How long does a typical migraine attack last. What are the four phases of a migraine attack. How can you recognize the early signs of a migraine. What are effective strategies for preventing and treating migraine attacks.

Decoding Migraine: More Than Just a Headache

Migraine is a complex neurological disorder that goes beyond the realm of a typical headache. It’s characterized by debilitating head pain that significantly impairs daily functioning. Accompanying symptoms often include nausea, vomiting, and heightened sensitivity to light, noise, and odors. The severity and duration of migraine attacks can vary widely among individuals, making it crucial to understand its nature for effective management.

Identifying a Migraine Attack

Recognizing a migraine attack is the first step towards proper treatment. While symptoms can differ from person to person, there are some common hallmarks:

• Moderate to severe head pain lasting several hours
• Throbbing or pounding sensation in the head
• Pain exacerbation with physical movement
• Interference with daily activities, work, or school
• Nausea and/or vomiting
• Increased sensitivity to light, smells, and noise

The head pain associated with migraine can be unilateral or bilateral, and may occur in various regions of the head, including behind the eyes or cheeks. Some individuals experience migraine with aura, a visual disturbance that typically precedes the headache phase and resolves within an hour.

The Four Phases of a Migraine Attack

A migraine attack typically progresses through four distinct phases, although not everyone experiences all phases, and the experience can vary between attacks even for the same individual.

1. Prodrome
2. Aura
3. Headache
4. Postdrome

The headache phase, which is often the most recognizable, can last anywhere from 4 hours to 3 days. The entire migraine attack, encompassing all four phases, may span from just over a day to slightly more than a week in extreme cases. However, a typical migraine attack usually lasts between one to two days.

Duration of Migraine Phases

Is there a typical duration for each phase of a migraine attack? While individual experiences vary, here’s a general breakdown:

• Prodrome: A few hours to several days
• Aura: 5 to 60 minutes
• Headache: 4 to 72 hours
• Postdrome: 24 to 48 hours

Unraveling the Causes and Triggers of Migraine

The exact causes of migraine remain elusive, but research suggests a combination of genetic predisposition and environmental factors. Many individuals can identify specific triggers that precipitate their migraine attacks. Common triggers include:

• Stress
• Certain foods
• Alcohol consumption
• Dehydration
• Sleep pattern changes
• Weather fluctuations
• Hormonal changes (e.g., menstrual cycle)
• Sensory stimuli (bright lights, strong odors)

It’s important to note that while trigger avoidance can be beneficial, many individuals experience spontaneous attacks without identifiable triggers. This underscores the complex nature of migraine and the need for comprehensive management strategies.

Preventive Measures: Lifestyle Modifications for Migraine Management

Can lifestyle changes help prevent migraine attacks? Absolutely. While not a cure-all, certain modifications can significantly reduce the frequency and severity of migraine attacks:

• Maintaining consistent sleep patterns
• Regular exercise routines
• Balanced and nutritious diet
• Adequate hydration
• Stress management techniques (e.g., meditation, yoga)
• Avoiding known triggers when possible

These lifestyle adjustments, when implemented consistently, can complement medical treatments and contribute to better migraine control. It’s advisable to consult with a healthcare provider to develop a personalized prevention plan.

Early Recognition and Prompt Treatment: Keys to Effective Migraine Management

Early identification of migraine symptoms is crucial for effective treatment. As an attack progresses, interventions become less effective and may have more side effects. Keeping a headache diary can help identify patterns and early warning signs, which may include:

• Fatigue
• Irritability
• Anxiety
• Frequent yawning
• Increased urination
• Difficulty concentrating
• Food cravings

Recognizing these prodromal symptoms allows for prompt treatment, potentially reducing the severity or even aborting the attack. Treatment options may include over-the-counter or prescription medications, specialized devices, or other therapeutic approaches.

Acute Treatment Options

What are some common acute treatments for migraine attacks? Here’s a brief overview:

• Over-the-counter pain relievers (e.g., ibuprofen, aspirin)
• Prescription triptans
• Ergotamines
• Anti-nausea medications
• Neuromodulation devices
• Combination medications

The choice of treatment depends on various factors, including the severity of symptoms, individual response, and potential side effects. It’s essential to work with a healthcare provider to determine the most appropriate treatment plan.

When Migraines Persist: Addressing Prolonged Attacks

In some cases, migraine attacks may extend beyond the typical duration, lasting more than 72 hours without pain-free intervals. This condition, known as status migrainosus, requires specialized treatment approaches. It’s crucial to have a plan in place with your healthcare provider for such scenarios.

Red Flags: When to Seek Emergency Care

Are there situations where a migraine attack requires immediate medical attention? Yes, certain symptoms warrant emergency evaluation:

• Sudden, severe headache unlike previous experiences
• Headache accompanied by fever, stiff neck, or rash
• Headache following head injury
• Headache with neurological symptoms (e.g., vision loss, weakness, confusion)
• Headache in individuals with risk factors for brain bleeds

If you experience any of these “red flag” symptoms or are unsure about the severity of your condition, it’s best to seek immediate medical attention or consult with your healthcare provider.

Chronic Migraine: When Attacks Become Frequent

Chronic migraine is a distinct classification characterized by frequent headache days. The current definition includes:

• 15 or more headache days per month for three consecutive months
• At least 8 of those headache days exhibiting migraine features or requiring migraine-specific treatment

This condition often requires a different management approach compared to episodic migraine, emphasizing the importance of accurate diagnosis and tailored treatment strategies.

Managing Chronic Migraine

How does the treatment approach differ for chronic migraine? Here are some key considerations:

• Preventive medications may be prescribed more frequently
• Combination therapy approaches are often utilized
• Lifestyle modifications become even more crucial
• Regular follow-ups with healthcare providers are essential
• Psychological support may be beneficial to manage the impact on quality of life

The goal of chronic migraine management is to reduce the frequency and severity of attacks while improving overall quality of life. This often requires a multidisciplinary approach and ongoing adjustments to the treatment plan.

Empowering Migraine Management: Knowledge and Personalized Care

Understanding the intricacies of migraine attacks, including their duration, phases, and management strategies, is crucial for effective control. By recognizing early symptoms, identifying triggers, and working closely with healthcare providers, individuals can develop personalized management plans that address their unique needs.

The Role of Patient Education

How does patient education contribute to better migraine management? It plays a vital role in several ways:

• Enhances recognition of early warning signs
• Improves adherence to treatment plans
• Facilitates better communication with healthcare providers
• Empowers individuals to make informed decisions about their care
• Reduces anxiety and improves overall coping strategies

Engaging in ongoing education about migraine, staying informed about new treatment options, and actively participating in care decisions can lead to better outcomes and improved quality of life for those living with migraine.

The Future of Migraine Treatment

What does the future hold for migraine management? Emerging research and technological advancements are paving the way for exciting developments:

• Targeted biological therapies (e.g., CGRP inhibitors)
• Advanced neuromodulation devices
• Personalized medicine approaches based on genetic profiles
• Improved understanding of migraine pathophysiology
• Integration of digital health technologies for better monitoring and management

These advancements offer hope for more effective and personalized migraine treatments in the future, potentially revolutionizing the management of this complex neurological disorder.

How Long Does a Migraine Attack Last?

Time is an important factor when it comes to migraine management. Find out how to recognize a migraine attack and when to take action.

When a migraine attack starts, you might have a lot of questions about what is happening, how long it will last and how you can treat your symptoms. Understanding the timing involved in a migraine attack—specifically the headache phase—will go a long way in helping you manage your migraine and knowing when to take action.

What is a migraine attack?

Migraine is not just a bad headache. It is a neurological disease with different symptoms and treatment options than other headache disorders. A migraine attack includes debilitating head pain that interferes with your ability to function normally. Other symptoms include nausea, vomiting and sensitivity to light, noise and smells.

How do you know if you’re having a migraine attack?

People with migraine often have different symptoms, as the presentation of migraine can vary from person to person. But if your head pain is moderate to severe, lasts several hours, causes a throbbing or pounding sensation, gets worse with physical movement and interferes with your life, work or school activities, you may be experiencing migraine. The head pain can be on one or both sides of your head, in the front or back. It can also be in or around your eyes or behind your cheeks.

Migraine can also cause nausea and/or vomiting and increase your sensitivity to light, smells and noise. Some people experience migraine with aura, a visual disturbance that typically occurs before the headache pain begins and resolves within an hour or less.

How long is a migraine attack?

