MIGRAINES - What should I know?

As anyone who has experienced one knows, there is absolutely nothing like a migraine headache. A migraine headache can be debilitating for hours and sometimes for days. The migraine headache is considered a vascular headache, although the precise mechanism and cause remain unknown. There are several known triggers, some of which include food allergies, blood sugar disturbances, stress load, mechanical injury, and hormonal fluctuations. Treating a migraine means working with these triggers.

Migraine may be classified as migraine without aura, formerly called common migraine, or migraine with aura, formerly known as classic migraine. The differences are based upon the presence or absence of neurologic symptoms prior to the onset of headache. The aura may consist of flashing lights, or zigzag lines, or may manifest as blind spots in the vision. Some people even experience speech difficulty, tingling in the face or hands, confusion, or weakness of an arm or leg. The majority of people suffering from classic migraine have an aura that develops 10-30 minutes prior to development of the actual headache. According to recent studies, the aura is believed to be the response to a trigger that creates a neuronal depression. This may result in as much as a 25-35 percent reduction in cerebral blood flow, and is certainly enough to cause the symptoms associated with the aura.

Auras are experienced by approximately 10 percent of those who have migraines.(1) The International Headache Society has developed a classification system of migraine headaches that includes six subdivisions under the heading migraine with aura. These range from a migraine with an aura that lasts for less than one hour to one that lasts for up to one week. The common migraine, or migraine without aura, occurs in approximately 85 percent of those affected.

1 Silberstein SD, Lipton RB. Overview of diagnosis and treatment of migraine. Neurology. 1994;44(suppl 7):S6-S16.


American Council for Headache Education, 1999. National Headache Foundation, 1999.




Migraines frequently occur in the early morning hours. Approximately 60 percent of people who have migraines experience symptoms, which may occur for hours or days before the onset of headache.(1) Early symptoms may vary widely among those suffering from migraine, yet are usually consistent in an individual. They can present as psychologic symptoms such as irritability, anxiety, depression, fatigue, drowsiness or euphoria; or neurologic symptoms such as increased sensitivity to light, sounds, and smells. Symptoms such as diarrhea, constipation, excessive urination, stiff neck, thirst, yawning, or food cravings may also occur.

Peak intensity of migraine pain typically occurs within an hour of onset. Pain is usually on one side, but can occur anywhere on the face or head, most often in the temple.(1) Typical migraine headaches are of moderate to severe intensity and are often described as pounding, pulsating, or throbbing. Activities of daily living are often affected as physical activity may worsen headache pain. Patients often seek a quiet, dark place to rest. Headaches may last from 4 to 72 hours and patients typically suffer from post-headache exhaustion, scalp tenderness, and recurrence of headache with sudden head movements.

1 Silberstein SD, Lipton RB. Overview of diagnosis and treatment of migraine. Neurology. 1994;44(suppl 7):s6-s16.

This information is educational in context and is not to be used to diagnose, treat or cure any disease. Please consult your licensed health care practitioner before using this or any medical information.


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