Debra Wood, RN
Migraine is a type of recurring headache. It involves nerves and brain chemicals. Other sensations, such as auras, may come before a migraine headache.
There are 2 types of migraines:
Migraine may happen several times a week or once every couple of years. They can be so severe that they interfere with the ability to work and carry on normal activities.
While the precise cause is not known, many potential triggers have been identified. Common triggers include:
A trigger sets the process in motion. It is possible that the nervous system reacts to the trigger by conducting electrical activity. This spreads across the brain. It leads to the release of brain chemicals, which help regulate pain.
Migraines are more common in women, especially before the age of 40. Other factors that increase your risk for migraines may include:
Migraines occur in phases that may include:
A warning may come before a migraine. In the hours or days before the headache, symptoms may include:
The most common aura is visual. The aura lasts about 15-30 minutes. It may produce the following sensations:
It is important to seek medical attention to make sure the symptoms are not due to a more serious cause. This can include
Migraine pain starts within an hour of the aura ending. Symptoms include:
Migraines usually last from 4-72 hours. They often go away with sleep. After the headache, you may experience:
You will be asked about your symptoms and medical history. A
will be done. You may also be given a neurological exam.
Your body fluids may be tested. This can be done with blood tests.
Images may be taken of your body structures. This can be done with:
Treatment options include:
are often needed to ease or stop the pain. Over-the-counter pain pills may ease mild symptoms.
Some pain relievers have caffeine as an ingredient, since it may help improve pain relief. If yours does not, talk to your doctor about taking a caffeine supplement with your pain reliever.
Regular use of some over-the-counter medications may cause a rebound headache.
Some prescription medications act directly to stop the cause of the migraine headache. These include drugs that:
These drugs can be taken by mouth. They may act more quickly in forms that dissolve in the mouth, are inhaled through the nose, or injected. They are more likely to be helpful if taken as soon as possible at the start of a migraine. Your doctor can help you choose the medication best for you.
Medications that can help stop a migraine once it has begun include:
Other drugs can help prevent migraines for people with frequent migraines. Preventive drugs are taken every day. Classes of preventive medications include:
Therapy may also be used to reduce the length and frequency of migraine headaches. It may be used with or without medication and may include cognitive behavioral therapy, biofeedback, or relaxation methods.
Botulinum toxin injections
may be used as a way to prevent migraines and to reduce the duration and intensity of the headaches in people who have headaches often.
In some people, migraines are triggered when a nerve in the head is stimulated. With this type of surgery, the nerve trigger point is located in the head and is deactivated. This surgery may reduce the number of migraines or completely eliminate them in sufferers who do not respond to conventional treatments. Most migraines are not treated with surgery.
Transcranial magnetic stimulation surgery may also be used in patients with migraine with aura who have not responded to other treatments.
Methods for preventing migraine include:
Healthy lifestyle habits that may help prevent migraines include:
Therapy that may decrease migraine or migraine pain include:
Foods are not proven to trigger migraine. But consider keeping a diary of migraine and diet to identify foods that may trigger migraines for you. Foods suspected to trigger migraine include:
American Headache Society
The National Migraine Association
The College of Family Physicians of Canada
Gilmore B, Michael M. Treatment of acute migraine headache.
Am Fam Physician.
Migraine in adults. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated July 25, 2014. Accessed January 15, 2015.
Migraine prophylaxis in adults. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated January 9, 2015. Accessed January 15, 2015.
NINDS migraine information page. National Institute of Neurological Disorders and Stroke website. Available at:
Updated September 26, 2014. Accessed January 15, 2015.
Recognizing stroke. National Stroke Association website. Available at:
http://www.stroke.org/site/PageServer?pagename=symp. Accessed January 15, 2015.
12/16/2008 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Jena S, Witt CM, Brinkhaus B, Wegscheider K, Willich SN. Acupuncture in patients with headache.
2/5/2009 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White A. Acupuncture for migraine prophylaxis.
Cochrane Database Syst Rev.
11/10/2009 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Guyuron B, Reed D, Kriegler JS, Davis J, Pashmini N, Amini S. A placebo-controlled surgical trial of the treatment of migraine headaches.
Plast Reconstr Surg.
10/25/2010 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: US Food and Drug Administration. FDA approves Botox to treat chronic migraine. US Food and Drug Administration website. Available at:
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm229782.htm. Published October 15, 2010. Accessed January 15, 2015.
3/3/2011 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Chankrachang S, Arayawichanont A, Poungvarin N, et al. Prophylactic botulinum type A toxin complex (Dysport) for migraine without aura.
9/25/2013 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Herman A. Episodic migraine linked to obesity. NEJM Journal Watch. 2013 Sept 12.
1/2/2014 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Huquet A, McGrath PJ, et al. Efficacy of psychological treatment for headaches: an overview of systematic reviews and analysis of potential modifiers of treatment efficacy. Clin J Pain. 2014;30(4):353-369.
1/2/2014 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Diener HC. Single-pulse transcranial magnetic stimulation: a new way to treat migraine attacks with aura.
Lancet Neurol. 2010;9(4):335-7.
4/1/2014 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed. Lip PZ, Lip GY. Patent foramen ovale and migraine attacks: A systematic review. Am J Med. [Epub 2013 Dec].
2/4/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Derry CJ, Derry S, et al. Caffeine as an analgesic adjuvant for acute pain in adults. Cochrane Database Syst Rev. 2012 Mar 14;3.
Last reviewed January 2015 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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