Migraine Awareness: Causes, Symptoms and Treatment

Migraines affect 1 in 5 women and 1 in 15 men, making them one of the most common health conditions. But what do they look like, what causes them and how can they be treated?

If you’ve ever experienced a migraine, you’re not alone - in fact, you’re one of almost one billion people who are affected by migraines worldwide. Migraines, which are often misunderstood or dismissed as "just a headache," can be disabling and disruptive to a person's daily life in more ways than one. In honor of National Migraine and Headache Awareness Month, we’re exploring some frequently asked questions about this common yet complex neurological condition.

What is a migraine?

Migraines were previously thought to be a severe headache, but research shows that they are actually a complex neurological condition. While the exact cause of migraines is still unknown, the most prevalent theory is that migraine pain occurs when certain brain cells become abnormally active, which then trigger certain chemicals that trigger and initial narrowing of blood vessels in the brain, followed by a dilation of these same vessels and essentially cause a focal area of brain swelling.

Migraines are often characterized by intense, throbbing pain on one side of the head, but can involve various other symptoms, such as light sensitivity, sound sensitivity, nausea, and vomiting. The pain and associated symptoms can last for hours, or even days. Some individuals may experience an aura, a set of visual disturbances, before the headache strikes. Migraines are often recurring and can interfere significantly with a person's quality of life.

What is the difference between a headache and a migraine?

Headaches and migraines, while related, are distinct conditions and it's important to distinguish between the two. Headache is a general term for pain in any region of the head or neck. Headaches can vary greatly in terms of pain location, intensity, and duration. They can occur on one or both sides of the head, be isolated to a certain location, radiate across the head from one point, or have a vise-like quality. They can be sharp, throbbing or dull, appear gradually or suddenly, and last from less than an hour to several days. The most common types of headaches are tension headaches and chronic daily headaches.

A migraine, on the other hand, is a specific type of headache characterized by certain features. Migraines are typically moderate to severe in intensity, often described as a throbbing or pounding pain. They usually occur on one side of the head, but can affect both sides. They are often accompanied by other symptoms like nausea, vomiting, and extreme sensitivity to light and sound. Migraines can last from 4 hours to 3 days and typically occur 1-4 times per month.

Migraines also have distinct phases. Before the onset of the headache, many migraine sufferers may experience an "aura," which can include visual disturbances like flashing lights or zigzag lines, loss of vision, or changes in speech or sensation. After the headache resolves, individuals often feel fatigued or washed out.

The exact cause of migraines is unknown, but they are thought to be due to alterations in the brain and its interactions with the trigeminal nerve, a major pain pathway. They can be triggered by a variety of factors including stress, changes in sleep patterns, certain foods or drinks, and hormonal fluctuations.

What are the top causes of migraines?

While the exact cause of migraines remains unknown, they are thought to result from abnormal brain activity that can be triggered by a variety of factors. These triggers vary widely among individuals and can include:

• Stress
• Caffeine withdrawal
• Changes in sleep patterns
• Changes in weather
• Certain foods or drinks (like chocolate, cheese, and alcohol)
• Certain medications or medication withdrawal
• Hormonal changes or fluctuations
• Sensory overstimulation (loud noises, bright lights, etc)

What are the symptoms of migraines?

Migraine symptoms vary from person to person. While the most common symptom of a migraine is a headache, other frequently occurring symptoms include:

• Moderate to severe throbbing pain, typically on one side of the head
• Sensitivity to light, sound, and sometimes smell and touch
• Nausea and vomiting
• Visual disturbances or aura
• Difficulty speaking
• Numbness or tingling in the face or extremities
• A feeling of weakness or fatigue

What are the different types of migraines?

There are actually a number of migraine types which are characterized by different triggers and symptoms. The most common migraine types include:

• Complicated migraines: These migraines are also known as migraines with auras, as almost one fifth of people with migraines experience auras
• Common migraines: A common migraine often occurs without the warning of an aura.
• Silent migraines: These migraines are also known as acephalgic migraines, and include an aura but no headache or head pain.
• Chronic migraines: If a migraine occurs at least 15 days per month, it’s characterized as a chronic migraine.
• Hemiplegic migraine: Those who experience hemiplegic migraines typically experience temporary paralysis, neurological or sensory changes on one side of your body. These changes can present as tingling, dizziness, vision changes, numbness or weakness and sometimes accompanied by headaches.
• Ocular migraines: Also known as retinal migraines, these migraines are often characterized by vision loss or impairment in your eyes. This vision loss can last briefly or persist for months, and should be discussed with a healthcare provider to ensure that it is not a sign of a more serious condition.
• Migraines with brainstem auras: Characteristics of these migraines include vertigo, slurred speech, double vision, ear ringing or loss of balance. The headache typically occurs towards the back of your head.
• Status migrainosus: This is a rare but extremely painful and severe type of migraine that can last longer than 72 hours. It can be caused by certain medications or withdrawal from certain medications.

What is the average age for people to develop migraines?

Migraines can occur at any age, but the first occurrence typically happens in adolescence or early adulthood. According to the Migraine Research Foundation, migraines most frequently strike individuals between the ages of 18 and 44.

Interestingly, migraines affect women more than men, with an estimated 85% of chronic migraine sufferers being women. While it’s not entirely clear why women are more prone to developing migraines, it’s thought that changes in estrogen levels (which are higher in biologically female bodies) may make certain nerves more sensitive to stimuli such as bright lights or loud noises, triggering migraines.

What is the best way to prevent a migraine?

Preventing migraines often involves lifestyle changes and, sometimes, medication. Identifying and avoiding personal triggers can be immensely helpful for migraine patients as well. This may involve keeping a headache diary, making changes to diet, ensuring regular sleep patterns, managing stress through techniques like yoga or mindfulness and regular exercise.

While there isn’t a cure for migraines yet, there are treatments that may help you manage the symptoms - that’s why it’s essential to consult with a healthcare provider for personalized advice and strategies.

What are the best medications for migraines?

Medications for migraines are typically divided into two categories: pain-relieving, which are medications that are taken during attacks and aimed at stopping symptoms; and preventive, which are medications that are taken regularly to reduce the severity or frequency of the migraines.

In terms of pain-relieving medications for migraines, over-the-counter migraine medications include drugs such as ibuprofen, aspirin and acetaminophen can help relieve mild migraines. These medications are available without a prescription and are typically available at your local pharmacy. For more severe migraines, prescription medications include:

• Rizatriptan (generic Maxalt)
• Sumatriptan (generic Imitrex)
• Topiramate (generic Topamax)

Preventive medications can include cardiovascular drugs, antidepressants, anti-seizure drugs and even Botox injections.

What is the best way to get migraine treatment?

It's important to understand that medication and other migraine treatments are not one-size-fits-all solutions. If you’re suffering from migraines, consult with your primary care physician or book an video migraine consult with a healthcare provider on Sesame to discuss treatment options and strategy. If deemed clinically appropriate, providers on Sesame can also write a prescription – or refill an existing one – during a virtual or in-person visit. Depending on the medication, you can arrange for same-day pickup at a pharmacy near you or order the medication to be delivered to your door for just $5.

Migraines are a serious and debilitating condition that deserves understanding, attention and appropriate treatment. If you or someone you know is suffering from migraines, seek professional medical care - there are a range of treatments available to keep your life from being ruled by migraines.