Migraine: All about it! 

By Dr. Pallavi Sharma

Table of Contents


We all have experienced headaches in our life time and it is the second most common reason for people to seek medical attention after toothache.

Headaches are also the leading cause of missed work days worldwide. The term “migraine” has gained so much popularity as people use it to define all headaches. Not all headaches are migraines, and migraines are not the only cause of headaches.

A headache can be classified as either primary or secondary, depending on the cause. Primary headaches are not associated with any other condition or disease process, while secondary headaches are related to another disorder or disease such as high blood pressure (hypertension), sinusitis, stroke, migraine, etc.

One of the most common causes of headaches is migraines, but there are many other causes as well. There is still no recognized cause of this neurological disorder has been identified. The severity of migraines can range from mild to severe.

Migraine headaches usually have a throbbing or pulsing quality, can be unilateral or bilateral, and are often accompanied by nausea and/or vomiting.

Each year, around 29.5 million Americans suffer from headaches, and internationally, the prevalence of migraines among women is higher. (Male: Female ratio = 3:4)

What exactly is a migraine?

A migraine is a type of headache that can be debilitating and disruptive to everyday life.

Migraine symptoms can vary from person to person, but in general, they are an intense throbbing or pulsing pain on one side of the head.

A migraine usually causes a throbbing pain on one side of your head.

A migraine typically lasts from four to 72 hours.

Migraine sufferers can experience various symptoms, including

  • Reduced visual acuity
  • Nausea
  • Numbness or tingling in the face, neck, and shoulders
  • Sensitivity to light, sound, or smell

A migraine typically begins with an “aura” phase—which may be a visual disturbance or other sensation followed by headache pain on one side of the head.

Migraine sufferers often have to deal with the pain and other symptoms of the condition for one to two or more days per month.

What triggers migraines more frequently?

Migraines can be triggered by many things.

Migraine triggers can include hormonal changes, stress, lack of sleep, skipped meals, alcohol consumption, and other stimulants such as caffeine or nicotine.

Common migraine triggers include

  • Food triggers
  • Strong Stimuli and Stress
  • Hormonal changes in women, including menstruation, pregnancy, and menopause
  • Changes in sleep patterns or eating habits

Migraines are not a disease, but rather a symptom of another underlying condition. The most common triggers of migraines are stress, lack of sleep, too much caffeine, hunger, dehydration, and hormonal changes.

Food triggers

Foods and beverages have been associated with various health conditions, and their consumption can trigger migraines in some people.

People with migraines tend to have trouble identifying what triggers their condition. Staying healthy includes making healthy choices and avoiding unhealthy ones when you have a migraine.

So the doctors recommend using a migraine diary to identify triggers of migraine.

Some believe that spicy foods or sodas can cause headaches, while others claim that fatty or spicy foods can worsen their condition. Chocolate has also been blamed for triggering migraines by causing a sudden rush of serotonin in the body.

It has also been discovered that some foods and food additives, including aged cheese, caffeine, red wine, and monosodium glutamate (MSG), might cause migraines.

Caffeine is another trigger for some people.

Strong stimuli and stress!

On the other hand, certain non-food items have also been blamed for triggering migraines.

Loud or sudden noises are one symptom that can be exacerbated by stress, which aggravates the condition and makes you more susceptible to particular stimuli.

Therefore, sufferers of migraines may wish to avoid loud environments when possible.

In addition to stress, barometric pressure changes, dehydration, skipping meals, and weather changes can also trigger migraines.

It is important to be aware of your own personal triggers in order to help prevent migraines.

Hormonal Changes

Women who menstruate may experience migraines. Most females have preceding migraines, which usually go away during menstruation.

Some women may develop migraines as a result of menopause or pregnancy.

It is widely accepted that hormonal changes might cause migraines because birth control pills can relieve menopausal migraines.


Lack of sleep is one of the most common triggers for migraines. It’s widely believed that lack of sleep causes the brain to produce more serotonin, which can lead to migraine attacks.

If you have ever experienced a migraine on a weekend when you had plenty of sleep, you are not alone. It is called a morning migraine.

According to the Migraine Research Foundation, lack of sleep is the most common trigger for migraines, but plenty of sleep can also trigger migraines.

Related Migraine Symptoms:

Prodomal phase

You may experience certain prodromal (pre-headache) symptoms before a migrain headache.

These may be indicative that a migraine is coming on, and can help you to take preventive medication or otherwise take steps to lessen the effects of the migraine.

The prodrome phase of a migraine can occur hours or even days before the migraine attack. Symptoms during this phase can include:

  • Constipation
  • Depression
  • Diarrhea
  • Hyperactivity
  • Increased urination
  • Irritability

Mood changes

The prodromal phase of a migraine can last for several hours or even a day or two.

Not everyone who experiences a migraine will have a prodromal, and the symptoms can vary from one person to the next.

The prodromal phase is often followed by the aura phase.


Migraine is a common type of headache that may occur with symptoms such as flashes of light, nausea, and vomiting.

It is a warning sign that a headache is coming. This can happen hours or days before the headache itself.

The aura often lasts between 30 minutes and an hour. Some may see flashes of light or zigzag lines, or have temporary vision loss. These are called auras, and they usually happen before or during the headache phase of a migraine.