There are four phases of a migraine attack: prodrome, aura, headache and postdrome. Not everyone experiences every phase during a migraine attack, and each attack may be different, even within the same person.

The headache portion of an attack can last from four hours to three days. An entire migraine attack—including prodrome, aura, headache and postdrome—may last anywhere from a bit more than one day to slightly more than a week at its very longest, though this is not typical. Most typically, a migraine attack will last for one to two days.

How to prevent migraine attacks

The causes of migraine aren’t clear, but it may have a hereditary link. Environmental factors can also play a role, and some people have identifiable triggers that can cause migraine attacks. Some common triggers include stress, certain foods, alcohol, dehydration, changes in sleep, changes in weather, hormone fluctuations (such as the menstrual cycle), light or smell.

While trigger avoidance may seem like a way for people to take matters into their own hands, many experience spontaneous attacks, which means there is nothing specific that caused them. Lifestyle changes that eliminate or reduce these triggers, such as consistent and adequate nutrition, hydration, exercise, sleep and stress management, can help decrease the frequency and severity of migraine attacks.

Learn more about preventive migraine treatments here.

How to reduce the effects and treat a migraine attack

Identifying your individual symptoms of a migraine attack can help you treat them early and more effectively. As a headache progresses, treatment is often much less likely to be effective and may have more side effects.

Start by maintaining a headache diary that notes what happens before, during and after the headache part of an attack. Symptoms during the prodromal stage can be non-specific, such as fatigue, irritability, anxiety, yawning, frequent urination, difficulty concentrating and food cravings. So they may be hard to recognize as part of an attack at first.

By noticing these early symptoms, you can quickly treat your migraine to reduce the effects and possibly stop the attack. Acute treatments include over-the-counter or prescription medications, devices or other therapies.

What do I do if my migraine lasts for more than 72 hours or won’t go away?

You should talk to your provider about a plan should your migraine extend past the 72-hour mark. You may need treatment for a condition called status migrainosus. We define this as a migraine that lasts more than 72 hours without a pain-free interval. Status migrainosus is often treated differently than shorter migraine attacks and may require you to receive different treatments.

If your pain is different, much more severe than usual and includes any “red flag” symptoms, get emergency treatment. If you’re unsure, call your doctor or a health information line.

How do I know if I have chronic migraine?

Chronic migraine is currently defined as having 15 or more headache days per month for three months, and at least 8 of those headache days include migraine symptoms or are treated like migraine. About 3 to 5% of people in the U.S. experience chronic migraine. Episodic migraine is defined as 14 or fewer headache days per month. It can become chronic in some people if it’s not recognized or treated.

A primary care physician or headache specialist can provide a diagnosis and help you manage your migraine. If you think you may have episodic or chronic migraine, keep track of all of your headache days—both migraine and other types of headache—and speak to your doctor.

Timing can play a role in diagnosis of other headache disorders, such as new daily persistent headache (NDPH) and hemicrania continua. Both disorders involve constant head pain that continues for over three months without relief. NDPH commonly has a distinct, sudden onset, while hemicrania continua is marked by pain only on one side of the head.

It’s important to share your symptoms and duration of pain with your doctor so they can diagnose and treat your condition appropriately. Factors like time, as well as location of pain and your specific symptoms, can help with getting a correct diagnosis and working on a treatment plan tailored to your lifestyle and headache.

The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.

The Migraine Timeline

Migraine is different for everyone. But many times, an attack follows the same pattern.

A typical migraine can have up to four phases:

• Prodrome phase
• Aura
• Headache
• Postdrome phase

Knowing more about these can help you predict and prepare for an attack.

Prodrome Phase

Before migraine pain hits, you may go through this, which is also called a “preheadache” phase. It can last from an hour up to a day or more.

The warning signs you have will be unique to you. Common ones include:

• Feeling irritable, sudden mood changes
• Yawning a lot
• Needing to pee more than usual
• Craving certain foods
• Extra sensitivity to light or sound
• Trouble concentrating
• Feeling tired and stiff
• Trouble talking or reading
• Nausea
• Problems sleeping  

Once you know the symptoms of your prodrome phase, you may be able to figure out steps that could ease your migraine attack or even stop it from happening.

Those steps may include:

• Medication
• Relaxation techniques like meditation
• Avoiding triggers you know will make your migraine worse

Aura Phase

Up to a third of people with migraines get an aura along with it. An aura typically happens before your migraine pain and could last anywhere from 5 minutes to more than an hour. Some people get them after their pain has already started.

Most of the symptoms of an aura have to do with your sight. They might include:

• Blurry vision
• Blind spots in one or both eyes
• Flashing lights
• Zigzags or patterns in your sight

You can also have some symptoms that don’t have anything to do with your sight, like:

• Numbness or tingling
• Vertigo
• Weakness
• Trouble speaking or hearing
• Memory problems

There’s not much you can do to keep an aura from happening. But knowing that a migraine will follow an aura can help you know it’s time to take medication that may ease or prevent oncoming migraine pain.

These same symptoms can also signal a stroke, so if a doctor hasn’t diagnosed these as part of your migraine, get medical help right away.

Headache Phase

This is when you usually have throbbing, pulsing pain on one or both sides of your head. You may only have this pain for a few hours, or it may go on for several days. It may be minor, or it could be very severe.

Other symptoms you could have, either with or without head pain, include:

• Sensitivity to lights, sounds, and smells
• Nausea or vomiting
• Blurred vision
• Lightheadedness and fainting

Your doctor can help you choose medication to make what you go through less severe. You can also lie in a dark and quiet room and put a cold washcloth to the back of your neck, or practice other relaxation techniques to keep symptoms from getting too bad.

Postdrome Phase

Once your attack symptoms go away, your migraine may not be over. The last phase is the postdrome phase, also known as a “migraine hangover. ” It’s common to have a postdrome phase, but you may not.

It doesn’t involve pain like the headache phase, but it can cause its own symptoms for 24 to 48 hours after your migraine ends. These symptoms can include:

• Trouble concentrating
• Fatigue
• Depression
• Euphoria
• Trouble understanding things
• Body aches
• Dizziness
• Sensitivity to light

Even though your migraine attack is over at this point, it’s still a good idea to stay away from migraine triggers, like bright light, certain smells, or certain foods.

You can try gentle stretching or yoga to help with sore muscles that might have been tense during your attack.

Be sure to also drink plenty of water and avoid stress as you recover.

How Long Do Migraines Last?

Around 39 million Americans experience migraines, which can be severe, recurrent, and potentially disabling. Someone with a migraine may experience nausea or heightened sensitivity to light, sound, or touch.  

Today’s question is, “How long do migraines last?” 

The good news is that they don’t last forever. In fact, most last between four and 72 hours. 

Migraine Duration and Frequency

On average, a migraineur suffers two to four headaches a month. Typically, the migraine lasts between four and 72 hours. The length and frequency vary between people, however. Some only get a migraine once or twice a year. In contrast, others may experience migraines more frequently — possibly one every few days. 

Around three percent of migraine sufferers might have an incredibly intense form of migraine called status migrainosus (SM)  that can last for more than 72 hours, even with treatment.

Migraines have recognizable stages, which can sometimes help a sufferer mitigate or even stop the attack. Unfortunately, not every migraine presents with all stages. However, learning to recognize the early stages is still helpful.

Stages of Migraine

The four recognized stages of migraine include (in order) prodrome, aura, headache, and postdrome.

Prodrome is the premonitory or warning stage. Prodrome can occur as little as a couple of hours before the aura stage to as many as several days. The individual may notice subtle changes that are not necessarily related to head pain.

Symptoms of prodrome can include:

• Insomnia 
• Anxiety, mood changes, irritability, and depression
• Constipation or diarrhea
• Food cravings or increased thirst and urination
• Fatigue, muscle stiffness, or neck stiffness
• Yawning 
• Light sensitivity
• Nausea 
• Problems concentrating, speaking, or reading

If you can recognize the signs of prodrome, you have a chance to reduce your migraine head pain or eliminate it entirely with medication or other treatment.

Aura is a sensory disturbance that can range from flashing lights to the inability to speak normally. Not everyone experiences aura. It typically afflicts about 25% of migraine sufferers.

Aura tends to occur shortly before the migraine attack and can last between five minutes to an hour. In up to a fifth of patients, aura lasts more than an hour. 

It’s more common in children, although some adults experience aura. Sometimes the aura symptoms occur during the migraine itself. Occasionally, a patient may experience an aura that is not followed by a headache.

