A migraine is a common type of headache that may occur with symptoms such as nausea, vomiting, or sensitivity to light. In many people, a throbbing pain is felt only on one side of the head. Some people who get migraines have warning symptoms, called an aura, before the actual headache begins. An aura is a group of symptoms, including vision disturbances, that are a warning sign that a bad headache is coming.
Migraine headaches tend to first appear between the ages of 10 and 45. Sometimes they may begin later in life.
- Migraines occur more often in women than men
- Migraines may run in families
- Some women, but not all, may have fewer migraines when they are pregnant
A migraine is caused by abnormal brain activity, which can be triggered by a number of factors. However, the exact chain of events remains unclear. Today, most medical experts believe the attack begins in the brain, and involves nerve pathways and chemicals. The changes affect blood flow in the brain and surrounding tissues. Alcohol, stress and anxiety, certain odors or perfumes, loud noises or bright lights, and smoking may trigger a migraine. Migraine attacks may also be triggered by:
- Caffeine withdrawal
- Changes in hormone levels during a woman’s menstrual cycle or with the use of birth control pills
- Changes in sleep patterns
- Exercise or other physical stress
- Missed meals
- Smoking or exposure to smoke
Migraine headaches can be triggered by certain foods. The most common are:
- Any processed, fermented, pickled, or marinated foods, as well as foods that contain monosodium glutamate (MSG)
- Baked goods, chocolate, nuts, peanut butter, and dairy products
- Foods containing tyramine, which includes red wine, aged cheese, smoked fish, chicken livers, figs, and certain beans
- Fruits (avocado, banana, citrus fruit)
- Meats containing nitrates (bacon, hot dogs, salami, cured meats)
This list may not include all triggers. True migraine headaches are not a result of a brain tumor or other serious medical problem. However, only an experienced health care provider can determine whether your symptoms are due to a migraine or another condition.
Vision disturbances, or aura, are considered a “warning sign” that a migraine is coming. The aura occurs in both eyes and may involve any or all of the following:
- A temporary blind spot
- Blurred vision
- Eye pain
- Seeing stars or zigzag lines
- Tunnel vision
Other warning signs include yawning, difficulty concentrating, nausea, and trouble finding the right words.
Not every person with migraines has an aura. Those who do usually develop one about 10 – 15 minutes before the headache. However, an aura may occur just a few minutes to 24 hours beforehand. A headache may not always follow an aura.
Migraine headaches can be dull or severe. The pain may be felt behind the eye or in the back of the head and neck. For many patients, the headaches start on the same side each time. The headaches usually:
- Feel throbbing, pounding, or pulsating
- Are worse on one side of the head
- Start as a dull ache and get worse within minutes to hours
- Last 6 to 48 hours
Other symptoms that may occur with the headache include:
- Increased urination
- Loss of appetite
- Nausea and vomiting
- Numbness, tingling, or weakness
- Problems concentrating, trouble finding words
- Sensitivity to light or sound
Symptoms may linger even after the migraine has gone away. Patients with migraine sometimes call this a migraine “hangover.” Symptoms can include:
- Feeling mentally dull, like your thinking is not clear or sharp
- Increased need for sleep
- Neck pain
Signs and Tests
Your doctor can diagnose this type of headache by asking questions about your symptoms and family history of migraines. A complete physical exam will be done to determine if your headaches are due to muscle tension, sinus problems, or a serious brain disorder. There is no specific test to prove that your headache is actually a migraine. However, your doctor may order a brain MRI or CT scan if you have never had one before or if you have unusual symptoms with your migraine, including weakness, memory problems, or loss of alertness. An EEG may be needed to rule out seizures. A lumbar puncture (spinal tap) might be done.
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Reference: U.S. National Library of Medicine