What Is A Migraine?

What is a migraine?

Migraines are essentially a brain malfunction. They are the result of something that’s not working properly. They are often described in the medical community as ‘a common primary headache disorder’. Which means it’s a disorder that is not caused by another underlying condition.

But what are they really and what do they feel like?

Migraines are a severe and debilitating headache that is accompanied by a specific set of symptoms which qualify it as a migraine and not just a bad headache.

To summarise the criteria from the International Headache Society, if you are experiencing moderate to severe pain, on one side of the head, nausea or vomiting and sensitivity to light or sound then you may be experiencing a migraine.  Read the diagnostic criteria here.

10 signs your having a migraine

The below signs are common symptoms of migraines. You may experience some or most of these in a single attack.

  1. Moderate to severe pain
  2. Pain aggregated by movement
  3. Pain is one sided in the head
  4. Pulsing or throbbing headache
  5. Nausea or Vomiting
  6. Sensitivity to light and sound
  7. Headache lasts 4-72 hours if untreated
  8. Aura or disturbed vision, light spots, stars, visual distortion (provide link)
  9. Vertigo
  10. Numbness, weakness or tingling.

If you are unsure about whether you get migraines, review the diagnostic criteria here.

Migraines are under-treated and under-diagnosed1.

Surprisingly, most people have not been diagnosed with migraine and may not know they get migraines. And less than 50% of migraineurs see a physician.2 As a result many sufferers may not be receiving the most appropriate treatment.

If you think you may get migraines or if in doubt, it is a good idea to check with your doctor.

Who gets migraines?

Migraines are one of the most common health conditions worldwide.3 Migraines affect around 1 billion people globally.4 Of those who suffer, just over half (54%) claim to experience one or more attacks per month. 13% claim one or more attacks per week.5 If you do the math, that’s around 130 million people who get weekly migraines.

Migraines typically affect more women than men. Ratio’s vary depending on how broad or where the study is. Some claim that women are 2x as likely, others claim women are 3x more likely than men to experience migraine.6 The reality is likely somewhere in between i.e. women are 2-3 times more likely to get migraines versus men.

Children can have migraines as well. They can start at any age but are most common in their early to mid teens.7

Regardless of age, sex, ethnicity, socio-economic status or culture, you can still have migraines.

Why do I get migraines?

Why do I get migraines and not others like my sibling? Interestingly, no one has figured out exactly what causes migraines and why exactly they occur in some people and not others. Recently medical researchers have discovered a genetic link between migraines. Which means that if your parents or grandparents had migraines then you are at risk of inheriting the tendency toward migraines.

For example if a mother experiences migraine, the child has a 50% chance of inheriting migraines. If both parents experience migraine, the child’s risk jumps to 75%.8

What do we know about what happens during a migraine?

Researchers still don’t know exactly what causes a migraine, which makes a cure that much more difficult to develop. The leading theories for the cause of migraine relate to hyper excitability within certain areas of the brain or a ‘glitch’ from the brain stem which triggers the migraine.

What is the brain stem? It is a small but extremely important part of the brain. It allows the nerve connections of the motor and sensory system to pass from the brain to the body. It basically covers all of our sensations and the ability to move our body. So it’s pretty important.

At the start of an attack, chemical changes are thought to develop at the brainstem which starts a series of reactions causing the brain to react abnormally to otherwise normal signals. It is thought that this leads to the migraine.

What causes a migraine?

For someone who has a physiological tendancy towards migraine there are a number of potential causes that can ‘set off’ a migraine attack. Unfortunately these are different for different people. And even in the same person, they can be different at different times.

Common migraine triggers such as stress, sleep, alcohol and hydration are used in this example. A migraineur may go out on the weekend, have a big night out on Saturday night, not get much sleep and drink a little too much. The next day they experience a migraine.

However the same migraineur may experience a migraine during the week at work when they didn’t drink or go out late. Instead they had a very stressful day and forgot to drink enough fluids. This may be enough to trigger another migraine.

Because they are many different scenarios and many different triggers it can be difficult for migraineurs to effectively control their migraines.

Some common migraine triggers include:

  • sleep disruption or changing sleep/wake cycle
  • stress
  • dehydration
  • menstruation in women
  • visual factors such as bright or flickering lights, screens or fluorescent lights

More about the most common migraine triggers and how to manage them are available here.

Understanding what migraines are and learning more about how and why they occur help you control them. Often just realizing your getting migraines is a challenge in itself.

How long did it take you to figure out you were getting migraines? Leave a response in the comments below.


