What are the early warning signs of a migraine attack. How can recognizing prodromal symptoms help prevent or manage migraines. What are the latest treatment options for migraine sufferers. How does migraine affect daily life and family relationships.

Understanding Migraine: Beyond the Aura

Migraines are often associated with auras – visual disturbances that precede the onset of head pain. However, contrary to popular belief, not all migraines begin with these telltale signs. In fact, the majority of migraine sufferers don’t experience auras at all. This revelation challenges our conventional understanding of migraine symptoms and highlights the importance of recognizing other, less obvious indicators.

Recent neuroimaging studies have shown that changes in the brain can occur up to 24 hours before the onset of pain. This period, known as the prodrome or premonitory phase, can last anywhere from a few hours to a few days. During this time, individuals may experience subtle symptoms that are easy to overlook but can be crucial in predicting and potentially preventing a full-blown migraine attack.

The Prodrome Phase: Early Warning Signs of Migraine

Recognizing the prodrome phase is essential for early intervention and migraine management. Here are some surprising signs that may indicate an impending migraine:

1. Neck Pain or Stiffness

Up to 70% of migraine sufferers experience neck pain or stiffness, either as part of the prodrome or accompanying the head pain. This symptom is often misinterpreted as muscular in origin, but it actually stems from changes in the brain related to migraine. Nerve fibers extend from the brain to the cervical spine and loop back up, creating a sensation of neck discomfort.

2. Excessive Daytime Sleepiness

Feeling unusually drowsy during the day is a common premonitory symptom of migraine. Studies have shown that nearly 20% of migraine sufferers report excessive daytime sleepiness compared to about 13% of those without migraines. While fatigue can be a symptom of various conditions, including sleep disorders, it’s particularly prevalent among those prone to migraines.

3. Frequent Urination

An increased need to urinate is another surprising sign that a migraine may be on its way. This urge can be accompanied by pelvic pain in some cases. While the exact mechanism behind this symptom is not fully understood, it’s believed to be related to changes in brain chemistry during the prodrome phase.

4. Mood Changes

Sudden shifts in mood, such as irritability, anxiety, or even euphoria, can occur in the hours or days leading up to a migraine attack. These emotional fluctuations are thought to be linked to the neurochemical changes happening in the brain during the prodrome phase.

5. Food Cravings

Some individuals experience intense cravings for specific foods, particularly sweets or carbohydrates, before a migraine strikes. While the exact reason for this is unclear, it’s believed to be related to changes in brain chemistry and potentially a subconscious attempt to counteract the impending pain.

The Importance of Keeping a Headache Diary

Given the subtle nature of many prodromal symptoms, experts recommend keeping a detailed headache diary. This practice can help individuals identify patterns and potential triggers, enabling them to take preventive measures. A comprehensive diary should include:

• Date and time of symptom onset
• Duration and intensity of symptoms
• Dietary intake
• Sleep patterns
• Stress levels
• Menstrual cycle (for women)
• Weather conditions
• Physical activity

By consistently logging this information, migraine sufferers can gain valuable insights into their personal triggers and early warning signs, allowing for more effective management and prevention strategies.

The Postdrome: Understanding the “Migraine Hangover”

After the acute phase of a migraine attack, which can last for hours or up to three days, many individuals experience what’s known as the postdrome or “migraine hangover.” This phase affects approximately 80% of migraine sufferers and can be just as debilitating as the migraine itself.

Common postdrome symptoms include:

• Fatigue
• Body aches
• Dizziness
• Sensitivity to sound
• Difficulty concentrating
• Mood changes

Understanding and preparing for the postdrome phase is crucial for managing the overall impact of migraines on daily life and productivity.

Evolving Treatment Options for Migraine Sufferers

The landscape of migraine treatment continues to expand, offering new hope for those struggling with this debilitating condition. Recent advancements include:

New Medications

Several innovative drugs have been developed specifically for migraine prevention and treatment. These include:

• CGRP inhibitors: These medications block a protein involved in pain transmission and have shown promising results in reducing migraine frequency and severity.
• Ditans: A new class of drugs that work similarly to triptans but with potentially fewer side effects.
• Gepants: Another class of CGRP-targeting drugs that can be used for both acute treatment and prevention of migraines.

