Common migraine triggers include the following:
Your doctor can diagnose migraines by the symptoms you describe. If the diagnosis is not clear, your doctor will perform a physical exam. Your doctor might want to do blood tests or imaging tests, such as an MRI or CAT scan of the brain, to be sure that there are no other causes for the headache. You may also be asked to keep a "headache diary" to help your doctor identify the things that might cause your migraines.
There are 2 types of medicines for migraine treatments. One type, called “abortive”, focuses on stopping the headache from becoming severe and relieving the headache pain. This type of treatment should be started as soon as you think you're getting a migraine. The other type, called “prophylactic or preventive” includes medicines that are taken every day to reduce how often headaches occur.
Talk to your doctor about which of these two types of medicine is best for you. Some people use both types. Nonprescription and prescription medicines that are used often or in large doses may cause other problems.
For mild to moderate migraines, over-the-counter medicines that may help relieve migraine pain include aspirin; acetaminophen (one brand name: Tylenol); an acetaminophen, aspirin and caffeine combination (one brand name: Excedrin Migraine); ibuprofen (one brand name: Motrin); naproxen (brand name: Aleve); and ketoprofen (brand name: Orudis KT).
People who have more severe migraines may need to try “abortive” prescription medicines. A medicine called ergotamine can be effective alone or combined with other medicines. Dihydroergotamine is related to ergotamine and can be helpful. Other prescription medicines for migraines include sumatriptan, zolmitriptan, naratriptan, rizatriptan, almotriptan, eletriptan and frovatriptan.
If the pain won't go away, stronger pain medicine may be needed, such as a narcotic, or medicines that contain a barbiturate. These medicines can be habit-forming and should be used cautiously.
To help manage your migraine pain, try the following:
Yes. Medicine to prevent migraines may be helpful if your headaches happen more than 2 times a month or if your headaches make it hard for you to work and function. These medicines are taken every day, whether you have a headache or not. Examples of medicines used to prevent migraines include certain antidepressants, anti-seizure medicines, cardiovascular drugs, botox injections, and leaf and root extracts of the butterbur plant.
While there are no sure ways to keep from having migraine headaches, here are some things that may help:
Written by familydoctor.org editorial staff