Headache and migraine

A migraine is a headache that causes severe throbbing pain or a pulsing sensation, usually on one side of the head. Migraine attacks may last up to days, and the pain is sometimes so bad that it could interfere with a person’s daily activities.

On an average, around 14.7 % of the people suffer from migraine globally with very high prevalence in India.

What is the difference between migraine and headache?

Head pain is a symptom of migraine. Every headache is not migraine, and some may be caused by other reasons. Typical characteristics of migraine headaches include:

  • Throbbing or pounding pain that worsen with movement.
  • Pain is felt mostly on one side of head.
  • Atleast one of the following symptoms are present: sensitivity to light and/or sound, nausea, and vomiting.

What are the symptoms of Migraine?

Migraines can progress through four stages: prodrome, aura, attack, and post-drome.

The symptoms during these stages may be as follows:

  1. Prodrome:

Maximum people with migraine may notice following symptoms hours or days before a headache.

  • Sensitivity to light, sound, or smell.
  • Getting tired without reason and also yawning excessively.
  • Food cravings or lack of appetite.
  • Feeling moody and changes such as irritability or sadness.
  • Feeling excessively thirsty and urinating more often consequently.
  • Digestive problems like having constipation or diarrhea.

  1. Aura

Auras are reversible symptoms of the nervous system and may occur before or during migraines in some cases. The symptoms begin gradually and may last for upto an hour.

Migraine auras include:

  • Seeing various shapes, bright spots or flashes of light (Visual phenomenon)
  • Vision loss.
  • Pins and needles sensations in an arm or leg.
  • Weakness or numbness in the face or one side of the body.
  • Difficulty speaking.
  • Ringing in ears

  1. Attack

If untreated, a migraine usually lasts from 4 to 72 hours and may occur rarely or strike several times a month depending on person to person.

The symptoms during a migraine are:

  • Pain usually on one side of your head, but often on both sides.
  • Pain that throbs or pulses.
  • Sensitivity to light, sound, and sometimes smell and touch.
  • Nausea and vomiting.

  1. Post-drome

A person may feel feel drained, confused and washed out for up to a day after a migraine attack or some people also report feeling elated.

What are the causes and risk factors of Migraine?

Genetics and environmental factors appear to play a role in migraine development. A migraine attack may start due to chemical changes in the brain when overactive nerve cells send out signals that lead to changes in the levels of certain chemical compounds in your body.

Risk factors for migraine:

Sex:  Women are three times more likely to get migraines.

Age: Nowadays, most people have migraine headaches between the young ages of 10 and 40. In some women, attacks get better or disappear after menopause.

Family history: Migraines are present in 4 out of 5 people amongst family members. A person has a 50% chance of getting of getting these types of headaches if either of the parent has them and about 75% if both parents have migraine.

Medical conditions: Depression, anxiety, bipolar disorder, sleep disorders, and epilepsy may increase the risk.

How is Migraine diagnosed?

The doctor may ask about a pperson’s health history and suggest them to keep a symptom diary or any other way to track symptoms. In case of unsual several tests to rule out other causes for your pain may be suggested.

An MRI scan: A magnetic resonance imaging (MRI) scan produces detailed images of the brain and blood vessels using powerful magnetic field and radio waves. MRI scans help in diagnosis of tumors, strokes, bleeding in the brain, infections, and other brain and nervous system.

A CT scan: A computerized tomography (CT) scan uses a series of X-rays to create detailed images of the brain that helps in diagnosing tumors, infections, brain damage, bleeding in the brain and headaches causing problems.

What are the treatment options for Migraine?

Treatment goals of Migraine aim at stopping symptoms and preventing future attacks. Medications aimed for migraine are:

  • Pain-relieving medications: Drugs taken during migraine attacks to stop symptoms.
  • Preventive medications: Regular medications are prescribed that are suggested to be taken daily, to reduce the severity or frequency of migraines.
  • Sometimes anti-nausea drugs are prescribed in case presence of those symptoms.

In case of severe migraine attack, alternative therapies such as learning relaxation techniques and acupuncture may be suggested by the doctor.

Migraine devices: Several devices are available that treat or prevent migraine symptoms. These use magnetic or electrical energy to target nerves or nerve activity involved in head pain, an approach called neuromodulation.

What are the triggers of migraine attack?

Hormone changes – Symptoms may also be tied to menopause, hormonal birth control methods, or some medications like hormone replacement therapy.

Stress – might lead to a headache.

Skipping meals

Changes in weather – Sometimes, changes in barometric pressure, strong winds, or changes in altitude can all trigger an attack.

Attack on senses – Loud noises, bright lights, and strong smells can set off a headache.

Medications – Such as vasodilators, which widen your blood vessels, can trigger headaches.

Physical activity – like exercise and sex.


Changes in sleep – Sleeping too much or not enough.

Migraine trigger foods –

  • Aged cheeses, alcohol, chocolate, and beans.
  • Food additives containing substances like nitrates, monosodium glutamate (in instant noodles, packaged foods, etc. and the artificial sweetener aspartame)
  • Foods or drinks containing caffeine, such as coffee and tea, can trigger headaches. Either having too much caffeine or too less than what you are used to, can cause an attack. Caffeine itself can be a treatment for headaches.

What can be done during a Migraine attack?

Apart from taking the prescribed medicine, following things may ease symptoms:

  • Rest with your eyes closed in a dark, quiet room
  • Put a cool compress or ice pack on forehead
  • Drink plenty of liquids
  • Place a warm compress or washcloth on the head or the back of your neck
  • Gently massage the neck, scalp, or temples
  • Meditating

It may also help keep a headache diary to record the symptoms This will help in learning more about the triggers of migraines and the most effective treatment.

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