Novel Drug Delivery Methods

Advancements in drug delivery systems have improved the efficacy and convenience of migraine treatments. These include:

• Nasal sprays: Provide faster relief by delivering medication directly to the nasal passages.
• Transdermal patches: Offer a steady release of medication through the skin, bypassing the digestive system.
• Auto-injectors: Allow for easy self-administration of injectable migraine medications.

Expanded Uses for Existing Treatments

Researchers continue to explore new applications for existing drugs and devices, such as:

• Botox injections: Originally used for cosmetic purposes, now approved for chronic migraine prevention.
• Neuromodulation devices: Non-invasive devices that use electrical or magnetic stimulation to prevent or treat migraines.

Migraine Management in Different Life Stages

Migraine patterns and treatment approaches can vary significantly across different life stages. Understanding these variations is crucial for effective long-term management.

Migraine After 60

Many individuals find that their migraine attacks become less frequent and less severe after the age of 60. This change is often attributed to hormonal shifts and changes in brain chemistry that occur with aging. However, for those who continue to experience migraines, treatment considerations may need to be adjusted:

• Newer medications may be safer options for older adults, as they tend to have fewer side effects and drug interactions.
• Non-pharmacological approaches, such as lifestyle modifications and stress management techniques, may become more important.
• Regular check-ups are crucial to monitor for any age-related health conditions that could interact with migraine symptoms or treatments.

Migraines and Hormonal Changes

Hormonal fluctuations can significantly impact migraine patterns, particularly in women. Key considerations include:

Menstrual Migraines

Many women experience migraines that are triggered or worsened by menstrual cycles. Management strategies may include:

• Hormonal birth control to regulate cycles and potentially reduce migraine frequency
• Short-term preventive medication use around the time of menstruation
• Lifestyle adjustments to minimize other potential triggers during vulnerable times

Pregnancy and Migraines

Pregnancy can have varying effects on migraine patterns. Some women experience improvement, while others may see worsening symptoms. Special considerations include:

• Careful selection of safe treatment options during pregnancy
• Increased focus on non-pharmacological management techniques
• Close monitoring and adjustment of treatment plans throughout pregnancy and postpartum periods

The Impact of Migraines on Family Life

Chronic migraines can have a profound effect on family dynamics and relationships. A recent study has confirmed what many migraine sufferers have long known: the condition significantly impacts family life. Key findings include:

• Reduced participation in family activities and events
• Increased stress and tension within the family unit
• Challenges in fulfilling parental and partner roles during migraine attacks
• Financial strain due to medical expenses and potential loss of work

Addressing these challenges requires a multifaceted approach:

1. Open communication: Educating family members about the nature of migraines and their impact
2. Developing coping strategies: Creating family plans for managing responsibilities during migraine attacks
3. Seeking support: Utilizing support groups or family counseling to navigate the emotional aspects of living with chronic migraines
4. Prioritizing self-care: Encouraging the migraine sufferer to prioritize their health and well-being without guilt

Lifestyle Modifications for Migraine Prevention

While medication plays a crucial role in migraine management, lifestyle modifications can significantly reduce the frequency and severity of attacks. Here are some key strategies:

Sleep Hygiene

Maintaining good sleep habits is essential for migraine prevention. Tips for improving sleep quality include:

• Establishing a consistent sleep schedule
• Creating a relaxing bedtime routine
• Optimizing the sleep environment (dark, quiet, cool)
• Limiting screen time before bed
• Avoiding caffeine and large meals close to bedtime

For those experiencing persistent sleep issues, it may be worth investigating potential sleep disorders, as these can exacerbate migraine symptoms.

