Migraine is not just a headache. Migraine is a neurological condition that can cause intense, disabling head pain along with many other symptoms. On average, most people with migraine experience episodic attacks two to four times a month. Some people with migraine have attacks more frequently. About 2.5 percent of people progress to chronic migraine, meaning they experience symptoms at least 15 days out of every month.
It can help to understand the terms associated with migraine. Although people commonly refer to migraine headaches as “migraines,” the medical world calls episodes of migraine symptoms “migraine attacks.” The singular word “migraine” is preferred over “migraines” and is used to talk about the disease as a whole.
People with migraine are sometimes referred to as migraineurs. Migraine is often treated by a neurologist — a specialist in disorders of the nervous system, including the brain and nerves. However, migraine is often diagnosed (and may be treated) by a general practitioner, family doctor, or other health care professional.
Migraine and headaches have been reported and studied during every period of history. Hippocrates wrote of migraine and visual auras in medical journals dating from 400 B.C.E. Hua T’o, a surgeon during the Han Dynasty in China, treated the emperor’s migraine attacks with acupuncture.
In the second century, the ancient Greek physician Galen distinguished migraine headaches from common headaches, calling them hemicrania, meaning “half skull.” Later, the word entered the French lexicon and was corrupted to “migraine.”
English clinician Thomas Willis introduced the term “neurology” in 1672. Willis is credited as the founder of modern brain anatomy and clinical neurology, and he categorized many causes of migraine attacks, including heredity, changes in season, and diet.
Throughout history, theories about the cause of migraine have been based on superstition, and many painful, sometimes potentially fatal, migraine “cures” were used. Anthropologists studying skulls from 9,000 years ago found evidence of trepanation (drilling holes into the skull). Sometimes called trephination, trepanation may have been performed to treat migraines, epilepsy, and mental illness. Some historians theorize that trepanation sought to release evil spirits believed to be trapped in the skull and causing the symptoms.
In the Middle Ages, migraine treatments ranged from bloodletting with leeches, cauterization (using heat to seal a wound) with a hot iron, and placing garlic into fresh skin incisions. Later, attempted migraine treatments included oil in the ears, electric shocks, radiation therapy, and lumbar puncture — piercing the membrane surrounding the spinal cord to release cerebrospinal fluid.
In the 1930s, American doctors John R. Graham and Harold G. Wolff published the vascular theory of migraine. According to vascular theory, the brain’s blood vessels dilate (widen) during migraine and cause pain and other symptoms. They used ergotamine, an ergot alkaloid drug, to cause vasoconstriction (narrowing of blood vessels) in the brain during migraine. Ergot alkaloid drugs such as dihydroergotamine (Migranal) and ergotamine/caffeine (Cafergot) are still important treatments for migraine today.
Triptans, another class of vasoconstricting drugs, were developed in the 1990s. Triptans such as sumatriptan (Imitrex) are used for the acute treatment of migraine attacks (also called abortive treatment).
The genetic theory of migraine gained support in 2012 when researchers showed that migraines are linked to specific genes. Current research indicates that inherited factors may account for as much as 30 percent to 60 percent of the risk of developing migraine.
Over the past 20 years, people with migraine began to report relief from their symptoms while taking medicines for unrelated conditions. To treat migraine, doctors used to prescribe drugs such as the following off-label (not for the approved purpose):
Eventually, several of these “borrowed” drugs for migraine were approved by the U.S. Food and Drug Administration (FDA) to treat migraine.
Notable historical and cultural figures who experienced migraine include Napoleon Bonaparte, Julius Caesar, Lewis Carroll, Charles Darwin, Albert Einstein, Sigmund Freud, Ulysses S. Grant, Thomas Jefferson, John F. Kennedy, Blaise Pascal, Elvis Presley, and Elizabeth Taylor. The Dutch artist Vincent van Gogh, also a migraineur, painted auralike forms in some of his works.
Across the globe, more than one billion people — over 10 percent of the population — live with migraine. These facts help illustrate just how common this condition is:
The most common migraine symptom is intense head pain. Migraine pain may be felt in different ways. Besides migraine headache, migraine symptoms can include fatigue, nausea, vomiting, numbness, weakness, uncontrollable movements, depression, and mood swings.
Most doctors describe migraines as having four distinct phases. However, people who get migraines don’t necessarily experience all four phases with every migraine attack. Understanding the phases of migraine can help people living with migraine better manage their condition by timing treatments for maximum effectiveness.
Scientists don’t yet know what causes migraine, but it may involve changes in the brain stem — the lowest part of the brain, just above the spinal cord. Migraine also seems to be connected to altered levels of chemicals, known as neurotransmitters, that transfer electrical impulses between cells.
In many people, migraine triggers may include stress, bright lights, a missed meal, sleep disturbance, alcohol, certain foods, or hormone fluctuations in the menstrual cycle. People with a family history of migraine are much more likely to develop migraine.
The two most common types of migraine are defined by the presence or lack of an aura — an abnormal feeling, visual or auditory disturbance, or smell that occurs before or during a migraine headache. Most people experience migraine either with or without aura. It’s rare but possible to get a migraine aura without headache pain.
Other specific types of migraine may be classified by unique symptoms:
It’s possible to get more than one type of migraine.
There’s no one conclusive test for diagnosing migraine. Migraine is typically diagnosed by a physician using a combination of a neurological and physical exam, a history of symptoms, and a family medical history. The doctor may also order blood tests, imaging tests such as CT or MRI scans, or a lumbar puncture (spinal tap) to rule out other potential causes of symptoms.
There are two main types of migraine treatment options. The first is preventive medication, taken regularly to help keep a migraine from starting. The second is abortive (symptomatic) treatment, taken when you’re experiencing a migraine attack.
Treatments for migraine prevention come in many forms. Examples of preventive treatment include:
Once a migraine attack has started, it may be treated with multiple types of abortive treatments, including:
Abortive therapy is usually most effective when used right when a migraine attack begins.
Read more about specific medications in this list of treatments for migraine.
Some people with migraine participate in clinical trials or try complementary or alternative approaches, such as relaxation training or cognitive behavioral therapy.
On average, people with migraine live a normal lifespan and die from the same conditions that cause death in most people, including cancer and cardiovascular disease. According to a 2016 article in The BMJ, some studies have found an increased risk of stroke in women with migraine, especially those who get migraine with aura. The risk of stroke was highest in women with additional risk factors for stroke, such as smoking, taking oral birth control, or having high blood pressure. If you’re concerned about your risk of stroke, ask your doctor to evaluate your risk and help you take steps to lower it.
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My headaches are I. My one,eye and goer down the,back of my neck I also have,sinus,headaches I don't get autos or throw,up
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