[UPDATED Aug 2, 2018] What is migraine? Migraine is more than just headache. It’s often a moderate to severe head pain accompanied by a range of symptoms which often include:

  • Nausea
  • Vomiting
  • Sensitivity to light, sound, smell, movement or touch

There are many other symptoms that may also be experienced which are described in some of the videos in more detail. Some of these may include:

  • Visual disturbances
  • Partial or temporary blindness
  • Loss of balance
  • Vertigo
  • Motor weakness
  • Numbness
  • Stroke-like symptoms such as paralysis of limbs

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.

Contents

What are migraine attacks really? 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.

10 signs you’re 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
  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-diagnosed.(1)

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 with migraine are not receiving the most appropriate treatment.

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

Who gets migraine?

Migraine is one of the most common health conditions worldwide.(3) Migraine affects around 1 billion people globally.(4) Of those with migraine, 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 migraine.

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 migraine versus men.

Children can have migraine 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. See this list of celebrities and influential people today and throughout history with migraine.

Why do I get migraine attacks?

Why do I get migraine attacks and not my sister for example? Interestingly, no one has figured out exactly what causes migraine and why exactly they occur in some people and not others. Recently medical researchers have discovered a genetic link between migraine. This means that if your parents or grandparents had migraine then you are at risk of inheriting the susceptibility of migraine.

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

Environmental factors also play a role. Several head injuries such as concussion, whiplash or trauma may set off migraine attacks. A lifetime of inadequate sleep, poor diet, lack of exercise, high stress may also play role. Physical abuse or difficult childhoods may also be linked with migraine incidence.

What happens during a migraine?

Researchers still don’t know exactly what causes a migraine attack, 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.

The brain stem 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 covers all of our sensations and the ability to move our body.

At the start of an attack, chemical changes are thought to originate in the brainstem which starts a series of reactions causing the brain to react and cascade into a migraine attack.

What causes a migraine attack?

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 everyone. And even in the same person, triggers can be different at different times.

Common migraine triggers such as stress, sleep, alcohol and hydration are used in this example. A migraine patient may go out on the weekend, have a late 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 patient 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 patients to effectively control their migraine condition.

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 common migraine triggers and how to manage them are available here.

Understanding what migraine is and learning more about how and why they occur will help control them. Sometimes simply realizing you have migraine is a challenge in itself.

Once you have been diagnosed with migraine, there are a number of helpful videos that take us deep into the brain to describe the hypothesized pathophysiology or mechanics of migraine.


Important Note:

The content and accuracy of these videos may vary. They may be based on information which may be incomplete, controversial or recently outdated. The science is moving very rapidly and changing our understanding of migraine.

The purpose of these videos is to illustrate different perspectives of potential migraine mechanisms so that patients might gain a better understanding of their condition.

Still today scientists don’t fully understand migraine, which makes developing a cure difficult.


Understanding what happens during a migraine attack [videos]

This is probably one of the most updated and in-depth animations of a migraine from this collection. It was published more recently in December, 2016.

If you want an indepth understanding of what you are experiencing, this is the video to watch.

This next video is a general introduction to migraine from the UK. It might take a minute to get used to the pronunciation of “migraine” as it is spoken differently there. It also refers to the controversial vascular theory of migraine which some experts argue has been disproven.

What is a migraine?

Why do we get migraine attacks?

This video reinforces the suggestion that migraine links all the way back to what we saw during childhood:

This next video below is a slightly older perspective on the pathophysiology of migraine.

Still curious? Here is yet another video from a different publisher with slightly different information.

Migraine biology

Here is a great video to show your family members who don’t really understand what a migraine is. It also discusses the migraine links to serotonin and genes.

This neurologist is also a migraine patient

This video was developed by a migraine patient who also happens to be a certified neurologist.

It’s not just in your head

If you’ve watched these videos then you should now have a better understanding of what may occur during a migraine attack and why you might be experiencing them.

Which video explanation did you like best or which makes the most sense to you? Let me know in the comments below.

Article References

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/HeadacheFrequentlyAskedQuestions. Accessed 2 Aug 2013.

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