Exercise and Physical Activity

Regular exercise can help reduce migraine frequency, but it’s important to approach physical activity carefully to avoid triggering attacks. Guidelines for exercising with migraines include:

• Starting slowly and gradually increasing intensity
• Staying well-hydrated before, during, and after exercise
• Avoiding high-intensity workouts during vulnerable periods
• Incorporating relaxation techniques like yoga or tai chi
• Paying attention to proper form and posture to avoid neck strain

Stress Management

Stress is a common migraine trigger. Effective stress management techniques include:

• Mindfulness meditation
• Progressive muscle relaxation
• Deep breathing exercises
• Regular engagement in hobbies or enjoyable activities
• Time management and prioritization strategies

Dietary Considerations

While individual triggers can vary, some general dietary guidelines for migraine prevention include:

• Maintaining regular meal times to avoid blood sugar fluctuations
• Staying hydrated throughout the day
• Limiting or avoiding common trigger foods such as aged cheeses, processed meats, and artificial sweeteners
• Moderating caffeine and alcohol intake
• Considering a food diary to identify personal dietary triggers

By implementing these lifestyle modifications and working closely with healthcare providers, many individuals can significantly reduce the impact of migraines on their daily lives. Remember that migraine management is often a process of trial and error, requiring patience and persistence to find the most effective combination of treatments and lifestyle adjustments for each individual.

5 Surprising Signs You’re About to Get Migraine

Contrary to popular belief, not all migraines start with auras — visual disturbances such as flashing lights or loss of vision, tingling or numbness, speech disturbance, or even weakness on one side of the body.

Although auras are thought to be the hallmark sign of an impending migraine, the majority of people who get migraines don’t actually experience them, says Mia Minen, MD, MPH, a neurologist and the director of headache services at NYU Langone Health in New York City.

But it’s not just aura that can precede the onset of headache in someone who has migraine. About 10 to 20 percent of people may also experience a prodrome — a premonitory symptom — up to 48 hours before their headache kicks in, according to a study from 2015. “Recent neuroimaging fMRI studies have demonstrated that there are changes in the brain up to 24 hours before the onset of pain,” Dr. Minen says. “Prodromal symptoms have been documented in both adolescents and adults. ”

The premonitory phrase can last for a few hours or a few days, according to the American Migraine Foundation (AMF), and some of these early symptoms — like fatigue and mood changes — can be subtle and easy to overlook. That’s why some experts recommend keeping a headache diary. By logging your dietary intake and lifestyle habits, you may be able to spot potential triggers and avoid migraine in the future.

3. You have neck pain or stiffness

This can be part of the prodrome or it can be accompanied by the head pain, Minen says. She estimates that up to 70 percent of people with migraine have neck pain.

“Recent neuroimaging fMRI studies have shown that this is due to the nerve fibers extending down from the brain to the cervical spine — the neck region,” she says. “These fibers then loop back up toward the brain. So while people may feel that their pain is muscular, it actually stems from the changes in the brain related to migraine.”

4. You’re excessively sleepy during the daytime

Feeling drowsy during the day is one of the most common signs of impending migraine attack. For example, a study published in 2016 found that nearly 20 percent of people with migraines reported experiencing excessive daytime sleepiness compared with about 13 percent of those who don’t have migraines. (It’s worth noting that daytime fatigue is a symptom of other conditions, too, including sleep disorders.)

5. You have to urinate frequently

Some people feel a need to urinate frequently during the premonitory phase of the migraine, according to the AMF, and this urge can also be accompanied by pelvic pain.

After the migraine attack, which can last for hours or up to three days, comes what’s called the postdrome, or the “migraine hangover.” The AMF estimates that approximately 80 percent of people can experience fatigue, body aches, dizziness, and sensitivity to sound — and the organization points out that these symptoms can be just as debilitating as those of migraine itself.

By recognizing your symptoms early on, there’s a chance that you can ward off some of the pain associated with migraine attack, either by taking medication or making adjustments to your everyday routine.

