Learn all about migraine, including risk factors, symptoms and treatment options
Anyone who has experienced migraine knows it is not just a headache—it is a neurological disease. Migraine has a variety of symptoms including headache, nausea, light and sound sensitivity, dizziness, and sensory disturbances (called aura).
Who Does Migraine Affect?
Migraine is the third most common disease in the world, and 12% of the global population has this condition. This number includes 1 in 5 women, 1 in 16 men, and 1 in 11 children. As many as 2% of people have chronic migraine, which is defined as experiencing at least 15 headache days, including eight migraine days, each month for three months.
Women are three times more likely to have migraine than men. Researchers believe hormonal changes such as fluctuations in estrogen during a woman’s menstrual cycle may play a role. Pregnancy, postpartum, and perimenopause can also cause changes in migraine attack frequency and intensity. This presents a need for different treatment options.
While the exact cause of migraine is unknown, the condition is thought to be genetic. Environmental factors such as sleep and diet are also a possible cause. Research also shows a link to connections between certain nerve cells and cerebral blood vessels in the brain becoming abnormally sensitive. In some cases, patients have an increase in an amino acid called calcitonin gene-related peptide (CGRP). In other cases, they may have imbalances in certain brain chemicals.
Symptoms and Diagnosis
Headache is the most common symptom of migraine. Patients often experience an intense pain in one area of the head that can last for three days if left untreated. The pain may seem to be throbbing or pulsing. Other associated symptoms include nausea, vomiting, dizziness, and sensitivity to light, sound and smells.
Up to one-third of patients experience warning signs of a migraine attack called an aura. Aura may involve the appearance of flashing lights or zigzag lines, blurry vision or temporary vision loss, and changes in sensation or speech.
You can found out if you have migraine by describing your symptoms to a healthcare provider or headache specialist. Before your visit, it is helpful to track your headache days in a journal. You should also include any other symptoms that might be related. Take note of what you experience before and after headaches, as well as potential triggers, such as stress, anxiety, hormonal changes, bright or flashing lights, lack of food or sleep, and certain foods. Also, make sure you know your medical history, medications you’ve taken or are currently taking, family history, and other lifestyle factors such as diet, exercise and sleep.
Treatment Options for Migraine
There is a wide range of treatment options for migraine, including both acute and preventive treatments. Acute treatments provide relief during migraine attacks, while preventive treatments work to prevent attacks before they happen.
A variety of medications exist, both over-the-counter medications (good for mild to moderate symptoms and gradual onset) and prescription medications (good for more severe symptoms and rapid onset). Most recently, medications like ditans, gepants, and anti-CGRPs have hit the market. These are the first-ever medications specifically designed for migraine, as opposed to medications designed for another purpose.
Non-medication treatments include acupuncture and brain stimulation. You might consider non-medication treatments if you are at risk of side effects or worry about headache from medication overuse. One option is a neuromodulation device or stimulator, which uses electrical or magnetic currents to regulate brain activity. Migraine prevention can include various relaxation or stress reduction techniques, regular exercise, and adequate hydration, nutrition, and sleep.
While there are effective treatments, there is no cure for migraine. Prevention and responsive treatment is important because the condition can affect quality of life and attacks may worsen over time. The key is finding the right treatment that works for you and your lifestyle, decreasing your headache frequency, severity, and duration with minimal side effects.