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Photography by Mendhak @ Flickr

Sources:

  1. World Health Organisation & Lifting the Burden. ATLAS of Headache Disorders And Resources in the World 2011. 2011.
  2. Pavone, Banfi, Vaiani & Panconesi, Cephalalgia. Sept 2007.
  3. World Health Organization. The Global Burden Of Disease: 2004 Update.
  4. Vos, T; Flaxman, AD; Naghavi, M; Lozano, R; Michaud, C; Ezzati, M; Shibuya, K; Salomon, JA et al. Years Lived With Disability (Ylds) For 1160 Sequelae Of 289 Diseases And Injuries 1990–2010: A Systematic Analysis For The Global Burden Of Disease Study 2010. Dec 2012.
  5. Steiner et al. Cephalalgia. 2003.
  6. Alexander, L. Migraine – ‘A Common And Distressing Disorder’. headacheaustralia.org.au/headache-types/17-migraine-a-common-and-distressing-disorder. Accessed 1 Aug 2013.
  7. Goadsby et al, Migraine — Current Understanding and Treatment. New England Journal of Medicine, 2002.
  8. National Headache Foundation http://www.headaches.org/education/Tools_for_Sufferers/Headache_-_Frequently_Asked_Questions.  Accessed 2 Aug 2013.

5 thoughts on “What Is A Migraine?

  1. I started getting severe headaches and vomiting in my early thirties. I put it down to alcohol. Gave up smoking, alcohol and coffee migraines persist with them now being chronic. I take 200 mg of Topomax daily. 150mg of Endep daily. I take a reliever when one hits but as I don’t get an aura often not much use. I take Endone for pain relief, try not to though. Sometimes they can hang on for a week at a time. The longest I have gone without one over the last ten or fifteen years is about two weeks. I am now 57 years old.

    • Hi Rosemary, it seems your migraines greatly impact your quality of life. I would like to try and help. Interesting that it started relatively later in your life (30’s). If you register for our free research study at http://migrainepal.com/research/ we can go into much more detail about your particular migraine condition and explore different options that you may have.

  2. hi my migraines started 30 years ago and i ahve them about 3 times every fortnight and major headaches between this time…. so it took me about 20 years b4 i had any idea what to do or that i even had migraines i thought it was all diet related but having tried to solve that it is only part of the problem … i eat very little variety enough to live a reasonbly healthy life,…… i live my life in a shell not much going out, very little excitement, when i get excited invariably i get a headache after…
    i take 10m endep but am very sensitive to all drugs and foods, so always small doses almost. also take disprin forte x 2half, also take immigran spray as taking the pills makes me sick.. after that i just have a quiet dark room and no movement times to help manage my pain.. the impact on my l;ife is huge rarely go out cant eat barely anything that is on offer in the shops… i walk through supermakets like a ghost not looking at 95 % of whats there as i cant eat it..cant work properly, my life has shut down since this all began.. everyday is a struggle and their seems to be no end in sight… my only relief comes from constant management of every facet of my day to day existence….. i am 56 years old….

  3. Hi Paul, thanks for your comment. I’m sorry to hear how much of a toll migraines have taken. From what you mentioned above it sounds like you experience a number of different triggers. The good news is we know a lot of the common triggers or ‘suspects’, The not so good news is that there are so many of them, each migraineur is different and often behavioural and lifestyle changes are required to see sustainable results that are not derived from medication.

    There are a number of options available but without knowing what you’ve tried and more about your particular condition it makes it tricky to make useful suggestions.

    Let me say firstly, that there is always hope.

    There are many, many avenues to improve your condition. But typically before going and seeing more specialists and paying a fortune for their therapy often the lowest hanging fruit is right in front of you. Like what time you go bed each night? How well do you sleep, stay hydrated, exercise, manage your stress/meditate etc etc. These are fundamental to other therapies in improving your condition and breaking decades of chronic illness pattern that your body seems to be now following by default. Almost every single person in our recent study underestimated the impact these factors had on their migraine condition prior participating.

    We are conducting another research study in the near future where you can uncover much of the above without the need for further expensive therapies which may or may not work. Located here if your interested (doesn’t matter for this next trial where you live) http://migrainepal.com/research/

  4. you know something , i hate reading but when it comes to migraine i read everything and i never get bored .

    i’m nadyah , nursing student at ksau-hs.edu.sa and a migraine sufrrere. i’ve experienced it since the age of 16 and now i’m 21 😦 . i visited doctors many times , everytime i go they just serve me a panadol . and i ignored the doctors prescription . and yea i experiance it almost every day . i tried the morning exercises and it works sometimes to relieve ( i usually exercise in the morning and the deep breathing exercise ) . or sometimes i go to the clinic and get voltaren injection . now i used to take the exylin syrup (cause it makes sleep and forget the pain ) . and always i turn off my bedroom lights and my parents get mad at me becuz of that and they don’t understand what i’m being through .

    this migraine interfers with my daily activties and i hate that 😦 .

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