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Thirst, Frequent Urination and Fatigue

Medically Reviewed

Despite its common occurrence, signs of this disease can be surprisingly difficult to spot, as many clues are subtle (if visible at all). Learn more about possible ways to tell if you have diabetes.

Updated May 27, 2020

Medical ReviewerRodrigo Barros, M.D., Ph.D.

Our Experts: Anthony Nguyen, D.O.; Stelios Mantis, M.D.; Katherine Araque, M.D.

Anthony Nguyen, D.O.Family Medicine Physician, Diabetes Health Initiative
Providence Hospital/Ascension Health
Mobile, AL

Stelios Mantis, M.D.Pediatric Endocrinologist
Rush University Medical Center
Chicago, IL

Katherine Araque, M.D.Director of Endocrinology
Pacific Neuroscience Institute at Providence Saint John’s Health Center
Santa Monica, CA

Diabetes can show up in many different ways—and some of them are easy to miss. In fact, of the 30 million Americans who have diabetes, nearly one-quarter of them don’t know it. That’s why paying attention to early signs is so important. If diabetes runs in your family or the symptoms below sound familiar, it’s probably a good time to check in with your doctor. Early and accurate diagnosis will give you a head start at beating this disease.

Basics

What Is Diabetes Again?

Diabetes mellitus is a disorder that causes people to have higher-than-normal levels of sugar—or, glucose—in their blood. There are three main types of diabetes: type 1, type 2, and gestational diabetes.

Here’s how it happens: After you eat a meal, your food is broken down into glucose (among other things) that serves as your entire body’s source of energy. Glucose enters the bloodstream and in response your pancreas releases insulin, a hormone that helps move glucose into fat and muscle cells so they can use it for energy.

In people with diabetes, though, glucose struggles to get out of your blood. This is because either your pancreas doesn’t produce enough insulin to help move glucose into your cells (type 1 diabetes), or because your body isn’t able to use insulin efficiently (type 2 and gestational diabetes), so you need to make more and more of it.

Either way, glucose begins to build up in the blood. Over time, high blood sugar causes inflammation and other major health troubles.

Get the Full Story on Diabetes

Symptoms

What Are the Symptoms of Diabetes?

Despite their differing causes, type 1, type 2, and gestational diabetes have similar symptoms. But because signs of the disease are often mild and develop slowly, they’re easy to miss or dismiss.

Classic Signs of Diabetes

There are two “signature” symptoms of the disease:

• Thirst: When there’s too much sugar in the bloodstream, your body pulls water from surrounding tissues to try to dilute it, leaving you dehydrated and parched. Some people with diabetes feel like no matter how much they drink, they can’t quench their thirst.

• Frequent urination: Feeling thirsty makes you to drink more, increasing the need to pee. Plus, diabetes causes the kidneys to work overtime removing sugar from the blood. The kidneys dump this sugar into your urine, creating more pee. And in more advanced stages of the disease, damaged nerves around the bladder may cause some people to feel the urge to pee frequently, even if little or nothing comes out.

Kids with diabetes may suddenly start to have accidents at night or even during the day, even if they’ve been potty trained for years.

Early Signs

Frequent urination and thirst often occur when blood sugar is already significantly elevated. But there are a few less obvious signs that can show up earlier on.

• Fatigue and muscle weakness: Glucose is one of your body’s most important sources of energy—but in diabetes, much of it remains in the bloodstream instead of nourishing your cells, making you feel tired.

• Feeling hungrier: To try to get the energy it needs to function, your brain ramps up hunger signals and cravings. Eating more doesn’t help, though, because the glucose from the food remains trapped in the bloodstream.

Common Symptoms of Diabetes

Along with feelings of thirst and hunger, as well as fatigue and the frequent need to pee, there are other clues that could possibly indicate diabetes. As always, having one or more of these symptoms doesn’t mean you have the disease. But it’s a good idea to see a doctor to have things checked out if you are experiencing:

• Headaches: When you body finds itself short of the glucose it needs to function, your central nervous system may send pain signals, in the form of headaches, as a warning sign. In addition, dehydration from excessive urination may also lead to headache pain, although the exact mechanism remains unclear. Also, high blood sugar may lead to increased production of epinephrine and norepinephrine, hormones that can constrict blood vessels in the brain, causing headaches.