Symptoms of aura include:

• Dizziness 
• Hearing noises
• Impaired vision or hearing with blurry or the appearance of blind spots
• Slurred speech or weakness in the face or body
• Temporary loss of sight
• Numbness or pins and needles feeling in the limbs
• The appearance of bright, flashing lights, sparkles, or stars, colored or dark spots, or geometric or zigzag lines

Rarely, individuals faint during aura or experience partial paralysis.  

Headache or main attack typically has the same symptoms each time, whether you experience an aura or not. The pain can last from several hours to three days. Headache is the most acute stage of migraine, with more than 90% of sufferers experiencing symptoms that are severe enough to prevent them from functioning normally.

Symptoms include:

• Blurred vision
• Extreme sensitivity to light and noise
• Possible sensitivity to odors, touch, or movement
• Dizziness or light-headedness
• Irritability, anxiety, or depression
• A feeling of burning, giddiness, or insomnia
• Stiffness in the shoulders and neck
• Nasal congestion
• Upset stomach, vomiting, or nausea

The pain is often described as throbbing, drilling, or like an icepick on one or both sides of the head. The pain tends to worsen with movement.

Postdrome, also called recovery or “migraine hangover,” may come after a resolution period. Typically, it occurs at the end of the headache stage for about 80% of migraineurs. Postdrome can last for 24 to 48 hours.

Symptoms of postdrome include:

• Confusion or difficulty concentrating
• Bodily aches
• Elation, depression, or dizziness
• Feeling drained
• Weakness or hunger, especially if the individual lost their appetite during the headache attack

How can you avoid migraine attacks or mitigate them in the early stages of prodrome?

Migraine Causes and Triggers

Many people find that specific triggers cause migraines. If you can identify your triggers using a headache diary to note your activities, foods, drinks, and environment before an attack, you may be able to avoid a migraine or stop it once it enters the prodrome.

Triggers differ between individuals. Here are some common triggers.

• Changes in the weather
• Bright lights
• Alcohol or caffeine
• Diet, skipped meals, or dehydration
• Some medications
• Hormonal changes such as menstruation
• Sleep problems
• Odors or stress
• Medication overuse (rebound headaches)
• Concussions or head injuries

You can treat migraines with home remedies. If those fail, a doctor may recommend prescription medication. 

Home remedies that many find helpful include:

• Increasing your water intake
• Resting or napping in a dark, quiet room
• Using a cold compress or massaging your temples
• Limiting your screen time
• Using lamps instead of overhead lighting
• Drawing the blinds or curtains to block bright sunlight
• Taking over-the-counter pain relievers like aspirin, ibuprofen, or naproxen

Prescription medications your doctor may recommend include:

• Anti-epileptics or anti-convulsants
• Beta-blockers
• Calcium channel blockers
• Antidepressants 
• Serotonin antagonists
• Botox^(R) (botulinum neurotoxin)
• CGRP antagonists

So you see, you have multiple options to help eliminate or mitigate the pain of migraines.  

When to Seek Help

According to the American Migraine Foundation, less than a third of migraine sufferers seek help from a physician. However, if you have a migraine episode that lasts longer than usual for you, seek a healthcare provider’s advice. 

If you experience migraines multiple times throughout the month or year, make an appointment to see your doctor to assess the symptoms and develop a treatment plan tailored to your unique issue.

Go to the emergency room if the migraine becomes too severe and at-home or prescription treatments aren’t working. 

Seek immediate assistance if you experience any of the following:

• An extremely severe headache, the “worst you ever had in your life”
• A headache that starts abruptly, especially if you are over 50
• The migraine lasts longer than 72 hours
• The migraine is accompanied by a stiff neck, fever, confusion, slurred speech, or a seizure
• If you are 40 or older and are experiencing your first migraine ever

If you sustain a head injury, always seek medical attention immediately.

Prevention

Identifying your migraine triggers is the most straightforward pathway to preventing migraine attacks. Track your migraine details, sleep and eating habits, and environmental exposure. You may find ways to reduce your migraine attacks drastically. 

If you find stress plays a role, try meditation or feedback. Your physician may suggest transcranial magnetic stimulation (TMS). Taking magnesium, vitamin B2, or coenzyme Q10 seems to help some sufferers prevent migraines. Your doctor may prescribe preventative medications to take that can limit your attacks.

In children, help them manage their sleep habits and improve their nighttime routine. 

Migraines are no fun. They hurt, can last for up to three days, and come with a range of bewildering symptoms and stages. You can feel irritable or tired. You might see flashing lights—your head aches.

Knowing what can trigger your migraines can help you avoid them or make them less severe. You also have options in home remedies and medical treatments.  

If you have questions or need assistance, contact the Migraine Relief Center. We know headaches.

Migraine | healthdirect

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What are migraines?

Migraines are severe headaches that typically last for between 4 and 72 hours. Migraine sufferers may experience nausea and vomiting as well as sensitivity to light or sound. They also frequently report throbbing pain that worsens with normal activity.

Migraines are common and usually very painful. There may be ways to prevent them, and there are good treatments for them.

When should I call an ambulance?

Most headaches are not serious. But headaches can also be a sign of a serious illness, such as a stroke or meningitis.

Call triple zero (000) and ask for an ambulance, or go to the hospital emergency department if you have a headache and:

• it comes on suddenly, is very severe, or has made you lose consciousness
• you have suffered a head injury
• you have trouble seeing, walking or speaking
• your arms or legs feel numb
• you have nausea or vomiting (if not clearly related to a flu or hangover)
• you have a high fever (above 38° C)
• you are sensitive to light and have a new rash

What are the symptoms of a migraine?

Many people who have migraines feel vaguely unwell for a day or two beforehand.

Some people get what is called an aura. An aura is when someone sees flashing lights or a change in their vision, while others can find problems with their speech, and some feel pins and needles in their arms and legs. This can happen before or during a migraine.

When the migraine starts, it is a severe pain usually only on one side of the head (unlike a tension headache, which is usually felt on both sides of the head). Your heads throbs, and it might hurt to see bright lights or hear noises. You might feel sick, and you might vomit. This can last anywhere between a few hours and a few days. A migraine can be so painful and distressing that everyday activities become impossible.

CHECK YOUR SYMPTOMS — Use our headache Symptom Checker and find out if you need to seek medical help.

What causes a migraine?

Nobody knows what causes migraines, although genetics and environmental factors seem to have a role. Migraines are thought to be caused by temporary changes in blood vessels and chemicals in the brain. They can run in families, but just because one family member gets them doesn’t mean another will.

What triggers a migraine?

Some people find that migraines are triggered by certain things, including:

• missing meals — this is the strongest dietary trigger
• eating certain foods, such as cheese, chocolate, citrus, red wine and food additives (for example, monosodium glutamate)
• altered sleep patterns — too much or too little sleep
• changes in the weather
• hormonal changes, such as menstruation, and the oral contraceptive pill for women
• alcoholic drinks (especially red wine and beer)

When should I see my doctor?

If you get severe headaches but don’t know what’s causing them, or if the pattern of your headaches changes, it is important for you to consult a doctor. Even if you have previously consulted a doctor and been diagnosed with migraines, but your prescribed treatment has not been successful, it is worth going again. Migraines can be managed.

FIND A HEALTH SERVICE — Our Service Finder can help you find doctors, pharmacies, hospitals and other health services.

ASK YOUR DOCTOR — Preparing for an appointment? Use our Question Builder for general tips on what to ask your GP or specialist.

How are migraines diagnosed?

Your doctor will diagnose migraines by talking to you and examining you. There is no specific test to diagnose migraines. However, your doctor may do tests to exclude other causes of headache.

How are migraines prevented or managed?

There are many ways to manage migraines — both to prevent an attack and to treat an attack once it starts (known as acute treatment). It is important to have a migraine management plan and this will probably involve lifestyle changes and medication.

If you suspect you are getting a migraine, you may get some relief from pain-relief medicines. Some people find they can prevent a migraine by treating it early.

Some people can manage migraine with pain relief available from pharmacies; others might need prescription medications to deal with an acute attack. Talk to your doctor or pharmacist about options.

During the migraine, rest in a quiet, dark room. Get as much help as possible with responsibilities at work, for family and so on.

If you get migraines fairly often, there is a wide range of preventive medicines that can reduce the number and severity of the attacks.

If you have just started getting migraines, keeping a diary about them can help you understand when they happen, and what triggers them. That may help you prevent them, and may also help you to explain what you are experiencing with your doctor.

