What is a Migraine

Ian Vicino
Jan 19
4 min read

(Disclaimer: The following is an example of patient education material to showcase my ability to write medical content. It is intended only to be informational. Links to references can be found at the bottom of the page. Please see your medical provider for questions about migraines, treatment, or other medical advice.)

A migraine is a headache that causes moderate to severe pain, often a throbbing or pulsing feeling, on one side of the head. It may also occur with nausea and vomiting and sensitivity to light, sound, or smells. It can last hours or days and can impact your ability to work or go through daily activities.

A migraine may arrive with a symptom that strikes before the onset of the migraine, known as an aura. An aura may be experienced vision changes such as a temporary loss of vision and flashes of light, or tingling to one side of the face, and arm or leg, or trouble speaking.

Humanity has long suffered with migraine headaches, and many well-known people of the past have experienced them including Julius Caesar, St. Paul, Thomas Jefferson, and Charles Darwin. Migraines have been documented as early as 3000 BC by the ancient Egyptians who described sudden and severe nerve pain, which documentation had continued through various regions and cultures until the present day.

Phases of a Migraine Attack and Symptoms

A migraine can be divided into four phases or stages, although not all stages will be experienced by everyone:

· The Prodrome

o This first phase begins 24 hours before experiencing the severe headache. Symptoms include food cravings, uncontrollable yawning, and increased urination.

· The Aura

o The aura, if experienced, occurs before the headache and can act as a warning that a headache is on its way, but can occur during the headache phase as well. It can impact your ability to feel, move, or speak and can last between 5 minutes to 60 minutes.

· The Headache

o The migraine headache can last between 4 hours to 72 hours (3 days). The migraine headache will often be localized to only one side of the head with various symptoms including:

§ throbbing or pulsing pain

§ sensitivity to light, sound and smells

§ nausea and vomiting

· The Postdrome

o This phase can last between a few hours to 48 hours (2 days). It is often known as a migraine hangover, because its symptoms are like those experienced after alcohol consumption:

§ Fatigue

§ Stiff neck

§ Sensitivity to light and sound

§ Nausea

§ Dizziness

Risk Factors

There are many risk factors or comorbidities that may cause a migraine headache. Some of these include insomnia, depression, anxiety, gastric ulcers, angina (reduced blood flow to chest) and epilepsy. What exactly causes migraines is still an ongoing question but there may be a link to genetics as 42% of migraines are inherited.

Estrogen Imbalances

Fluctuating estrogen hormones are associated with migraines. Women suffer from migraines at least twice as often as men, with some studies suggesting three times as much. During menstruation, pregnancy, menopause, while taking contraceptives, or during/after hormone replacement therapies, women’s estrogen levels change which has been associated with migraine headaches.

Stress

Stress may be the most common trigger of migraine attacks. Stress was found to be a trigger of migraines in 62% of patients.

Thyroid Hormones

Migraines may be a result of high thyroid stimulating hormone (TSH). People with hypothyroidism have high TSH levels and thus may experience migraines.

Obesity

Obesity is considered a risk factor for experiencing migraines. This is especially true for women under the age of 55 years old.

Sleep Disorders

There is a strong relationship between sleep disturbances and migraines. Migraines are associated with insomnia, sleep apnea, and narcolepsy. Sleep problems are one of the most common factors linked with experiencing migraines.

Eating Disorders

Skipping meals, and fasting have been associated with Migraines. However, eating a balanced intake of foods containing high omega-3 essential fatty acids, low omega-6 fatty acids, as well as healthy dieting can help reduce migraines.

Cardiovascular disease

Migraines are a risk factor for cardiovascular, or heart, diseases. Because migraines may be due to insufficient blood flow to the brain and heart, experiencing migraines may be lined to heart problems. Patients with migraines with aura are at higher risk of stroke, arrhythmia, and heart attack.

Anxiety and Depression

Individuals who experience migraines are at an increased risk of experiencing anxiety. Those who experience migraines may be three times as likely to experience anxiety.

Individuals who experience migraines are more likely to experience depression as well. The link goes both ways, however. Migraine attacks may be a prediction for depression, or depression may predict future migraine attacks.