Migraine Symptoms and Other Common Questions

While we do not yet fully understand what causes migraines, we do know that both genetics and environmental factors play a role. Certain changes in the brainstem, and how the brainstem interacts with the trigeminal nerve, may also be involved. Some experts are investigating the role of chemicals like serotonin and calcitonin gene-related peptide.

A range of situations and factors may trigger a migraine. Hormonal changes, such as those that occur during pregnancy, menstrual periods, or menopause, are common triggers. Some people find sensory factors, such as bright lights, as well as weather changes stimulate their migraines. A person’s diet can also contribute, as can physical activity.

Migraines go through four stages: prodrome, migraine aura, attack, and postdrome. In the prodrome stage, a person may feel unique symptoms that indicate an oncoming migraine. After a day or two, some people enter the aura stage. About 30% of people with migraines experience aura. This stage can involve visual and auditory hallucinations and numbness and tingling in various parts of the body. The third stage, known as the attack stage, contains the headache that most people associate with migraines. After four to 72 hours, the headache ends and the postdrome phase begins, lasting 24 to 48 hours.

Symptoms vary between each stage.

• The prodrome stage typically involves changes in energy or body function, such as sleepiness, yawning, loss of appetite, or constipation.
• A person in the aura stage experiences hallucinations and physical sensations, and they may become hypersensitive to stimuli.
• The attack stage causes an intense headache, dizziness, confusion, nausea, and stiffness.
• The final, postdrome stage leaves most people feeling exhaustion or fatigue, though some individuals experience euphoria.

In addition to the more common issues, some people have rare or unique migraine symptoms. During the prodrome stage, it is possible to experience mood changes from depression to euphoria. In the aura stage, some people experience Alice in Wonderland syndrome, where objects around them seem much larger or smaller. Difficulties with language or speaking are also possible.

Some people do not experience the intense headache that is typical of migraines. These instances are commonly known as silent migraines. This type can cause any of the typical migraine symptoms, except the pain. In some cases, people experience symptoms that resemble a stroke or transient ischemic attack, like weakness, vision problems or trouble speaking. Because of this, it is incredibly important to seek medical attention as the symptoms begin.

Several factors indicate a risk for migraines. People with a family history of migraines are more likely to have migraines themselves. Most individuals begin having migraines in adolescence, with the attacks peaking in their 30s. The events tend to become less severe as people get older. Females are three times more likely to have migraines than males. People with hormonal changes are also more prone to attacks.

Certain healthy lifestyle practices may reduce the frequency and severity of migraines. When a person feels the prodrome stage, they should try to enter a calm environment and reduce stress. Getting plenty of sleep on a regular schedule is effective long-term. Eat healthy meals on a consistent schedule and limit foods with chocolate or caffeine.

People who experience migraines should be aware of a few key signs that indicate a need for immediate medical attention:

• Intense headaches that develop abruptly
• Headache occurring alongside fever, confusion, neck stiffness, seizures, double vision, numbness, weakness, or trouble speaking
• Chronic headaches that worsen after coughing or straining
• Headache following a head injury
• Intense headaches after age 50

Medications are the most common treatment method and typically fall into two categories: preventative and pain-relieving. Preventative medications follow a schedule, usually daily doses, and can reduce both severity and frequency of migraines. Pain-relieving medications are acute treatments, meaning a person only takes them during a migraine attack to limit its severity.