Migraines—not merely a pain in the neck

It can feel like gross confusion, or it can feel like you’ve got a railroad spike pounded through the side of your head. Their exact cause is unknown, but one thing is for certain, a migraine headache can significantly affect your quality of life and interrupt your daily activities. Some people only get them once or twice a year, others get them weekly or monthly. Three times more women suffer from migraines than do men, although this is arguable, since women generally visit their physicians more often than men.

Migraine versus Headache

Migraines involve the dilation of blood vessels in the head, while a normal headache involves constriction of the blood vessels in the head. This dilation of the blood vessels is significant in the relationship between migraine sufferers and increased incidence of strokes. One practical observation is that a headache is not disabling and you can continue your daily activities without interruption. More often than not, a migraine is debilitating.


There are four phases of a migraine episode: Prodrome, Aura, Migraine, and Postdrome

  1. Prodrome

The prodome phase is experienced by approximately 60% of people with migraines, and it occurs within hours or up to days before a migraine attack.

Symptoms of prodrome include:

  • stiff neck
  • chills
  • lethargy
  • dizziness
  • increased thirst
  • increased urination
  • loss of appetite
  • diarrhea
  • constipation
  • fluid retention
  • food cravings
  • sensitivity to light and/or sound
  • depression
  • euphoria
  • irritability
  • restlessness
  • mental slowing
  • hyperactivity
  • fatigue
  • drowsiness
  1. Aura

Approximately 20% of migraine sufferers experience aura right before a migraine attack which develops anywhere from 5 to 20 minutes before the full migraine attack occurs.

Symptoms include:

  • scintillation scotomas, which are characterized by a bright rim around an area of visual loss and flashing lights or jagged lines that block the visual field
  • visual resizing or reshaping of objects
  • numbness or tingling of the face, arm, or hand on one side of the body
  • muscular weakness
  • mild paralysis on one side of the body
  • difficulty speaking or loss of speech
  1. Migraine headache

Migraine headache symptoms are distinct from other types of headaches, such as tension-type or cluster headaches. Symptoms that distinguish migraines from other headaches, include: headache on one side of the head (unilateral), behind the eyes (retrorbital), or around the eyes (periorbital), pain intensity that is moderate to markedly severe and worsened by physical activity.

Some migraines may develop on both of sides of the head and then shift to one side of the head. In other individuals, the pain may develop on one side of the head and then become more generalized.

  1. Postdrome. While migraines subside during the postdrome phase, sufferers may experience any or all of the following symptoms: fatigue, irritability, impaired concentration, scalp tenderness, and mood changes.

Common Triggers

The most common migraine triggers are:

  • Stress (either during a stressful time or right after stress subsides).
  • Menstrual cycle in women.
  • Too much or too little sleep.
  • Fasting or skipping meals.
  • Changes in barometric pressure and weather.
  • Bright light or reflected sunlight.
  • Foods such as chocolate.
  • Excessive caffeine or caffeine withdrawal.
  • Smoking or being around someone who smokes.
  • Strong emotions, such as depression or anxiety.
  • Physical exercise.
  • Alcohol, such as red wine and port.
  • Aspartame, found in diet sodas, light yogurts, and other sugar-free foods.
  • Monosodium glutamate (MSG), found often in Chinese food and as a seasoning for meats and other foods.

Treatment and Prevention

The best way to avoid a migraine is to keep a migraine headache diary to try and identify triggers, then avoid them as much as possible. If you still get hit with a migraine, getting treatment early on is the most effective, and to be most effective, medications should be taken within an hour of the onset of symptoms.

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