What Is A Migraine?

Migraines are essentially a brain malfunction. They are the result of something that's not working properly. They are often described in the medical community as ‘a common primary headache disorder’. Which means it's a disorder that is not caused by another underlying condition.

But what are they really and what do they feel like?

Migraines are a severe and debilitating headache that is accompanied by a specific set of symptoms which qualify it as a migraine and not just a bad headache.

To summarise the criteria from the International Headache Society, if you are experiencing moderate to severe pain, on one side of the head, nausea or vomiting and sensitivity to light or sound then you may be experiencing a migraine.  Read the diagnostic criteria here.

10 signs your having a migraine

The below signs are common symptoms of migraines. You may experience some or most of these in a single attack.

  1. Moderate to severe pain
  2. Pain aggregated by movement
  3. Pain is one sided in the head
  4. Pulsing or throbbing headache
  5. Nausea or Vomiting
  6. Sensitivity to light and sound
  7. Headache lasts 4-72 hours if untreated
  8. Aura or disturbed vision, light spots, stars, visual distortion (provide link)
  9. Vertigo
  10. Numbness, weakness or tingling.

If you are unsure about whether you get migraines, review the diagnostic criteria here.

Migraines are under-treated and under-diagnosed1.

Surprisingly, most people have not been diagnosed with migraine and may not know they get migraines. And less than 50% of migraineurs see a physician.2 As a result many sufferers may not be receiving the most appropriate treatment.

If you think you may get migraines or if in doubt, it is a good idea to check with your doctor.

Who gets migraines?

Migraines are one of the most common health conditions worldwide.3 Migraines affect around 1 billion people globally.4 Of those who suffer, just over half (54%) claim to experience one or more attacks per month. 13% claim one or more attacks per week.5 If you do the math, that’s around 130 million people who get weekly migraines.

Migraines typically affect more women than men. Ratio’s vary depending on how broad or where the study is. Some claim that women are 2x as likely, others claim women are 3x more likely than men to experience migraine.6 The reality is likely somewhere in between i.e. women are 2-3 times more likely to get migraines versus men.

Children can have migraines as well. They can start at any age but are most common in their early to mid teens.7

Regardless of age, sex, ethnicity, socio-economic status or culture, you can still have migraines.

Why do I get migraines?

Why do I get migraines and not others like my sibling? Interestingly, no one has figured out exactly what causes migraines and why exactly they occur in some people and not others. Recently medical researchers have discovered a genetic link between migraines. Which means that if your parents or grandparents had migraines then you are at risk of inheriting the tendency toward migraines.

For example if a mother experiences migraine, the child has a 50% chance of inheriting migraines. If both parents experience migraine, the child’s risk jumps to 75%.8

What do we know about what happens during a migraine?

Researchers still don’t know exactly what causes a migraine, which makes a cure that much more difficult to develop. The leading theories for the cause of migraine relate to hyper excitability within certain areas of the brain or a ‘glitch’ from the brain stem which triggers the migraine.

What is the brain stem? It is a small but extremely important part of the brain. It allows the nerve connections of the motor and sensory system to pass from the brain to the body. It basically covers all of our sensations and the ability to move our body. So it’s pretty important.

At the start of an attack, chemical changes are thought to develop at the brainstem which starts a series of reactions causing the brain to react abnormally to otherwise normal signals. It is thought that this leads to the migraine.

What causes a migraine?

For someone who has a physiological tendency towards migraine there are a number of potential causes that can ‘set off’ a migraine attack. Unfortunately these are different for different people. And even in the same person, they can be different at different times.

Common migraine triggers such as stress, sleep, alcohol and hydration are used in this example. A migraineur may go out on the weekend, have a big night out on Saturday night, not get much sleep and drink a little too much. The next day they experience a migraine.

However the same migraineur may experience a migraine during the week at work when they didn’t drink or go out late. Instead they had a very stressful day and forgot to drink enough fluids. This may be enough to trigger another migraine.

Because they are many different scenarios and many different triggers it can be difficult for migraineurs to effectively control their migraines.

Some common migraine triggers include:

  • sleep disruption or changing sleep/wake cycle
  • stress
  • dehydration
  • menstruation in women
  • visual factors such as bright or flickering lights, screens or fluorescent lights

More about the most common migraine triggers and how to manage them are available here.

Understanding what migraines are and learning more about how and why they occur help you control them. Often just realising your getting migraines is a challenge in itself.

How long did it take you to figure out you were getting migraines? Leave a response in the comments below.


Free Referenced Fact Sheet

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Photography by Mendhak @ Flickr

Sources:

1. World Health Organisation & Lifting the Burden. ATLAS of Headache Disorders And Resources in the World 2011. 2011.
2.Pavone, Banfi, Vaiani & Panconesi, Cephalalgia. Sept 2007.
3.World Health Organization. The Global Burden Of Disease: 2004 Update.
4.Vos, T; Flaxman, AD; Naghavi, M; Lozano, R; Michaud, C; Ezzati, M; Shibuya, K; Salomon, JA et al. Years Lived With Disability (Ylds) For 1160 Sequelae Of 289 Diseases And Injuries 1990–2010: A Systematic Analysis For The Global Burden Of Disease Study 2010. Dec 2012.
5.Steiner et al. Cephalalgia. 2003.
6.Alexander, L. Migraine – ‘A Common And Distressing Disorder’. headacheaustralia.org.au/headache-types/17-migraine-a-common-and-distressing-disorder. Accessed 1 Aug 2013.
7.Goadsby et al, Migraine — Current Understanding and Treatment. New England Journal of Medicine, 2002.
8.National Headache Foundation http://www.headaches.org/education/ToolsforSufferers/Headache-FrequentlyAskedQuestions. Accessed 2 Aug 2013.