Frequently Asked Questions about Migraine Headaches: Causes Diagnosis, and Treatments

By Dr. Atul Prasad in Centre For Neurosciences

Mar 21 , 2023 | 5 min read

What is a Migraine?

Migraine is an often chronic, painful condition that causes severe pain in the head. Other accompanying disabling symptoms can result in a person being affected at school, at work or in social situations.Migraine headacheis believed to be hereditary and is undiagnosed in a large section of the population. There are four observable phases of migraine:
  • Prodrome:It could serve as a warning sign, allowing a person to take appropriate medication.
  • Aura:Not everyone experiences aura or changes in the senses.
  • Headache: It could be unilateral or sometimes spread to the other side also.
  • Postdrome:It leaves affected persons exhausted and in depression, with trouble concentrating on routine activities.
There is throbbing pain usually on one side of the head, along with a feeling of sickness and increasing sensitivity to light and sound. The exactcause of migraine is unknown and certain chemical changes in the brain are believed to cause such episodes. Some of the common triggers include:
  • Menstrual period/ hormonal changes
  • Stress, being tired
  • Certain types of food or drinks
  • Skipping meals

How Many Types of Migraines Are Known?

There are two main types of migraine and each of them has several subtypes.

Migraine without aura (Common Migraine)

Migraine without aura is the more common type affecting 3 out of 4 persons with migraine. They last for 3-4 hours without treatment and affect women more than men. During a typical episode, affected persons go to the head pain phase directly from the prodromal phase. The pain presents on one side of the head and is pulsating or throbbing, and the person is sensitive to light and sound.

Migraine with Aura (Classic Migraine)

About a quarter of migraine-affected persons develop an aura or neurological changes. They have symptoms like changes in vision, hearing, smell and touch. Speech and movement may sometimes be affected. The aura phase tends to last up to 30 minutes. It could be aura without a headache, hemiplegic migraine or retinal migraine.

Status Migrainosus

Unlike regular attacks that last for 4-5 hours, status migrainosus is an attack that lasts for more than 72 hours or one that doesn’t respond to regular treatment. It may require ahospital visit. It is triggered by stress, lack of sleep, or any change in medication. Some of the typical symptoms include:
  • Throbbing pain on one or both sides
  • Extreme sensitivity to sound or light
  • Nausea, vomiting, fatigue.
  • It is important to seek medical care in such a situation to exclude a more serious condition like a stroke.

Migraine Headache Faqs: Causes

Migraine Headache - Who Gets It and Risk Factors?

Anyone can be affected bymigraine headachesbut some persons are more vulnerable due to certain risk factors like:
  • Heredity:Some studies show that 80% of people with migraine have a relative who is already affected.
  • Gender:Migraine is more common in women, especially between the ages of 15 and 55. The hormonal activity during these ages is believed to be responsible for the condition.
  • Stress:Stress is a major trigger for a migraine attack.
  • Smoking

Migraines - Hereditary?

In a majority of people with migraines, there is a family history of migraine. A child has a 50% chance of getting migraines if one parent has had them.

Can Migraines Cause Brain Damage or Any Other Disease?

Migraines do not cause brain damage.

Migraines in Children - is It Possible?

Children can get migraines but the episodes are generally shorter. They are more prone to migraine equivalents with gastrointestinal symptoms.

Migraine and Stroke - Is there a link?

There is a very small risk of people affected by migraines experiencing astroke. Prompt treatment in an emergency is very important to avoid strokes from causing permanent damage. Read More:How to Handle Migraines at Home?

FAQs: Miscellaneous

Whom to Consult for My Migraine Pain?

A person who has migraines or a family history of migraines should consult with a General Practitioner who can startmigraine treatment. If necessary they may refer to aneurologist who is trained to treat headaches and will recommend tests likeMRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scans.

Migraine headaches - When to see a doctor?

A General Practitioner can be consulted if there are more than 4-5 migraine episodes a month. When there is paralysis, difficulty in speech, high fever with headache and a stiff neck, or seizures, it is an emergency and requires immediate medical attention.

Headache FAQs: Treatment

What is Migraine Rescue?

Rescue migraine drugs are those that are taken if regular NSAIDs and the usual migraine medicines don’t work. Rescue drugs cannot stop a migraine attack that has started, but can be useful for severe pain and nausea. They are given for a week to ten days to break the cycle. They could include stronger pain relievers, muscle relaxants or steroids either orally or intravenously.

Preventative Medications - What are they?

Migraine prevention medicines are used to reduce the frequency, duration, or severity of an attack. They are meant to be taken daily by someone who has about 4-5 episodes in a month. The most common preventive drugs are calcium channel blockers, antidepressants, and methysergide.

What lifestyle changes should I make to prevent migraines?

Affected persons can handle their migraines better with the acronym SEEDS, which researchers have outlined. It stands for:
  • Sleep:A constant sleep routine with about 8 hours of sleep
  • Exercise:There is evidence to suggest that moderately intense aerobic exercises are more effective than regular drugs for migraines.
  • Eat:Small meals that are rich in protein, fibre, and healthy fats will keep blood glucose levels stable, and not be a trigger for an attack.
  • Diary:Affected persons are encouraged to keep a diary to identify patterns that could help in prompt diagnosis and acute management.
  • Stress:Stress is a known trigger for migraine attacks, and can be managed through meditation and proper breathing techniques.

Stopping a Migraine - How to do it?

There are drugs meant to stop a migraine attack. These acute or abortivemigraine headache treatmentdrugs should be taken within 15 minutes of the start of pain. They work better as a single large dose, and should not be used more than 2-3 times per week. They include aspirin, NSAIDs, and acetaminophen. These pain relievers must be combined with drugs like triptans, ergotamines, or dopamine antagonists, for severe pain and vomiting.

Headache FAQs: Diagnosis

Complicated Migraine - What is it?

The term complicated migraine, although no longer used, refers to migraines with prolonged aura symptoms lasting for several hours to days. The disorder includes ophthalmoplegic migraine with partial or total paralysis of nerves that are required for eye movements, hemiplegic migraine, retinal migraine and alternating hemiplegia of childhood.

Migraine Equivalent - What is it?

Sometimes, a migraine manifests symptoms other than the usual headache. The most common kind is abdominal migraine with symptoms like vomiting and abdominal pain. It can last for several hours and typically affects female children.

Hypnic Headache - What is it?

Previously called alarm clock headache, a hypnic headache is a rare chronic condition that occurs during sleep, usually at the same time. These dull aches wake the person from sleep and are seen usually after the age of 50.

Hemicrania Continua - What is it?

It is a persistent headache with continuous pain that always occurs on the same side of the head and face. Hemicrania continua attacks are accompanied by red eyes, runny nose, drooping of the eyelid, or iris contracture. Read more:Ways To Get Rid Of A Headache Quickly