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Headache and Migraine Pain

What is migraine?

Migraine is a condition that causes attacks (episodes) of headaches. Other symptoms such as feeling sick (nausea) or being sick (vomiting) are also common Between migraine attacks, the symptoms go completely.

Who gets migraine?

Migraine is common. About 1 in 4 women and about 1 in 12 men develop migraine at some point in their lives. It most commonly first starts in childhood or as a young adult. Some people have frequent attacks – sometimes several a week. Others have attacks only now and then. Some people may go for years between attacks. In some people, the migraine attacks stop in later adult life. However, in some cases the attacks continue (persist) throughout life.

What are the types and symptoms of migraine?

There are two main types of migraine attack:
Migraine attack without aura (also called common migraine): This is the most common type of migraine. Symptoms include the following:

  • The headache is usually on one side of the head, typically at the front or side Sometimes it is on both sides of the head Sometimes it starts on one side, and then spreads all over the head The pain is moderate or severe and is often described as throbbing or pulsating Movements of the head may make it worse It often begins in the morning, but may begin at any time of the day or night Typically, it gradually gets worse and peaks after 2-12 hours, then gradually eases off However, it can last from 4 to 72 hours
  • Other migraine symptoms that are common:
    Feeling sick (nausea)
    Being sick (vomiting)
    Not liking bright lights or loud noises, so that you may just want to lie in a dark room
  • Other symptoms that sometimes occur:
    Being off food
    Blurred vision
    Poor concentration
    Stuffy nose
    Tummy (abdominal) pain
    Passing lots of urine
    Going pale
    Scalp tenderness
    Sensations of heat or cold

Migraine attack with aura (also called classic migraine): About 1 in 4 people with migraine have migraine with aura. The symptoms are the same as those described above (migraine without aura), but also include a warning sign (an aura) before the headache begins.

Visual aura is the most common type of aura. Examples include a temporary loss of part of vision, flashes of light, objects may seem to rotate, shake, or boil. Numbness and pins and needles are the second most common type of aura. Numbness usually starts in the hand, travels up the arm, then involves the face, lips, and tongue. The leg is sometimes involved. Problems with speech are the third most common type of aura. Other types of aura include an odd smell, food cravings, a feeling of well-being, other odd sensations.

One of the above auras may develop, or several may occur one after each other. Each aura usually lasts just a few minutes before going, but can last up to 60 minutes. The aura usually goes before the headache begins. The headache usually develops within 60 minutes of the end of the aura, but it may develop a lot sooner than that – often straight afterwards.

How is migraine diagnosed? Do I need any tests?

Migraine is usually diagnosed by the typical symptoms. There is no test to confirm migraine. A doctor can usually be confident that you have migraine if you have typical symptoms and by an examination which does not reveal any abnormality.

What causes migraine?

The cause for migraines is not clear. It was believed blood vessels in parts of the brain become narrower (go into spasm) which accounted for the aura. The blood vessels were then thought to open wide (dilate) soon afterwards, which accounted for the headache. It is now thought that some chemicals in the brain increase in activity and parts of the brain may then send out confusing signals which cause the symptoms.

Migraine treatment

Medication: Paracetamol or aspirin works well for many migraine attacks. Take a dose as early as possible after symptoms begin. If you take painkillers early enough, they often reduce the severity of the headache, or stop it completely. A lot of people do not take a painkiller until a headache becomes really bad. This is often too late for the painkiller to work well.

Anti-inflammatory painkillers probably work better than paracetamol. They include ibuprofen and aspirin.

Injections: For treating chronic migraines and headaches, injections like the Occipital nerve block and Sphenopalatine ganglion block have proven to be effective. BOTOX® injections are the first and only FDA-approved preventive treatment proven to reduce migraine and headache days every month.