A Migraine Headache is a powerful that often happen with nausea, vomiting, and sensitivity to light. They can last from 4 hours to 3 days, and sometimes longer.
The American Migraine Foundation estimates that more than 36 million Americans get them, women 3 times more often than men. Most people start having migraine headaches between ages 10 and 40. However, many women find that their migraines improve or disappear after age 50. They generally last between 4 and 72 hours.
What Causes Migraine Headaches?
Migraine headaches are a symptom of an overall condition known as migraine. Doctors don’t know the exact cause of migraine headaches, although they seem to be related to changes in the brain as well as to genes that run in families. You can even inherit the triggers that give you migraine headaches, like fatigue, bright lights, weather changes, and others.
A migraine starts when overactive nerve cells send out signals that activate the trigeminal nerve-the nerve that supplies sensation to your head and face. Activation of the nerve causes release of certain chemicals like serotonin and calcitonin gene-related peptide (CGRP). CGRP causes blood vessels in the lining of the brain to swell. This releases neurotransmitters that create inflammation and pain.
Common migraine triggers include:
- Stress. When you’re stressed, your brain releases chemicals that can cause the blood vessel changes that can lead to a migraine.
- Foods. Some foods and drinks, such as aged cheese, alcohol, and food additives like nitrates (in pepperoni, hot dogs, lunchmeats) and monosodium glutamate (MSG) may be responsible for up to 30% of migraines.
- Caffeine. Getting too much or withdrawing from it can cause headaches when the level in your body abruptly drops. Blood vessels seem to get used to caffeine, and when you don’t have any, you may get a headache. Caffeine itself can be a treatment for acute migraine attacks.
- Changes in weather. Storm fronts, changes in barometric pressure, strong winds, or changes in altitude can all trigger a migraine.
You can have a mix of migraine symptoms. Common ones include:
- A headache that often begins as a dull ache and grows into throbbing pain. It usually gets worse during physical activity. The pain can shift from one side of the head to the other, can be in the front of the head, or feel like it’s affecting your entire head.
- Sensitivity to light, noise, and smells
- Nausea and vomiting, upset stomach, and belly pain
- Loss of appetite
- Feeling very warm or cold
- Pale skin
- Blurred vision
- Fever (this is rare)
Most migraine headaches last about 4 hours, but severe ones can go for more than three days. How often they happen differs for everyone, but it’s common to get two to four headaches per month. Some people may get migraine headaches every few days, while others get them once or twice a year.
Types of Migraine Headaches
The terms for two types of migraine headaches refer to the symptoms that signal when one is about to start, called an aura.
Migraines usually are associated with sensitivity to sound, light, and smells. This may be accompanied by nausea or vomiting. This type of headache often involves only one side of the head, but in some cases, patients may have pain bilaterally or on both sides.
Migraine Symptoms by Stage
- Prodromal Phase: Early Warning Signs
- Aura Phase: Strange Feelings Start
- Attack Phase: The Headache Begins
- Postdromal Phase: After It Stops
A migraine can be complicated, with symptoms that change over hours or even days. They tend to move through several stages:
Prodromal Phase: Early Warning Signs
Hours before the migraine begins — and sometimes even the day before — many people may feel:
- Either unusually energetic and excitable or depressed
- Cravings for specific foods
- Sleepy, with a lot of yawning
- The need to pee more often
In some cases, these symptoms before the headache can help doctors diagnose the problem as a Migraine Headache .
Aura Phase: Strange Feelings Start
About 1 in 3 to 1 in 4 people with migraines get an “aura” that begins before the headache or starts along with it. It may not happen with every headache, though.
An aura can include:
Changes in vision, such as:
- A flickering, jagged arc of light. It may have a complicated shape. It usually appears on the left or right side of your vision. Over a few minutes, it may get bigger.
- A blind spot in your field of vision. This problem — combined with the flickering lights — can make it hard to drive or focus your eyes on small objects.
- You might “see” images from the past or have hallucinations.
An aura can start 1 hour before the pain and usually last for 15 minutes to 1 hour. Visual auras include:
- Bright flashing dots or lights
- Blind spots
- Blurry vision
- Temporary vision loss
- Wavy or jagged lines
Other auras can affect your other senses. You might just have a “funny feeling” and not be able to describe the sensation. You could also have ringing in the ears or changes in smell (such as strange odors), taste, or touch.
Rare migraine conditions include these types of auras:
- Hemiplegic migraine. A short period of paralysis (hemiplegia) or weakness on one side of the body. You might also feel temporary numbness, dizziness, or vision changes. If you get these symptoms, it’s important to know how to tell them apart from the signs of a stroke, which can seem similar. Get emergency medical help right away if you have these symptoms.
- Ophthalmic migraine. Short-lived, partial, or complete loss of vision in one eye, along with a dull ache behind the eye, which may spread to the rest of your head. Seek immediate medical help for any visual disturbance.
- Migraine with brainstem aura. Dizziness, confusion, or loss of balance can happen before the headache. The pain may affect the back of your head. These symptoms usually start suddenly and can happen with trouble speaking, ringing in the ears, and vomiting. This type of migraine is strongly linked to hormone changes and mainly affects young adult women. Again, these symptoms need to be checked out by a doctor right away.
- Status migrainosus . This rare and severe type of migraine can last more than 72 hours. The pain and nausea are so intense that you may need to go to the hospital. Sometimes medicines, or medication withdrawal, can cause them.
- Ophthalmoplegic migraine. Pain around the eye, including paralysis of the muscles around it. This is a medical emergency because the symptoms can also be caused by pressure on the nerves behind the eye or an aneurysm. Other symptoms of this rare type of migraine include a droopy eyelid, double vision, or other vision changes.
Migraine headaches without auras are more common. Several hours before the headache starts, you can have vague symptoms, including:
- Feeling very tired
These symptoms may continue to get worse over the next several minutes.
Skin sensations. You might feel tingling or “pins and needles” in your body during an aura. It may also cause numbness. These feelings often affect the face and hands, but they can spread out across the body. They may continue to expand over the next several minutes.
Language problems. You may have a hard time communicating with others. Symptoms may include:
- Trouble expressing thoughts when you speak or write
- Trouble understanding spoken or written words
- Trouble concentrating
Attack Phase: The Headache Begins
The attack portion of a migraine can last from a few hours to several days. During this phase, you’ll probably want to rest quietly and find it hard to do your normal activities.
The pain of a migraine:
- Usually begins above the eyes
- Typically affects one side of the head, but it may happen to the entire head or move from one side to the other. It may also affect the lower face and the neck.
- Tends to feel throbbing
- May throb worse during physical activity or when you lean forward
- May get worse if you move around
Other symptoms that might happen during this phase:
Postdromal Phase: After It Stops
Following the most severe phase of the migraine, you may not feel well for up to a day. Symptoms of this post-migraine phase may include:
- Extreme tiredness
- Head pain that flares up when you lean over, move quickly, or get a rush of blood to the head
Your migraines may change over time, including how often they happen and how severe they are. Attacks may not always include all of these stages. Also, you may eventually get the aura without having a Migraine Headache. Since many of the symptoms found in these stages of migraines can also occur in very serious conditions such as stroke or seizures, seek immediate medical help for any new symptoms, or ones that have never been evaluated by your doctor.