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April 3, 2023

When suffering with chronic migraine pain, it’s easy to ask yourself, “Why me?” If it’s any consolation, you’re not alone. According to the American Migraine Foundation,1 migraine is one of the 10 most disabling medical illnesses on Earth that affects nearly 1 billion people worldwide. And yet, despite the widespread impact of migraine, less than half of people who experience migraines seek diagnosis and migraine treatment from a health care professional.

At GuideWell Emergency Doctors, our door is open to those looking to find the underlying cause of their headache. Though there is no “cure” for migraine, the medical community continues to learn more about migraine headaches. That knowledge has led to migraine treatment options and migraine medications that can be a game changer for those living with migraine symptoms.

What is a migraine?

Migraines are misunderstood on a number of levels. Many who haven’t experienced migraine headache pain firsthand don’t get the big deal. After all, it’s just a headache, right? In fact, migraine is a disabling neurological disease. It’s characterized by recurrent attacks of intense throbbing head pain
Just as people are unique, migraines seem to affect each person differently. Migraine headache pain comes with a wide range of symptom severity. Some people have the occasional migraine attack, while others suffer regularly from migraine episodes that are quite disabling and disruptive to their life. Some people are under the impression that migraines are something we can “push through” when in reality, there’s a lot we can do in the treatment of migraine—from taking steps to prevent migraines to prescribing migraine medications. Why suffer when you don’t have to?

Typical migraine symptoms

As if the throbbing head pain weren’t enough, migraines are often accompanied by these other symptoms that may make the migraine experience that much more debilitating, including:

  • Nausea
  • Vomiting
  • Increased sensitivity to light, sound, and smell

Less typical migraine symptoms

In more extreme migraine cases, symptoms may include:

  • Numbness and tingling
  • Sweating
  • Feeling very hot or very cold
  • Dizziness
  • Difficulty speaking
  • Even temporary loss of vision in the case of a migraine with aura or “classic migraine,” which we’ll cover in a bit.

Most people experience migraines in the morning—upon waking up. Some tend to get migraines at particular times (such as before menstruation or after an especially stressful event or work week). An untreated migraine attack can last for hours to days, with pain that can be so severe, daily activities like driving or focusing on a simple task may feel virtually impossible.

More than one type of migraine

While there are actually several kinds of migraines, the two main types of migraines are:

  • Migraine with aura (classic migraine)
  • Migraine without aura (common migraine)
     

Stages of migraine

A migraine may progress through four stages. Not everyone experiencing migraine symptoms may go through all stages of migraine. They include:

Migraine Prodrome

Warning signs of a pending migraine can happen hours to days in advance. Subtle changes to watch for include:

  • Irritability/change of mood
  • Craving certain foods
  • Difficulty concentrating
  • Tiredness/frequent yawning
     

Migraine Aura (experienced by 15%-20% of migraine sufferers)

Auras are reversible sensory, motor, and speech symptoms that usually act like warning signals of a coming migraine attack. Migraine aura symptoms typically develop gradually and last for up to an hour. The aura usually begins just before the headache starts. Some individuals experience migraine aura followed by only a mild headache or no headache at all. Aura symptoms can include:

  • Temporary blind spots or colored spots
  • Blurred vision
  • Eye pain
  • Seeing stars, zigzag lines, or flashing lights
  • Tunnel vision
  • Prickling, tingling, or numbness

 

Migraine Attack

During a migraine attack, people can experience throbbing or pulsing headache pain that goes well beyond a normal headache. Sometimes it’s concentrated in one area, like your forehead. Other times, both the left and right side of the head are affected. Add in nausea, vomiting, and hypersensitivity to light, sound, and smell and you’re in the throes of a full-blown migraine attack. Left untreated, a migraine attack tends to last 4-72 hours. The time varies greatly from person to person.
 

Migraine Postdrome

After a migraine attack, it’s very common to feel physically and mentally drained. People tend to feel tired and a little bit “out of it” the following day.
 

At-risk factors and causes of migraine

Anyone can get migraines. However, there are increased risk factors. Migraine is more common for:

Women.* The fact that women are three times more likely to get migraine than men** is linked to hormonal differences, namely estrogen.

Those with a family history of migraine. Some people are genetically predisposed to get migraine. In fact, if a parent has migraine, there's about a 50% chance that their child may also develop migraine.

Those with other medical conditions. It's not uncommon for people with depression, anxiety, or sleep disorder to get migraines. Serious conditions like bipolar disorder or epilepsy have also been tied to migraine.

 

Causes that can trigger migraines

There’s also a “trigger factor” to migraine suffering. For some people, it seems all it takes is eating a certain food or running low on sleep to trigger the onset of a migraine attack. Then again, not everyone is food sensitive. What may trigger migraines for one person may have no effect on someone else.

Factors that can trigger migraines include:

  • Hormonal changes (fluctuation of estrogen can occur during menstrual periods, pregnancy, and perimenopause)
  • Certain medications
  • Alcohol (red wine, in particular)
  • Caffeine
  • Dehydration
  • Stress
  • Sensory stimulation (bright lights, strong smells, too much noise)
  • Sleep changes
  • Weather changes (like barometric pressure)
  • Skipping meals

 

Migraine pain—when to see a doctor

If you experience migraine occasionally, you may not think it’s worth a trip to the doctor. In the case of chronic migraine, keep a record of your attacks, including what you think might trigger your migraines and symptoms you may have. Jot down any migraine medications you’ve taken, too, and make an appointment with a headache specialist. If your headache comes on very suddenly with no warning signs or if you have a headache that doesn’t go away or comes back, it’s a good idea to seek immediate medical attention.

Signs that could indicate a serious situation include:

  • Slurred speech/drooping on one side of face
  • Migraine aura lasting more than an hour
  • Fever/stiff neck
  • Seizures
  • Double vision
  • Difficulty speaking
  • Numbness or weakness in the limbs
  • Loss of consciousness


 

* Women to include people assigned female at birth
** Men to include people assigned male at birth


If you are having migraine symptoms or headaches, GuideWell Emergency Doctors can help diagnose and treat the cause of your symptoms. If you need immediate medical attention, call 911.

 

1 American Migraine Foundation is a nonprofit organization focused on promoting research, advocacy, and awareness for the 39 million Americans living with migraine (https://americanmigrainefoundation.org)


2 Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. Physicians and scientists from every medical specialty work in collaborative teams to advance discovery and translational research on behalf of patients (https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201)
 

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