In the longer term, non-medicine therapies can also help to prevent migraine. These include:

Migraine | Symptoms, Causes and Treatment

Migraine is a condition that causes attacks (episodes) of headaches. Other symptoms such as feeling sick (nausea) or being sick (vomiting) are also common. Between migraine attacks, the symptoms go completely.

What causes migraines?

The cause is not clear. A theory that used to be popular was that blood vessels in parts of the brain become narrower (go into spasm) which accounted for the aura. The blood vessels were then thought to open wide (dilate) soon afterwards, which accounted for the headache. However, this theory is not the whole story and, indeed, may not even be a main factor. It is now thought that some chemicals in the brain increase in activity and parts of the brain may then send out confusing signals which cause the symptoms. The exact changes in brain chemicals are not known. It is also not clear why people with migraine should develop these changes. However, something may trigger a change in activity of some brain chemicals to set off a migraine attack.

The cause of, or trigger to, menstrual migraine is thought to be the fall of the level of oestrogen that occurs at this time in the cycle. Oestrogen is one of the chemicals (hormones) that control the menstrual cycle. The blood level of oestrogen falls just before a period. It is not a low level of oestrogen that is thought to be the trigger, but the drop in the level of oestrogen from one level to another.

Migraine is not classed as an inherited condition. However, it often occurs in several members of the same family. So, there is probably some genetic factor involved. Therefore, you are more likely to develop migraine if you have one or more close relatives who have migraine.

Treatment

There are various treatments for a migraine attack, from simple painkillers to migraine medication which is specifically for migraine, such as triptans.

There are also various treatments you can take to prevent migraine attacks, if you have frequent or severe attacks. It may not stop all attacks, but their number and severity are often reduced. Medicines to prevent migraine are taken every day. They are not painkillers and are different to those used to treat each migraine attack.

See the separate leaflet called Migraine Medication, Treatment and Prevention.

What are the types and symptoms?

Migraine without aura

This is the most common type of migraine. Symptoms include the following:

• The headache is usually on one side of the head, typically at the front or side. Sometimes it is on both sides of the head. Sometimes it starts on one side and then spreads all over the head. The pain is moderate or severe and is often described as throbbing or pulsating. Movements of the head may make it worse. It often begins in the morning but may begin at any time of the day or night. Typically, it gradually becomes worse and peaks after 2-12 hours, then gradually eases off. However, it can last from 4 to 72 hours.
• Other migraine symptoms that are common:
• Feeling sick (nausea).
• Being sick (vomiting).
• Not liking bright lights or loud noises, so that you may just want to lie in a dark room.
• Other symptoms that sometimes occur:
• Being off food.
• Blurred vision.
• Poor concentration.
• Stuffy nose.
• Hunger.
• Diarrhoea.
• Tummy (abdominal) pain.
• Passing lots of urine.
• Going pale.
• Sweating.
• Scalp tenderness.
• Sensations of heat or cold.

Migraine with aura

This is less common than migraine without aura. The symptoms are the same as those described above, but also include a warning sign, called a migraine aura, which comes on before the headache begins.

• Visual aura is the most common type of migraine aura. It usually affects just one side of your vision and gradually gets bigger over 5-20 minutes. Examples include:
• A temporary loss of part of vision.
• A bright, shimmering light, often in a C-shaped pattern, a bit like looking through an old-fashioned kaleidoscope, or zig-zag lines.
• Objects or letters on a page may seem to rotate, shake, or boil.
• Numbness and pins and needles are the second most common type of migraine aura. Numbness usually starts in the hand, travels up the arm and then involves the face, lips and tongue. The leg is sometimes involved.
• Problems with speech are the third most common type of migraine aura.
• Other types of migraine aura include an odd smell, food cravings, a feeling of well-being, and other odd sensations.

One of the above migraine auras may develop, or several may occur one after each other. Each aura usually lasts just a few minutes before going but can last up to 60 minutes. The aura usually goes before the headache begins. The headache usually develops within 60 minutes of the end of the aura but it may develop a lot sooner than that – often straight afterwards. Sometimes, just the aura occurs and no headache follows (silent migraine). Most people who have migraine with aura also have episodes of migraine without aura.

Triggers

Most migraine attacks occur for no apparent reason. However, something may trigger migraine attacks in some people. Triggers can be all sorts of things. For example:

• Diet. Dieting too fast, irregular meals, cheese, chocolate, red wines, citrus fruits, foods containing a food additive called tyramine and not drinking enough water (dehydration).
• Environmental. Smoking and smoky rooms, glaring light, VDU screens or flickering TV sets, loud noises, strong smells.
• Psychological. Depression, anxiety, anger, tiredness, stress, etc. Many people with migraine cope well with stress but have attacks when they relax, leading to so-called weekend migraine.
• Medicines. For example, hormone replacement therapy (HRT), some sleeping tablets, and the contraceptive pill. See the separate leaflet called Migraine and Combined Hormonal Contraception for more details.
• Other. Periods (menstruation), shift work, different sleep patterns, and the menopause.

It may help to keep a migraine diary. Note down when and where each migraine attack started, what you were doing, and what you had eaten that day. A pattern may emerge, and it may be possible to avoid one or more things that may trigger your migraine attacks. See the leaflet called Migraine trigger diary. This gives more details and includes a diary that you can print out and fill in.

How long do migraines last?

A migraine attack can typically be divided into four phases:

• A warning (premonitory) phase occurs in up to half of people with migraine. You may feel irritable, depressed, or tired, have food cravings, or just know that a migraine is going to occur. You may have these feelings for hours or even days before the onset of the headache.
• The aura phase (if it occurs).
• The headache phase.
• The resolution phase when the headache gradually fades. During this time you may feel tired, irritable, or depressed, and may have difficulty concentrating.

Typically the headache of a migraine without aura lasts from 4 hours to as long as 72 hours.

A migraine aura usually takes a few minutes to develop then lasts for five minutes to an hour before the headache comes. The headache usually starts within an hour of the aura ending and lasts the same as the headache of a migraine without aura.

Migraine and children

Some points to note about migraine in children include the following:

• Migraine is common in children. It affects about 1 in 10 children of school age.
• Symptoms can be similar to those experienced by adults. However, sometimes symptoms are not typical. For example, compared with adults, attacks are often shorter, and pain may be on both sides of the head. Also, associated symptoms such as feeling sick (nausea) and being sick (vomiting) may not occur.
• Abdominal migraine (described earlier) mainly affects children.
• Common triggers in children include missing meals, lack of fluid in the body (dehydration), and irregular routines. So, if a child is troubled with migraine attacks, it is important to try to have regular routines, with set meals and bedtimes. Also, encourage children to have plenty to drink.
• Many of the medicines used by adults are not licensed for children. Find out more about migraine medication for children in the separate leaflet called Migraine Medication, Treatment and Prevention.

Migraine when pregnant or breastfeeding

The good news is that about 2 in 3 women with migraine have an improvement whilst pregnant or breastfeeding. However, about 1 in 20 women with migraine find that their migraine gets worse whilst pregnant. The bad news is that many of the medicines used to treat migraine should not be taken by pregnant or breastfeeding women. Learn more about migraine medication when pregnant or breastfeeding in the separate leaflet called Migraine Medication, Treatment and Prevention.

How is migraine diagnosed? 

Migraine is usually diagnosed by the typical symptoms. There is no test to confirm migraine. A doctor can usually be confident that you have migraine if you have typical symptoms and by an examination which does not reveal any abnormality. However, some people with migraine have non-typical headaches. Therefore, sometimes tests are done to rule out other causes of headaches. Also, with some uncommon or rare types of migraine such as ocular migraine, tests are sometimes done to rule out other causes of these symptoms. For example, temporary loss of vision can be due to various causes apart from ocular migraine.

Remember, if you have migraine, you do not have symptoms between attacks. It is the episodic nature of the symptoms (that is, they come and then go) that is typical of migraine. A headache that does not go, or other symptoms that do not go, are not due to migraine.

Tension headaches are sometimes confused with migraine. These are the common headaches that most people have from time to time. See the separate leaflet called Tension Headache for more details.  Note: if you have migraine, you can also have tension headaches at different times to migraine attacks.

Cluster headaches may also be confused with migraine. Cluster headaches are attacks of severe one-sided pain in the head, usually centred in or around one eye or temple, which occur in groups or clusters. The pain is extremely severe and can be accompanied by eye watering, eyelid drooping and facial sweating on the affected side. Cluster headaches usually last 45-90 minutes. See the separate leaflet called Cluster Headaches for more information.