• Weight Loss: Some people, especially those with type 1 diabetes, may experience unexpected weight loss, even though they are eating more. When insulin is lacking or there is resistance to it, your body breaks down more fat, causing you to shed pounds.

• Rash: People with diabetes are more likely to get fungal skin infections from organisms like yeast. An overgrowth of yeast on the skin can trigger an itchy, scaly rash in warm nooks and crannies like the underarms or between the toes.

• Skin Changes: In type 2 diabetes, your pancreas pumps out large amounts of insulin to try and move glucose from your blood into your body’s cells for energy. High levels of insulin can cause skin cells to multiply rapidly, resulting in darkened, velvety-feeling patches of skin called acanthosis nigricans. They can occur anywhere on your body, but are often found in skinfolds of the neck, groin, or armpit.

• Ketoacidosis: In an effort to get the fuel it needs, your body may start to break down its own fat stores. This floods the bloodstream with substances called ketones, making the blood acidic and become toxic. Ketoacidosis causes shortness of breath, confusion, extreme fatigue, and nausea, and requires immediate treatment. It’s more common in type 1 diabetes, but it can also happen in people with type 2.

• Numbness: The longer blood sugar stays high—and the higher it spikes—the more damage is done to nerves, blood vessels, and other organs in the body. Over time, excess blood sugar can damage nerve endings and lead to tingling, burning, or numbness in the fingers and toes.

• Diarrhea: Sometimes high blood sugar can damage nerves in the intestinal tract. If this kind of damage—called autonomic neuropathy—happens, a person might swing back and forth between periods of diarrhea and constipation.

Testing

Should I Get Tested for Diabetes?

The U.S. Preventive Services Task Force recommends that anyone over age 40 with a BMI of 25 or more should be screened for diabetes, then checked every three years thereafter. People with additional risk factors—like a strong family history of diabetes or autoimmune disorders—should be screened earlier and more often.

The first step in getting a diabetes diagnosis is a blood test. If you are diagnosed with the disease, your doctor may want to perform additional tests to find out which type it is. Correct diagnosis is important since treatment differs for the different types.

Blood Tests

• A1C (or glycated hemoglobin) blood test: This test measures what percentage of your red blood cells have been coated with glucose over the past two to three months. It’s the most common test for diabetes. The higher your blood sugar, the higher your score. An A1C result below 5.7 is considered normal; 5.7 to 6.4 is prediabetic; 6.5 or above suggests diabetes.

• Fasting blood sugar test: A result under 100 milligrams per deciliter is normal for this test, which involves taking your blood first thing in the morning. (You will not eat or drink before this test.) 100 to 125 mg/dL is prediabetic; 126 mg/dL indicates diabetes. Your doctor will likely want to do the test twice before officially diagnosing you.

• Random blood sugar test: Blood is drawn at any time of day, whether you’ve eaten recently or not. A result of 200 mg/dL indicates diabetes.

• Antibody test: To further differentiate between type 1 and type 2 diabetes, your doctor may also want to draw blood for an “autoantibody” test to see if your immune system is attacking your pancreas, as happens in type 1 diabetes. People with type 1 often test positive for several specific autoantibodies, while those with type 2 (or the rare monogenic diabetes) won’t.

Urine Ketones Test

Your doctor may want to test your urine for ketones, chemicals your body produces when it has to break down fat for energy. The test can generally be done at home, or in a lab or doctor’s office by peeing into a specimen cup. If you’re doing the test at home, it will come with paper test strips to dip into the urine.

Extremely high levels of ketones are a sign of ketoacidosis, a potentially fatal complication of diabetes that requires emergency treatment. Ketones usually happen in type 1 diabetes, but on rare occasions, it can occur with type 2, too.

