Migraine is both the common and medical name given to a particular type of severe headache, which affects around 1 in every 5 women and 1 in 15 men. It can be an extremely debilitating condition, with the headaches having specific characteristics, that mark it as being distinctly different, certainly to headaches, and even severe headaches, in that they are felt as a throbbing pain at the front and side of the head, and predominantly begin in early adulthood.
There are three main types of migraine
- one with aura, warning sign just prior to the headache, usually flashing lights,
- one without the aura, i.e. the headache only
- and one with an aura but no headache.
Some people will have several migraines per week, others only occasionally. and there are instances where several years go by without experiencing an attack.
The main symptoms manifest as an intense headache at the front or side of the head, with the throbbing sensation, that feels worse on movement and prevents a sufferer from carrying out their daily activities. Occasionally the pain will be on both sides of the head, with the face and neck becoming affected also. Some people suffer additional symptoms such as nausea, vomiting, and increased sensitivity to light & sound. It is for this reason that people are advised to rest in a quiet and dark room. One in three of the people for whom regular migraines occur experience the symptoms of an aura or warning episode of a migraine attack. The aura occurs just before the onset of the headache, and manifest as visual problems, such as flashing lights or blinds spots, dizzy spells and loss of balance, very rarely loss of consciousness occurs. The aura stage develops over about 5 minutes and can last for up to 1 hour, with the headache stage beginning straight after.
The exact cause of migraine is unknown, but it is thought to be the result of abnormal brain activity which temporarily affects the nerve signals, chemicals and blood vessels in the brain. However it is not clear what the causes of these changes are; possibly they could be genetic.
There are various triggers for migraine attacks. They fall into 6 main categories - hormonal, emotional, physical, dietary, environmental and medical. These are all discussed in many literature sources on migraine, but the main ones are hormonal, which affect women just prior to the time of their period, probably caused by changes in hormone levels such as oestrogen; emotional triggers, especially stress and tension; and environmental factors, especially bright lights.
There is no specific test to diagnose migraine. The process that a GP must go through to make an accurate diagnosis of migraine involves identifying a pattern of recurring headaches along with the associated symptoms already described and discussed. This picture is often not clear because other symptoms occur along side, so obtaining an accurate diagnosis can take some time.
IHS 2004. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd Edition. Cephalgia 2004; 24:1-160.