If you take painkillers too often for any kind of headache you may develop medication-overuse headache (also called medication-induced headache and sometimes also called an analgesic headache). You can read more about this type of headache in the separate leaflet called Migraine Medication, Treatment and Prevention.  

What is a silent migraine?

Sometimes you will hear people talk about ‘silent migraine’ or ‘migraine aura without headache’. This occurs when you develop a migraine, either with or without aura, that is typical in every other way but doesn’t cause a headache. So you experience all of the phases described above but miss out the headache phase. Silent migraine can occur in someone who used to have migraine but can also happen from time to time in people who still get the more typical migraine attacks.

Less common types

There are various other types of migraine which are uncommon, and some more types which are rare. These include:

Menstrual migraine. Menstrual migraines are migraines that happen around the time of a woman’s period. The symptoms of menstrual migraine are just the same as migraine with or without aura; it is the timing of the migraine that makes it a menstrual migraine. You can read more about menstrual migraine in our leaflet on menstrual migraine and in the separate leaflet called Migraine Medication, Treatment and Prevention.

Abdominal migraine. This mainly occurs in children. Instead of headaches, the child has attacks of tummy (abdominal) pain which last several hours. Typically, during each attack there is no headache, or only a mild headache. There may be associated with sickness, being sick (vomiting) or aura symptoms.

Commonly, children who have abdominal migraine switch to develop common migraine in their teenage years.

Ocular migraine, sometimes also called retinal migraine, ophthalmic migraine or eye migraine. This causes temporary loss of all or part of the vision in one eye. This may be with or without a headache. Each attack usually occurs in the same eye. There are no abnormalities in the eye itself and vision returns to normal.

Important note: consult a doctor urgently if you have a sudden loss of vision (particularly if it occurs for the first time). There are various causes of this and these need to be ruled out before ocular migraine can be diagnosed.

Hemiplegic migraine. This is rare. In addition to a severe headache, symptoms include weakness (like a temporary paralysis) of one side of the body. This may last up to several hours, or even days, before resolving. Therefore, it is sometimes confused with a stroke. You may also have other temporary symptoms of:

• Severe dizziness (vertigo).
• Double vision.
• Visual problems.
• Hearing problems.
• Difficulty speaking or swallowing.

Important note: consult a doctor urgently if you get sudden weakness (particularly if it occurs for the first time). There are other causes of this (such as a stroke) and these need to be ruled out before hemiplegic migraine can be diagnosed.

Vestibular migraine may affect up to one in a hundred people. It causes recurring episodes of severe dizziness (vertigo) alongside other typical migraine symptoms and lasts between 5 minutes and 72 hours. The dizziness that you get with vestibular migraine is not an aura. It occurs at the same time as a headache. It can occur in people who get migraine with aura and those who get migraine without aura.

Basilar-type migraine. This is rare. The basilar artery is in the back of your head. It used to be thought that this type of migraine originated due to a problem with the basilar artery. It is now thought that this is not the case, but the exact cause is not known.

Symptoms typically include headache at the back of the head (rather than one-sided as in common migraine). They also tend to include strange aura symptoms such as:

• Temporary loss of vision.
• Double vision.
• Dizziness.
• Ringing in the ears.
• Jerky eye movements.
• Trouble hearing.
• Slurred speech.

Unlike hemiplegic migraine, basilar-type migraine does not cause weakness. There is an increased risk of having a stroke with this type of migraine.

Important note: consult a doctor urgently if you develop the symptoms described for basilar-type migraine (particularly if they occur for the first time). There are other causes of these symptoms (such as a stroke) and these need to be ruled out before basilar-type migraine can be diagnosed.

Status Migrainosus – an overview

What the Future Holds for Pediatric Headache

One of the biggest hurdles to be overcome in pediatric headache care is the paucity of drugs approved by the Food and Drug Administration (FDA). Currently, only rizatriptan is approved for ages 6 years and above, and almotriptan is approved for ages 12 years and above. Despite its widespread use, oral sumatriptan is not FDA approved for pediatric use.

In 2013, sumatriptan in a patch formulation was released for adult use. Since many migraineurs suffer nausea with migraine attacks, this unique delivery system may offer a more tolerable injection-free method of treatment for adults and pediatric patients. However, FDA approval is not likely to be granted in the near future. DHE in an inhaled form (MAP0004) is in the final stages of study and will likely soon be available. In many emergency departments, IV DHE is part of the therapy for status migrainosus. Tepper and colleagues have shown that unlike triptans, the efficacy of orally inhaled DHE is not reduced once central sensitization has occurred.¹¹⁰ This difference is quite significant. One could potentially consider using inhaled DHE in the home setting to try and prevent an ER visit for status migrainosus.

Calcium gene-related peptide (CGRP) related therapy for acute migraine is currently the target of extensive research. CGRP is released by both peripheral and central trigeminal ganglion neurons, and is the main mediator of pain signals from the trigeminal nerve. If CGRP is blocked, cortical spreading depression is significantly inhibited.¹¹¹ Five CGRP receptor antagonists have shown efficacy: one of these agents could not be produced in an oral form, two others were discontinued due to liver toxicity, and the two remaining agents (BI44370A and BMS-927711) have shown promise as possible acute migraine therapies in the future. ¹¹²

No drugs have received FDA approval for treatment of chronic migraine in the pediatric patient. Amitriptyline and topiramate are frequently used in this setting, but as “off-label” therapy. Hershey and Powers are currently conducting the multicenter Children and Adolescent Migraine Prevention (CHAMP) Study, comparing amitriptyline and topiramate versus placebo and versus each other, in the hope of establishing the usefulness of these drugs for chronic migraine. The study should also determine which drug should be first-line therapy.

In the adult population, Botox has received a lot of attention as the only approved treatment for chronic migraine. In a small study in adolescents, Chan and colleagues showed that Botox has the potential for benefit in pediatric patients, but further study was recommended.¹¹³ A double-blinded study is being attempted, but few parents are willing to allow their child to possibly receive 31 injections of a placebo.

Beyond therapies one can hope that in the near future research will provide a better understanding of the relationship between migraine and GI disorders such as inflammatory bowel disease and celiac disease (if a relationship exists at all). Other autonomic disorders, such as postural orthostatic tachycardia syndrome (POTS), may be involved.

More needs to be discovered about the genetics of headache: who gets them and why; why some of our patients quickly progress to chronic migraine but most do not; and why medications have such variable results when treating headaches with the same phenotype.

Finally, more evidence-based therapy is needed, whether for acute migraine, migraine prophylaxis, or ER/hospital treatment. Many centers rely on their own tried and true therapies and pathways. It is hoped that these interventions will be compared in a prospective manner to decide the best courses of care for our patients.

Migraines

What is a Migraine?

It is important to keep in mind that not all headaches are migraines, and there are different types of very severe headaches. For example, a cluster headache is a less common, very intense, recurring, and isolated (occurring in a “cluster”) headache that can be worse than a migraine. Migraines are also different than typical headaches, or tension headaches.

Migraines typically present suddenly, with intense pain, and unilaterally. These one-sided headaches are experienced as a throbbing or pounding sensation in the head, and symptoms can be worsened by physical activity. Patients can also experience a sensitivity to light or sound, nausea, and vomiting during or immediately prior to experiencing a migraine. Though migraines are typically experienced as pain on one side of the head, about 1/3 of migraine episodes affect both sides of the head.

The severity of migraines is often debilitating and can interfere with work, school, or everyday social activities and responsibilities. Symptoms of a migraine attack vary from patient to patient, and can even differ between different attacks in the same patient.

Half of all migraine sufferers had their first migraine attack before the age of 12. Migraines can begin at any age, though they are more common during active adulthood (ages 25 to 55. ) Although post-pubertal women are more likely to experience migraines, young boys are more likely than pre-pubertal young girls to get a migraine attack.

Migraines are also referred to as Migraine disorders, Migraine headaches, Migraine attacks, or Sick headaches.

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What Causes Migraines?

The exact cause of migraines is not fully understood. Current scientific thought points to both genetic and environmental influences causing migraines. Some believe that migraines occur when blood vessels in the brain become constricted or inflamed. Migraines may also be caused by imbalances in neurotransmitters, or chemicals in the brain, such as serotonin. Lower than normal levels of serotonin trigger the body’s trigeminal system to release neuropeptides, which cause head pain by traveling to the brain’s meninges, or outer covering.