The good news, no matter what your symptoms may be, is that if you do have diabetes, the disease is highly manageable. Through daily insulin injections, medications, and modifications to your diet and exercise routine, you can stay one step ahead of this condition.

Classic symptoms are increased thirst and having to pee a lot. Other symptoms include fatigue, headaches, skin infections, and darker, velvety patches of skin. The disease can also cause tingling in your extremities, blurry vision, and sores on the feet.

Type 1 diabetes cannot be cured, and people with the disease need to take insulin every day. Type 2 diabetes is treatable with diet and exercise changes and medications that lower the levels of sugar in the blood.

People with diabetes often feel tired even when they get plenty of rest. That’s because glucose, one of your body’s most important sources of energy, remains stuck in the bloodstream instead of nourishing your cells if you have the disease, making you feel tired.

No single diet will cure you of diabetes. But vegetarian and vegan diets, a traditional Mediterranean diet rich in vegetables and seafood, and low-carbohydrate diets have all been shown to lower blood sugar.

• Diabetes Prevalence: National Institute of Diabetes and Digestive and Kidney Diseases. (2019). “Current Burden of Diabetes in the U.S.” niddk.nih.gov/health-information/communication-programs/ndep/health-professionals/practice-transformation-physicians-health-care-teams/why-transform/current-burden-diabetes-us

• Diabetes Definition: National Institute of Diabetes and Digestive and Kidney Diseases. (2019). “What is Diabetes?” niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes

• Diabetes Symptoms: National Institute of Diabetes and Digestive and Kidney Diseases. (2019). “Symptoms & Causes of Diabetes.” niddk.nih.gov/health-information/diabetes/overview/symptoms-causes#type2

• Diabetes and Headaches: Mayo Clinic. (2020). “Hyperglycemia in Diabetes.” mayoclinic.org/diseases-conditions/hyperglycemia/symptoms-causes/syc-20373631

• Diabetes and Skin Infections: American Academy of Dermatology. (2020.) “Diabetes: 12 Warning Signs that Appear on Your Skin.” aad.org/diseases/a-z/diabetes-warning-signs

• Diabetes and Nerve Damage: Mayo Clinic. (2020). “Diabetic Neuropathy.” mayoclinic.org/diseases-conditions/diabetic-neuropathy/symptoms-causes/syc-20371580

• Diabetes and Diarrhea: American Diabetes Association. (2020). “Autonomic Neuropathy.” diabetes.org/diabetes/complications/neuropathy/autonomic-neuropathy

• Diabetes and Ketoacidosis: U.S. National Library of Medicine MedlinePlus. (2020.) “Diabetic Ketoacidosis.” medlineplus.gov/ency/article/000320.htm

• Diabetes and Screening: American Family Physician. (2016). “Diabetes Mellitus: Screening and Diagnosis. ” aafp.org/afp/2016/0115/p103.html

• Diabetes and Diagnostic Tests: Mayo Clinic. (2019). “Diabetes.” mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451

• Ketones Urine Test: US National Library of Medicine/MedlinePlus. (2019). “Ketones in Urine.” medlineplus.gov/lab-tests/ketones-in-urine/

Notes: This article was originally published January 30, 2020 and most recently updated May 27, 2020.

Our Review Process

How to distinguish a migraine from a stroke

Migraine and stroke are common causes of severe headaches, but they require very different treatment approaches.

Contents

• Migraine symptoms and treatment
• Migraine radiates to the eye
• Severe migraine and nausea
• Arm numbness due to migraine
• Migraine: stuffy ears
• Migraine: speech disorder
• Migraine and frequent urination
• Hallucinations in migraine
• Does the pressure increase with migraine
• Migraine: syncope

At the same time, if the doctor usually has no doubts in such a case, then for the average person it can be quite difficult to distinguish a migraine from a stroke.

