What is a migraine? A migraine has the power to not only affect the brain but the rest of the body as well. If you or a loved one is a victim of migraines, click here to learn more about Prairie Spine’s headache & migraine management program. Continue reading to find out more about migraine symptoms, migraine causes, and more.
Migraine is a neurological disease characterized by repeated episodes of symptoms, called attacks, that usually include headache, often accompanied by nausea; vomiting; sensitivity to light, touch, smell, or sound; dizziness; visual disturbances; and tingling or numbness in the face, hands, or feet.
Migraine attacks may come on suddenly without warning, or they may be preceded by certain known triggers, such as skipping a meal, being exposed to smoke or air pollution, or experiencing a change in hormone levels as part of the menstrual cycle. Most migraine attacks last from 4 to 72 hours, although effective treatment can shorten them to a matter of hours. On the other hand, some migraine attacks can last even longer than 72 hours.
Having migraine can be disabling and can lead to missing days of school or work, being less productive at school or work, being unable to perform household responsibilities, and missing out on family, social, and leisure activities.
An estimated 1 billion people worldwide, and 39 million Americans, have migraine.
While a variety of triggers can set off migraine attacks, they don’t directly cause the attacks or the underlying disease.
There are still gaps in doctors’ understanding of what causes migraine. However, some doctors describe the migraine brain as hyperactive, or supersensitive, by which they mean that the brain of someone with migraine reacts more strongly to environmental stimuli such as stress or sleep disturbance than the brain of someone who doesn’t have migraine, resulting in the symptoms known as a migraine attack.
There is no cure for migraine, but treatments and lifestyle approaches can help minimize the number of attacks a person has and shorten or reduce the severity of those that do occur.
Types of Migraine
There are two main types of migraine: with or without aura. Migraine with aura is further divided into four subtypes: migraine with typical aura, migraine with brain stem aura, hemiplegic migraine, and retinal migraine. And some of these subtypes have sub-subtypes of their own. A person can have more than one type of migraine simultaneously as well as other types of headaches.
Migraine is also categorized as chronic or episodic, based on the number of days per month a person has symptoms. Chronic migraine is defined as migraine pain that is experienced for 15 or more days per month for at least three months. Episodic migraine is defined as fewer than 15 days of migrainous symptoms per month.
An estimated 144 million people worldwide — and 3 to 7 million Americans — have chronic migraine. As with episodic migraine, chronic migraine is up to 3 times more common in women than men.
Identifying what type of migraine you have may help you and your doctor choose the right treatment for you. It can be essential if you want to participate in clinical trials.
Migraine Without Aura
Formerly known as common migraine, migraine without aura is characterized by a headache that’s usually on one side of the head, has a pulsating quality, is worsened by physical activity, and is accompanied by nausea or light and sound sensitivity.
Migraine without aura may have a prodrome, or warning, phase, in which a person experiences symptoms such as depression, food cravings, difficulty focusing, uncontrollable yawning, and others.
It can also have a postdrome phase, when the headache pain has receded, but a person feels tired and achy and has trouble concentrating.
Alternatively, a person may feel elated and even euphoric after the headache phase of a migraine has passed.
Migraine With Aura
Migraine with aura, formerly called classic migraine, occurs in up to 30 percent of people who have migraine. It usually causes the same symptoms as a migraine without aura, except that the headache phase of the migraine attack is preceded by neurologic disturbances that may include visual, speech, or sensory changes.
Examples of visual aura include seeing stars, zigzags, or flashing lights; blurred vision; temporary blind or colored spots; and tunnel vision. Sensory disturbances may include a feeling of pins and needles or numbness in a part of the body, face, or tongue. In some cases, aura symptoms occur with no headache accompanying or following them.
Migraine With Brain Stem Aura
This type of migraine, formerly known as basilar-type migraine, is a rare type of migraine with aura. It usually includes neurologic symptoms such as double vision, problems speaking and hearing, dizziness, and loss of balance and coordination.
This type of migraine comes in two forms: familial hemiplegic migraine and sporadic hemiplegic migraine. Both are characterized by aura, fever, and hemiplegia (paralysis on one side of the body). Both are relatively rare.
Retinal migraine is an extremely rare cause of temporary visual loss in one eye. It’s diagnosed when a person has repeated attacks of one-sided visual disturbance — including the types of visual symptoms commonly seen in migraine aura — or blindness associated with migraine headache. These symptoms tend to evolve over five or more minutes, may last as long as an hour, and may be accompanied or followed by a headache.
Chronic migraine is defined as headache occurring 15 or more days per month for at least three months, with the headache having migrainelike features on at least eight of those days.
Given the frequency of symptoms in chronic migraine, it can be impossible to determine when one migraine attack ends and another begins. It can also be difficult to determine whether an individual in fact has chronic migraine or has another condition, such as medication-overuse headache, that would be expected to cause daily or near-daily head pain.
According to The International Classification of Headache Disorders, keeping a detailed headache diary for at least month may be necessary to determine what sort of headache — or headaches — a person is experiencing.
Syndromes That May Be Associated With Migraine
Certain disorders occur more frequently among people with migraine or people, usually children, at a higher risk of developing migraine:
- Cyclical Vomiting Syndrome. In cyclical vomiting syndrome, an individual experiences attacks of severe nausea and vomiting lasting an hour or more for up to 10 days at a time. Between attacks, which occur on a regular cycle, the person has no symptoms of nausea or vomiting.
- Abdominal Migraine This type of episodic migraine is diagnosed mostly in children. Symptoms include abdominal pain, nausea, and vomiting. Kids who experience abdominal migraine often don’t have attacks involving headache in adolescence but go on to develop them as adults.
- Benign Paroxysmal Vertigo In this syndrome, otherwise healthy children experience recurrent brief attacks of vertigo that come on without warning and resolve spontaneously without loss of consciousness. During the attacks, a child may have nystagmus (uncontrolled horizontal or vertical eye movement), impaired balance or coordination (called ataxia), vomiting, pale skin, and fearfulness.
- Benign Paroxysmal Torticollis Occurring in infants and small children, this syndrome causes the head to tilt to one side, with or without slight rotation, and stay tilted for minutes to days before spontaneously resuming its normal position. During the attack, the infant or child may be pale and irritable, seem uncomfortable or generally unwell, vomit, or in older children, have impaired balance or coordination.
Other Types of Headaches
Other rare types of headaches include these varieties:
- Cluster Headache These intensely painful headaches last 15 to 180 minutes without treatment and happen in cycles, or clusters.
- Paroxysmal Hemicranias Severe, sometimes throbbing pain on one side of the face or around the eyes lasts 2 to 30 minutes and occurs more than 5 times a day.
- Ice-Pick Headache As the name implies, an ice-pick headache is a migraine characterized by stabbing pain. Fortunately, it is relatively uncommon and typically short in duration.
- Intractable Headache Any headache, including migraine, that doesn’t respond to treatment.
- Occipital Neuralgia This disorder causes pain in the back of the head and upper neck.