Other theories have focused on the inherited component as the cause of migraines, and believe that migraines are neurological abnormalities due to genetic mutations. Researchers at the National Institute of Neurological Disorders and Stroke have found a mutation in a gene that codes for a potassium ion channel, the TRESK gene. These potassium ion channel mutations can yield overactive nerve cells that have much lower thresholds for responding to pain levels, thus producing the sudden and intense pain associated with migraine headaches. Statistics have shown the strong genetic component to migraine attacks. Patients with one parent who suffers from migraines have a 40% chance of also suffering from migraines, while patients with both parents who suffer from migraines have up to a 90% chance of having migraine attacks.

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Although the exact cause of migraines is not fully comprehended, there are certain known triggers that lead to migraine attacks. Such migraine triggers include:

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• Stress

• Anxiety

• Hormonal changes (particularly changes in estrogen in women before or during menstruation, pregnancy, or menopause)

• Lack of sleep

• Too much sleep, oversleeping

• Intense physical exertion (including sexual activity)

• Lack of food

• Weather or environmental changes, such as changes in barometric pressure

• Exposure to light (usually bright light or sun glare)

• Loud sounds

• Strong smells (perfume, secondhand smoke, paint)

• Foods

• Alcohol

• Caffeine

• Medications

Signs and Symptoms of a Migraine

Patients often notice they are experiencing a migraine due to the sudden, intense, and throbbing pain in a localized part of the head.

There are four stages of a migraine attack – prodrome, aura, headache, and postdrome – although some patients may not experience all four stages each time a migraine attack occurs.

The prodrome stage typically occurs 24 to 48 hours prior to the onset of a migraine. Symptoms may include:

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The second stage, the aura stage, includes neurological symptoms that typically last between 20-60 minutes and occur prior to migraine symptoms. Symptoms of auras are not long-lasting, and occur in about 15-20% of migraine attacks. Not all patients who have migraines experience auras. Auras may be alarming to some patients, as the symptoms often mimic what seems to be a stroke. Symptoms of auras may include:

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• Loss of vision (temporary)

• Blind spot

• Distorted or blurry vision

• Visual phenomena – flashing lights, flashing dots, strange shapes, wavy lines, jagged lines, blind spots

• Sensation of tingling and “pins and needles” in the extremities (arms or legs) or face

• Speech or language difficulties

• Limb weakness

• Numbness or weakness in one side of the body

The migraine headache is the third stage. This stage includes symptoms that are typically associated with migraine attacks. The International Headache Society has set guidelines for diagnosing migraines based on the pain it causes and the number of attacks. Contingent on this classification, migraines are diagnosed after at least 5 attacks of mild to intense head pain, with each episode lasting between 4-72 hours if no medical intervention or treatment is sought. Additional migraine symptoms include the following, and not all symptoms are seen with every patient, or at each migraine attack:

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• Throbbing, intense, pounding/pulsating pain (typically on one side of the head, can be seen on both sides of the head)

• Eye pain

• Sensitivity to light (photophobia)

• Sensitivity to sounds (phonophobia)

• Sensitivity to smells (osmophobia)

• Sensitivity to touch

• Nausea

• Vomiting

• Blurry vision

• Sensations of being warm or cold

• Paleness

• Feelings of lightheadedness

• Fainting

• Fever (this is rare)

The postdrome stage is the fourth and final stage of a migraine attack. While most patients feel some level of exhaustion, some patients have noted feelings of euphoria in this post-headache stage.

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Prevention of Migraines

When dealing with migraine attacks, two routes for medical care include prevention of the onset of symptoms, and treatment of existing symptoms.

Migraine prevention varies among patients who suffer from these attacks. Techniques and options for prevention include:

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• Lifestyle changes

• Changes in diet (avoiding certain foods may help those whose migraines are triggered by particular foods)

• Increasing water intake and hydration

• Dietary supplements

• Herbal medicinal products

• Cognitive behavioral therapy or other psychological techniques

• Biofeedback mechanisms

• Exercise

• Acupuncture

• Massage therapy

• Yoga, meditation, or other relaxation techniques – these can help prevent triggers as well as manage pain associated with migraines

Obese patients suffering from recurring migraines may find relief after managing their weight through a weight loss program.

Some patients find it helpful to document their migraine attacks, so they may identify certain triggers that lead to these headaches, and make proactive lifestyle changes to avoid the probability of future attacks.

Preventive medications can be helpful in patients who experience long-lasting and/or frequent headaches. These are taken every day, to minimize the frequency, severity, and duration of migraine headaches and attacks. Sometimes, preventive medications are taken before certain expected triggers, such as prior to the onset of menses each month in women. Examples of preventive medications include:

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• Blood pressure medications – such as propranolol (Inderal), nadolol (corgard), verapamil (Clan, Covera, Isoptin, Verelan), flunarizine

• Anti-seizure medications – such as divalproex sodium (Depakote), topiramate (Topamax), gabapentin (Neurontin, Gralise)

• Antidepressant medications – such as amitriptyline, venlafaxine

• Supplements – such as magnesium, butterbur, riboflavin, vitamin B12, coenzyme Q10

Some patients who experience almost daily migraines are sometimes given Botox (Botulinum toxin A) injections, in an attempt to lessen the severity and frequency of the migraine attacks.

It is important to keep in mind that certain patients are more susceptible, or genetically predisposed to, suffering from migraine attacks. Techniques for prevention can help manage migraine symptoms, but are not guaranteed to completely eliminate the possibility of attacks.

Treatment of a Migraine

Treatment of migraines can often be difficult, as the specific causes are not fully understood. Treatment of migraines involves management of symptoms, as there is no cure for migraine attacks. Treating the symptoms associated with migraine headaches often involves medications, both over-the-counter and prescription. The specific course of treatment depends on how often and how long each migraine episode lasts.

Many people find that lying down in a quiet, dark room helps relieve the headaches associated with migraine attacks. Other helpful techniques include placing a cool towel over the eyes, or using a cooling pad over the affected side of the head.

Certain over-the-counter medications can help relieve migraine symptoms, such as:

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• Acetaminophen (Tylenol)

• Ibuprofen (Advil, Motrin)

• Combination of acetaminophen, aspirin, and caffeine (Excedrin Migraine)

Common prescription medications for pain relieve due to migraines include:

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• Sumatriptan (Imitrex, Alsuma, Sumavel DosePro)

• Rizatriptan (Maxalt)

• Eletriptan (Relpax)

• Zolmitriptan (Zomig)

• Naratriptan (Amerge)

• Almotriptan (Axert)

• Frovatriptan (Frova)

• Combination of sumatriptan and naproxen sodium (Treximet)

When Should I Call a Doctor?

Many patients with migraines do not seek medical care, and migraines are often undiagnosed and untreated.

Pregnant women who commonly suffer from migraines are encouraged to seek medical advice early in or before their pregnancy, to develop a safe treatment and prevention plan during their pregnancy.

Consider speaking with a medical provider if you are experiencing side effects from any medications you take to manage migraine headache pain.

Although sensitivity to light is a common symptom of migraine headaches, it is rare to experience eye pain. If you are experiencing pain in your eye, either alone or in combination with blurry vision or temporary blindness, you should speak with a medical provider as soon as possible.

If you are experiencing any new or unusual symptoms associated with a migraine headache, speak with a medical provider.

Rarely, migraine-like symptoms are indications of much more serious conditions, such as an aneurysm or tumor. Although uncommon, these conditions may become severe and life-threatening. New, sudden, and extremely painful headaches (“the worst headache of your life,”) headaches that wake you up in the night, headaches that occur after an injury or accident, or headaches that lead to unusual changes in behavior warrant medical evaluation. Circumstances and migraine-related symptoms that are emergency warning signs include:

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• Unstoppable and uncontrollable vomiting – this may lead to dehydration or signal a stroke

• Unstoppable and uncontrollable diarrhea – this may lead to dehydration or signal a stroke

• Migraines lasting longer than 72 hours – this may increase your risk of a stroke

• The worst headache or migraine of your life – this may be a sign of an aneurysm

• A fever with a stiff neck – this may be a sign of meningitis

• Difficulty speaking, difficulty walking, with severe vomiting and nausea – this may be a sign of a hemorrhagic stroke

If you experience any of these signs, head to the closest Emergency Room. If possible, have somebody else drive you.

If you are worried about symptoms related to migraine headaches, or would like medical advice regarding the possibility of migraine attacks, consider setting up an appointment and discussing your questions and concerns with a medical provider.