Migraine: symptoms and treatment

1. Headache. Headache is the main symptom of migraine. A migraine headache is very often unilateral, meaning it feels sick on the right or left side of the head. In addition, migraine headaches are very rarely mild – they are usually moderate or severe/very severe. The nature of migraine headache is usually throbbing, while the pain becomes stronger with any tension and any physical activity. Most often with migraine pain is felt in the eye, temple, parietal region. Another important characteristic of migraine pain is its long duration – from 4 hours or more. In some cases, for example, in the absence of treatment or improper treatment, the duration of a migraine attack can be up to 72 hours. And finally, the last characteristic, very typical for migraine, is the effect of pain on the ability to work and life, psychological and social adaptation, and, in general, on the quality of life of a migraine patient.
2. Nausea and vomiting. Nausea and vomiting, together or separately, often accompany a migraine attack. The occurrence of these symptoms is associated with irritation of the brain structures in the region of the vomiting center as a result of vascular and nervous changes associated with the development of a migraine attack. Nausea may be short-lived, or it may persist throughout the migraine attack. Vomiting can be single or repeated and does not bring relief.
3. Light and sound intolerance. Light and sound intolerance, also called phono/photophobia, are common symptoms of migraine. Usually, exposure to sound or visual stimuli leads to an increase in headache and an additional deterioration in the patient’s well-being.
4. Deterioration of general well-being. Against the background of severe headache and its accompanying symptoms (nausea, vomiting, phonophobia, photophobia), a significant deterioration in the patient’s general well-being occurs. Poor health persists until the end of the attack. In the interictal period, most migraine patients feel quite satisfactory.

Several groups of drugs are used to treat migraine [1]. Analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), or triptans are prescribed to relieve an acute attack. For prevention (long-term treatment to prevent recurrent migraine attacks), calcium channel antagonists, beta-blockers, NSAIDs, antidepressants, and anticonvulsants (anticonvulsants) are used.

In the following, we will look at symptom variants that may be misunderstood by the migraine patient and cause him or her to suspect a stroke.

Migraine: pain “radiates” to the eye

Pain in the eye socket is typical of migraine. Usually the pain is pulsating in nature, increases with any physical activity and is felt on one side of the head. After the end of the migraine attack, sensations in the eye completely disappear, and an examination by an ophthalmologist does not reveal any deviations from the norm. If the pain in the eye is caused by something other than a migraine, a doctor’s examination will likely reveal a number of eye disorders.

Severe migraine and nausea

Nausea and vomiting are symptoms associated with migraine headache. At the same time, nausea is central (it occurs as a result of irritation of brain structures) and vomiting does not bring relief. Anti-nausea medications such as domperidone and metoclopramide are prescribed to relieve nausea during a migraine attack.

Arm numbness due to migraine

Limb numbness may be one of the manifestations of migraine aura. In this case, numbness may be the only symptom of the aura or may be associated with visual disturbances (eg, flickering spots or streaks) and/or speech disturbances. As a rule, migraine numbness disappears within an hour and completely disappears after the development of a typical migraine headache. At the end of the attack and in the interictal period, the sensitivity is fully restored. If the numbness lasts more than 1 hour, persists throughout the headache attack, and does not disappear after the attack ends, the association of numbness with migraine is doubtful. In this case, it is necessary to look for other diseases, such as a stroke.

Migraine: stuffy ears

Hearing impairment can occur with basilar and vestibular forms of migraine. Usually, patients note tinnitus, a temporary hearing loss. In parallel, dizziness, vomiting, and balance disorders may occur. The duration of these symptoms usually does not exceed 60 minutes, the symptoms disappear as the headache increases. Most often, such forms of migraine are observed in adolescents and young women.

Migraine: speech disorder

Speech impairment can also be one of the manifestations of migraine aura. Most often, this violation is manifested by the inability of the patient to find words to express his thought. Like other aura symptoms, speech impairment develops gradually, lasts no more than 60 minutes, and is completely reversible. After an attack, speech difficulties in a patient with migraine completely disappear. Unlike migraine, speech impairment in a stroke is a sign of severe brain damage and it takes a long time to restore this function.

