Migraine—Adult

Definition

Migraine is a type of recurring headache. It involves nerves and brain chemicals. Other sensations, such as auras, may come before a migraine headache.There are 2 types of migraines:
  • Occurring with an aura—formerly called a classic migraine
  • Occurring without an aura—formerly called a common migraine
Migraine may happen several times a week or once every couple of years. They can be so severe that they interfere with the ability to work and carry on normal activities.

Causes

While the precise cause is not known, many potential triggers have been identified. Common triggers include:
  • Environmental triggers, such as odors and bright lights
  • Dietary triggers, such as alcohol
  • Certain medications
  • Changes in sleep patterns
  • Stress
  • Physiologic changes, such as menstruation and puberty
  • Weather changes
A trigger sets the process in motion. It is possible that the nervous system reacts to the trigger by conducting electrical activity. This spreads across the brain. It leads to the release of brain chemicals, which help regulate pain.

Risk Factors

Migraines are more common in women, especially before the age of 40. Other factors that increase your risk for migraines may include:
  • Family history of migraines
  • Menstruation
  • Obesity
  • Presence of patent foramen ovale—a congenital heart defect

Symptoms

Migraines occur in phases that may include:

Warning

A warning may come before a migraine. In the hours or days before the headache, symptoms may include:
  • Changes in mood, behavior, and/or activity level
  • Fatigue
  • Yawning
  • Food craving or decreased appetite
  • Nausea
  • Diarrhea
  • Sensitivity to light

Aura

The most common aura is visual. The aura lasts about 15-30 minutes. It may produce the following sensations:
  • Flashing lights, spots, or zig zag lines
  • Temporary, partial loss of vision
  • Speech difficulties
  • Weakness in an arm or leg
  • Numbness or tingling in the face and hands
  • Confusion
  • Lightheadedness
  • Speech disturbances
It is important to seek medical attention to make sure the symptoms are not due to a more serious cause. This can include stroke or seizure .

Headache

Migraine pain starts within an hour of the aura ending. Symptoms include:
  • A headache (usually on one side but may involve both sides) that often feels:
    • Moderate or severe in intensity
    • Throbbing or pulsating
    • More severe with bright light, loud sound, or movement
  • Nausea or vomiting
  • Diarrhea
  • Lightheadedness

Post-Headache Period

Migraines usually last from 4-72 hours. They often go away with sleep. After the headache, you may experience:
  • Trouble concentrating
  • Fatigue
  • Sore muscles
  • Irritability
  • Mood changes

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