90,000 Children’s migraine

Migraine headaches in children: guidelines for teachers and school health personnel.

Children get headaches too! Headache occurs at any age, even in children between the ages of two and three. The number of severe headaches peaks during adolescence. Headache symptoms in children are not at all the same as in adults. As a result, children are often left without a correct diagnosis for many years, until the headache “symptoms” into a more adult picture.Migraine headache in adults with loss of performance that lasts up to 3 days, as well as nausea, vomiting, and / or sensitivity to light and sound. Since children with severe headaches may not always be able to describe how they are feeling, this description of the symptoms will be important for parents to take action in time. With close observation and in-depth questioning, you can get an idea of ​​your child’s headache, which will help in making a correct diagnosis. Differences in headaches in children.The episodic headaches that children experience can actually be migraines with or without an aura.

There are some notable differences when comparing the clinical symptoms of migraine between children and adults: 1. Headaches can be shorter, lasting as little as an hour or two. 2. Attacks do not happen as often. They can only happen once a month, or every few months. 3. The pain is most often localized in the forehead on both sides, which is one-sided. As children and adolescents get older, the pain tends to become one-sided.4. Young children may develop other migraine syndromes even before they complain of headaches. The two most common are cyclical vomiting syndrome and abdominal migraine.

* Cyclic vomiting syndrome is defined as regular, predictable bouts of vomiting over several weeks. These bouts of vomiting can be severe and can lead to dehydration.

* Abdominal migraine is similar to a common migraine, but instead of headache, children complain of abdominal pain.Vague or cramping pain around the navel.

Since occasional abdominal pain or vomiting can occur due to gastrointestinal problems, parents should take this into account and consult a gastroenterologist to assess their child’s condition before starting migraine therapy.

5. Children may not be able to report on many of the common symptoms commonly associated with migraines, such as sensitivity to light or sound. They may also complain about trouble concentrating.(These symptoms can be suspected by the child’s behavior during a headache attack.)

Helping Your Child If your child has episodic headaches, it is important that the doctor diagnoses it correctly as soon as possible. After the diagnosis has been clarified, your child will be prescribed effective therapy to relieve a headache attack and, if necessary, preventive treatment. Ideally, therapy should stop the headache, or at least reduce it within 2 hours, and prophylactic treatment will reduce the incidence of the headache by 50% or more.If the therapy is not effective, then you need to show the child to a pediatric neurologist or a headache specialist (cephalgologist).

ADDITIONAL THERAPY FOR CHILDREN SUFFERING WITH MIGRAINE.

Currently, there are only two approved drugs for the relief of migraine attacks in children. Most parents need to use additional ways to help their children with migraines.

There are many methods available that will ease your little one’s suffering:

Cold use – cold compresses placed on the head and relieve headaches.For very young children, you can use bags in the shape of animals or other interesting shapes. For older children, cold compresses should be applied to the hands.

Acupuncture is a minimally invasive procedure that does not have any serious adverse reactions, however it is important to select a well trained professional to administer the sessions.

Managing Nausea:

• Recent research has shown that wrist bands with sea salt can help regulate nausea.

• Lemon, lime, or ginger with soda and salty crackers can help calm the stomach.

• You can also use mints.

• Many adults find ginger or peppermint tea to be a sedative. If your kids don’t like a hot drink, make tea and add ice to it.

Sun and light protection. If you are at home, close the blinds and curtains in the nursery to keep the light out. When you are away from home and cannot change the environment, you need to wear sunglasses or a sleep mask on your child to protect him from irritating sunlight.

Minimization of noise. It is advisable that during a migraine attack, it is calm and quiet around. Tuck it in your bedroom and leave it alone if possible. Minimize noise propagation in the child’s room or use ear plugs.

Temperature control. Most children with migraines prefer to wait out the attack in a cold room, so try to ventilate and cool the room as much as possible.

Aromatherapy.Using high quality oils that contain soothing aromas such as lavender, mint, or tangerine can be incredibly beneficial and safe. If you choose to use pure essential oils for aromatherapy, keep in mind that, with the exception of lavender, oils should never be applied undiluted to the skin as they can cause skin irritation or burns. Dilute them before use. Coconut oil is a good choice because it doesn’t smell of its own and can be easily disposed of if it gets on your clothes or bedding.

Balanced nutrition and adherence to drinking regime. It is important that your child gets enough fluids to prevent dehydration. In addition to plain water, you can dilute the fruit juice with water for a change. Using electrolyte drinks may seem like a good idea, but they often contain substances that trigger migraine attacks, so it is very important to be thoughtful and understand whether this is right for your child or not. Food should be something simple, such as chicken broth and a few crackers, if your child is capable of eating any food at the time of the attack.

The author of the article is a neurologist, cephalgologist Toropova A.A.

The fastest and most effective way to relieve a child of migraines is botulinum therapy .

90,000 Let’s beat the headache together!

– Marina Igorevna, tell us what headaches are and how they affect a person’s life?

– Headaches are primary, which include tension headache and migraine, and secondary, which are the result of some other disease.Contrary to popular belief, most often (more than 90% of cases) headaches are of a primary nature. Headaches sharply reduce the quality of a person’s life, affecting not only his ability to work, but also rest, relationships in the family, with family and friends. Many people view headaches as something inevitable that they have to put up with and with which it is useless to fight. But this is not true! You cannot put up with the existence of a headache, especially frequent. It is very important to beat the headache before it becomes a chronic illness.

– Which types of headaches are more typical for women and which are more common for men?

– A typical female headache is migraine. According to statistics, the ratio of women and men suffering from migraines is about five to two, however, men with migraines rarely seek help, since they usually have this disease in a milder form. Migraine is a severe headache with nausea, increased sensitivity to sounds, smells, light, fatigue, and decreased performance.A migraine attack can last from 4 to 72 hours and is very exhausting for the patient. Migraine usually begins in adolescence and is mild before the age of 25-30. The peak of migraine, according to international statistics, falls on 35-45 years. This is a hereditary, genetically predetermined disease. I have a whole family of patients: a mother and two daughters, and all three suffer from migraines, although each of them has it differently, and each has been individually treated.

According to international statistics, tension headache is also more common in women, but based on my experience, it is men who treat this disease more often.Men have a strong sense of responsibility for their work, for their company and its employees, and over time, constant anxiety and emotional stress cause tension headaches in them. Cluster headache is also typical for men. It is a hereditary disease that develops between the ages of 30 and 40. In England, this disease is called “alarm clock” headache, because it wakes up a person at 4-6 in the morning with unbearable attacks of headache. But there is a developed treatment for cluster headache, and an experienced specialist can successfully relieve the patient of this problem.

– What are the characteristics of the qualifications of a headache specialist?

– Western education plays an important role. Due to the fact that in Russia this problem began to be paid attention only recently, the necessary training in approaches to the diagnosis and treatment of headaches at the moment can be obtained only abroad. The European Headache Federation conducts training courses in various countries for doctors interested in this problem.The last such Headache School I attended was in September 2010 in Italy and was organized according to existing teaching standards in the diagnosis and treatment of headaches. In addition to training courses, the headache specialist is helped by European and world congresses, at which doctors from different countries exchange experience. At international congresses, much attention is paid to modern scientific achievements, cases that require complex diagnostics are discussed.So at the congress on migraine and headache, which was held in October 2010 in Nice, a separate seminar was devoted to chronic migraine and the complex aspects of its diagnosis and treatment.

– What are the objectives of the Headache Center?

– The main task of our Center is to help people suffering from headaches. In Russian medicine, in particular in neurology, little attention has been paid to headache for a long time.It was believed that this problem is not as serious as heart attacks or strokes. In this regard, specialized treatment of headache in Russia began to develop only relatively recently. In our country, there are only about a dozen doctors who specialize in this problem. At the same time, there are a huge number of people suffering from headaches. Making a correct diagnosis, choosing a treatment, teaching a person to live without pain – these are tasks that require experience and professionalism. Of course, there are many neurologists who are good at headaches, but they tackle this problem along with other neurological conditions such as back pain, epilepsy, or sleep problems.And all over the world, especially in Europe, it is a specialized approach that is very important, which implies knowledge of many special points in the diagnosis and treatment of headache.

– What diagnostic methods are relevant for diagnosing a patient with a headache?