Migraine and urinary frequency

Frequent urination is not a symptom of stroke or migraine. The presence of this symptom during a headache attack may be associated with a form of arterial hypertension, but more often indicates problems with the kidneys and urinary system (pyelonephritis, cystitis).

Hallucinations in migraine

There are no hallucinations in the medical sense of the word with migraine. However, migraine aura is often manifested by visual disturbances in the form of flickering spots and stripes, which some patients may consider hallucinations. These visual phenomena gradually increase and disappear within 60 minutes. At the same time, examination of the patient’s eyes and nervous system in the interictal period does not reveal any disorders that could provide another explanation for such symptoms.

Does blood pressure increase with migraine

An increase in blood pressure is not a symptom of migraine. However, often migraine and arterial hypertension can develop in the same patient. In such a situation, a migraine attack can provoke a sharp jump in blood pressure, and a hypertensive crisis can lead to a full-fledged migraine. Patients with this combination of diagnoses require regular monitoring and careful selection of therapy.

Migraine: syncope

Fainting and other forms of loss of consciousness are not characteristic of migraine. However, diseases that cause fainting (the so-called syncope) often occur in patients with migraine, and require additional examination and increased attention from the attending physician.

Literature

Materials of Symposium No. 58 “MIGRAINE: MODERN CONCEPTS OF DIAGNOSIS AND THERAPY” were used. INTERNET VIEW FOR MEDICAL AND PHARMACEUTICAL PRACTITIONERS PROFESSIONAL MEDICAL PORTAL

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what is a migraine and how to live with it

Approximately every tenth inhabitant of the Earth has had a migraine at least once in his life. Not everyone can correctly diagnose it, distinguishing it from a common headache. Here’s everything you need to know about this extremely unpleasant condition.

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Four phases of migraine

Do not self-medicate! In our articles, we collect the latest scientific data and the opinions of authoritative health experts. But remember: only a doctor can diagnose and prescribe treatment.

Many consider migraine to be a very severe headache, but the reality is much more complex. Here are the four phases of a migraine, and not all of them occur in every attack, and some people may not have all phases.

Phase 1. Prodromal

A day or two before the onset of a migraine, you may notice the following health characteristics:

• thirst,
• frequent urination,
• food cravings,
• constipation,

9 0009 neck pain,

• mood changes,
• constant yawning.

These symptoms can be quite disturbing. If it’s not the first time you’ve had a migraine, you may realize that you’ll need to take medication soon. The sooner you start treatment, the more effective it will be.

Phase No. 2. Aura

Every third sufferer enters this phase just before the onset of a migraine or when a headache begins. Visual discomfort usually begins: glowing dots, zigzags, distortions that can migrate across the entire field of view. Often there is a blind spot, so drivers caught in the aura should park and wait for the problem to subside.

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Some people experience an unpleasant chemical odor, begin to stutter and blush, and experience numbness of half of the body. Usually this phase lasts from 20 minutes to an hour, the symptoms increase, then pass.

Phase 3. Headache (attack)

Migraine can be quite mild, but most often it is a severe throbbing headache. Usually it is localized in one part of the head, but it can cover the entire head. It lasts from 4 to 72 hours, often accompanied by blurred vision, dizziness and fainting.

Migraines are episodic and chronic. In the latter version, they interfere with living for more than 15 days a month for three months.

In addition to the headache, one may experience nausea, sensitivity to light and sound. Many people want to hide in a dark, quiet room and go to sleep.

Migraine often forces people to break plans and agreements, and this is what especially spoils the lives of many.

Phase No. 4. Postdromal

After the end of the main “action”, you can feel something similar to a hangover: lack of confidence in movements, weakness, thirst.

Some people do not have an aura phase, others do not have a headache itself (most often those who are familiar with migraine from adolescence, when all phases were present).

When to see a doctor?

If painkillers do not help and you want to stop suffering faster, you should find a good doctor who is familiar with the issue.

It is also helpful to keep a migraine diary: time of onset, duration, quality of sleep the previous night, food notes, emotional state, and so on.