– Often enough information about the course of the disease and the patient’s complaints to make a diagnosis. In those cases when the picture looks ambiguous, additional diagnostic procedures are needed to exclude the secondary nature of the headache.For these purposes, we use magnetic resonance imaging of the brain, which helps to exclude such life-threatening and health-threatening diseases as tumors and vascular aneurysms. In some cases, we also use transcranial Doppler ultrasonography of the head and neck vessels and duplex scanning of the neck vessels. For chronic headache, encephalography is used, and in more rare cases, an x-ray of the cervical spine is used.

In the practice of our Center, the European headache diary is widely used.This diary was developed by the European Headache Federation and has been validated in 25 headache treatment centers in Europe. A headache diary is very effective and convenient for diagnosis and treatment – both for the patient and the doctor. The diary is based on a series of questions related to the nature of the headaches and accompanying symptoms. During the month, the patient fills in the diary every day. Quite often, according to the results of filling out the diary, he discovers that he has headaches much more often, and he takes much more drugs than he previously thought.A headache diary is used at all stages of diagnosis and treatment – it helps to diagnose and further monitor the results of the prescribed treatment.

– What treatments do you use?

– First of all, you need to choose the right drugs to relieve a headache attack. It so happens that at the initial stage, the patient requires a large number of medications – due to the severity and frequency of the attacks.However, over time, the number of attacks and their intensity decrease, and the number of drugs used decreases. The second step is to identify the factors that provoke headaches. Headache provocateurs are individual for each patient. These can be both certain food items and the characteristics of the patient’s lifestyle. So with a migraine, insufficient or excessive sleep is very often a provocateur of attacks.

There is such a thing as “weekend migraine.”For migraine sufferers, weekend headaches are common. During the week, a person is mobilized at work, he keeps himself in constant tension, and his head does not hurt, and on the day off he allows himself to sleep longer (which is not very good with migraines) and relaxes – and then he is overtaken by a headache, which especially offensive on the weekend. I had a patient who had a migraine every Saturday. It turned out that on weekdays she gets up at seven in the morning, and on Saturday she allows herself to sleep until eleven.Selecting the necessary medication and changing the wake-up time on Saturdays to an earlier one reduced the number of seizures to one per month.

– What results can be achieved with headache treatment?

– A well-chosen treatment allows achieving, if not a complete disappearance of headaches, then, in any case, a significant reduction in the frequency and intensity of attacks, which significantly improves the patient’s quality of life!

Headache Treatment Center: st.Paradnaya, 7.

Tel. +7 (812) 600-78-21

90,000 Scientists have warned of the long-term effects of coronavirus on the body – RBK

The initial assumption that pneumonia is the only consequence of the disease turned out to be erroneous.A variety of organs can be affected

Photo: Timur Batyrshin / RIA Novosti

Initial assumptions that COVID-19 has a negative effect only on the respiratory system turned out to be incorrect.According to Reuters, scientists in various research centers in the United States have come to the conclusion that the disease strikes the entire human body, and its negative consequences can affect for many years to come.

So, cardiologist Eric Poplar from the Institute in La Jolla, California indicates that the coronavirus hits the heart, liver, and kidneys. “At first we thought it was a respiratory disease. And they could not even think that pneumonia is only the first stage, ”he said.According to the doctor, the negative consequences of the disease can be deteriorated blood clotting, severe headaches, and dizziness.

Collective immunity in Sevastopol. Pandemic news on December 4

Cardiologist Sadia Khan from Chicago also points out that the negative effects of the coronavirus came as a surprise to scientists.According to him, if at first doctors were more interested in how the disease progresses in patients with chronic diseases, now it is equally important to understand how the recovery process is going in those who have had coronavirus without hospitalization. “Many people complain of fatigue, shortness of breath. And it is very difficult to say how long all this will last for them, “admitted the deputy head of the American Center for Disease Control Jay Butler. Although, on average, the coronavirus lasts 2-3 weeks in the human body, in 10% of cases the symptoms remain even with an already negative test.This includes loss of smell and taste.

Earlier, scientists from California, whose study was reported by the Financial Times, concluded that the coronavirus stretches out its tentacles from infected cells, which is why it spreads throughout the body.

This discovery led scientists to speculate that drugs that were commonly used to treat cancer could be used to combat the disease.

Complete diagnostics, treatment and prevention of recurrent migraine attacks in Moscow, price

03.11.2021

The article was checked by a chiropractor, neurologist, reflexologist, vertebrologist Gudel R.S. is for general informational purposes only and does not replace specialist advice.
For recommendations on diagnosis and treatment, a doctor’s consultation is required.

At the Yauza Clinical Hospital, migraine is treated with all modern methods aimed at arresting and preventing attacks – pharmacotherapy, teaching the patient important regimens for the prevention of exacerbation, as well as botulinum therapy, carried out by certified specialist .

Complaining about a headache is one of the most common people with which they turn to a neurologist. Meanwhile, from 10% to 25% of all these complaints are associated not only with headaches, but with migraines.

Migraine is a disease characterized by recurrent bouts of intense headache. Usually the attack is localized in one half of the head, accompanied by nausea, vomiting, increased sensitivity to light and sounds.

According to statistics, women are three times more likely to suffer from migraines than men. Usually, the disease begins before age 20, and the peak occurs at 30-40 years. The presence of the disease in the mother or father increases the chances of children also suffering from migraines, and the risk of inheriting the disease from the mother is higher – about 70%.

Specialists of the Department of Neurology of the Clinical Hospital on Yauza try to detect migraine in the early stages, when it has not become severe, relieve pain syndrome, and also give recommendations on the prevention of recurrent attacks, avoidance of triggers (factors provoking an exacerbation).

Migraine symptoms

Migraine is characterized by an attack of a throbbing headache that is localized in one half of the head. As a rule, this is a dull pain of moderate intensity or severe, which is further intensified with physical activity, tilting the head, etc. The patient is nauseous and irritated by loud noises or light.

Migraine sufferers experience a pallor or redness of the face, a decrease in the temperature of the hands and feet. In some cases, numbness, tingling in the extremities may occur.Typically, an attack of this type of headache lasts from 4 to 72 hours.

In about 20% of cases, an aura precedes a migraine attack. This is a collection of neurological symptoms that can be visual, auditory, vestibular, and others. For example, the visual aura may consist in the flickering of small flashes, the loss of an image from the field of view, or its distortion. Also among the symptoms of the aura are numbness of the limbs, attacks of panic, fear, palpitations, tremors, weakness. All symptoms of the aura disappear over time.

Causes of migraine

Scientists have not yet established the exact causes of migraine, but the mechanism of its occurrence is known. There is a narrowing of the arteries going to the membranes of the brain, and then their expansion. As a result, pain receptors that are located around the vessels are irritated, however, the reason leading to the compression and expansion of the vessels has not yet been clarified.

Among the factors that contribute to the onset of migraine, there are:

• heredity
• gender (women suffer from migraines more often than men)
• stress and overload
• hormonal disorders, including taking hormonal contraceptives
• sleep disturbance (both lack and excess)
• change of climatic zones, abrupt change of weather
• motion sickness
• taking vasodilators
• smoking, alcohol abuse, unhealthy diet

Diagnosis of migraine at the Clinical Hospital on Yauza

If you periodically suffer from an intense throbbing headache, it is better not to postpone your visit to the doctor until the migraine attacks become more frequent and intense.A neurologist at the Clinical Hospital on Yauza will make a diagnosis based on the patient’s history and complaints.

Also, a specialist at the Clinical Hospital on Yauza will offer to undergo a special test for migraine. In some cases, additional examination may be required, which includes a general analysis of blood and urine, consultations of narrow specialists (ophthalmologist, cardiologist), magnetic resonance imaging, ultrasound Doppler ultrasound.

Treatment of migraine at the Clinical Hospital on Yauza

To relieve headache attacks and accompanying migraine symptoms, a neurologist usually prescribes triptans – serotonin derivatives, simple and combined analgesics, nonsteroidal anti-inflammatory drugs.An antiemetic is also prescribed if necessary.

In the treatment of chronic migraine, botulinum therapy methods are used.

Also, in the Department of Neurology of the Clinical Hospital on Yauza, an individual program for the prevention of recurrent migraine attacks is being developed for each patient.

price 526 – Cost of services

More details prices for services you can look at the price list or specify by phone, indicated on the website.

Literature:

4. Parfenov V.A. Nervous diseases. General neurology: textbook. for students // First Moscow State. honey. un-t them. I.M.Sechenov. 2014.

5. Yakhno N.N., Shtulman D.R., Melnichuk P.B. Diseases of the nervous system. A guide for doctors // Moscow. 2003.

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