An aura is a kind of sensory disturbance that can take place before or during the headache itself. Not everyone who experiences migraines will have an aura, but for those who do, it can be a very troubling symptom.

People who experience migraine headaches not only have to deal with the pain of the headache itself but also with any number of related migraine symptoms.

There are a few types of auras.

Visual Aura

An aura usually takes the form of flashes of light or blind spots, but it can also include other visual disturbances, such as wavy lines or bright, sparkling dots.

Tactile Aura

Other less common auras can cause tingling in an arm or leg in some people. Some may feel jerky movements of their limbs as well.

Dyaphasic Aura

There are some people who experience difficulty speaking a few hours before a migraine.

Sound or Smell

Some migraineurs will become extremely sensitive to sound or smell before the actual episode of migraine.

Post drome

Migraine attacks may be unilateral or bilateral, and they typically last for three to four hours. The period following a migraine attack ilateral, and they typically last for three to four hours. The period following a migraine attack is also debilitating to the patient.

This is more appropriately described as a hangover stage in which prodromal symptoms like brain fog, nausea, and hypersensitivity to smell or light may still last. This time frame of the prodromal stage can persist for hours to days.

Patients who are not on preventive drugs frequently experience recurrent migraine attacks after a short time of remission.

How Long Does a Migraine Last?

You are not alone if you experience migraines. Migraines are more common in women than in men and most often begin during adolescence or early adulthood.

The duration of a migraine can vary, but on average it lasts about four to six hours. While migraines can vary in severity, the average person experiences a headache for about three hours.

This means that a migraine can keep you from functioning normally for anywhere from four hours to 72 hours.

Types of Migraine

Migraines are thought to be caused by a combination of genetic and environmental factors, though the exact cause has not been found. Migraines are often classified by their symptoms. The three main categories are migraines with aura, migraines without aura, and chronic migraines.

Apart from the symptomatic classification of migraine, there are other types of migraine,

  • Acute or Episodic Migraine
  • Chronic migraine
  • Ocular migraine

Acute or Episodic Migraine

Episodic migraine (EM) is defined as having 1–14 migraine headaches per month.

Acute migraine is the general term used for migraines that aren’t diagnosed as having a more specific cause. About 12% of the population suffers from EM, and it can significantly interfere with a person’s quality of life.

Chronic Migraine

Chronic migraine (CM) is defined as having 15 or more migraines each month for three months or more. Patients with CM often have headaches every day, and some may even have chronic, daily headaches that aren’t migraines.

For this reason, a diagnosis of chronic headaches requires that at least eight out of 15 or more headaches in a three-month period exhibit migraineous symptoms.

While chronic migraine has been known to affect people of all ages, it is most common in women between the ages of 25 and 44. The cause of chronic headache is linked to family history and may combined to environmental factors as well.

Not only do they cause an intense headache, but they can also lead to other debilitating conditions like nausea and sensitivity to light.

The pain can be so severe that it renders the person unable to do basic activities such as working, studying, or sleeping. Fortunately, there are treatments available that can decrease or even eliminate the frequency of migraines.

Ocular Migraines

Ocular migraines are a type of headache that is accompanied by changes in vision. They can range from mild to severe and can result in temporary unilateral blindness.

The headache is accompanied by changes in vision, which can vary from mild and temporary to more persistent and life-threatening.

Ocular migraines have a variety of causes but are generally categorized by the part of the head that is affected. Individuals with ocular migraines usually experience a strong, pounding headache that is localized to one side of the head and changes in vision, which can be mild and temporary or more persistent and life-threatening.

Ocular migraines are a type of headache that often affects people’s vision.

They can cause changes in vision, such as blurred or double vision. Some people experience ocular migraines more often during periods of hormone change, such as before menstruation or during menopause.

In cases like this, it is important to rule out any other possible causes for the headache, such as sinus infections or a head cold, and then take appropriate action.

Diagnosis of Migraine

Migraines can be difficult to diagnose and can be confused with other conditions. If you are experiencing persistent headaches, seek help from a healthcare professional.

Migraine is a disorder that is diagnosed based on the history of the type of headache, triggers, and stages of the headache.

Migraineurs may experience a variety of physical symptoms, such as throbbing pain in one or more areas of the head, nausea, vomiting, and sensitivity to light and sound. Some people experience auras, which are a precursor to migraines.

These may include visual disturbances such as changes in colors, patterns, or brightness. Some people also experience an intense, throbbing pain on one side of their heads.

Most people have a family history of migraines that runs in their genetics.

Some may have excessive stress levels that can lead to migraines.

So if there are unusual symptoms, the physician may do a set of screening investigations to rule out other differential diagnoses like tumors, strokes, aneurysms, etc.

The other screening investigations are CT brain, MRI brain, anemia, autoimmune antibody screening etc.

Migraine Medication

Migraine sufferers may find relief with over-the-counter medications.

These medications can help to abort a migraine, reduce its intensity, and prevent a recurrence. However, as with any medication, overuse or abuse of these medications can lead to serious complications. Always consult with your doctor before taking any over-the-counter medications for migraines.

Your doctor may prescribe two types of migraine medications once you have been diagnosed with migraine.

  • Pain relieving medication
  • Preventative medications

These are designed to reduce the pain, severity, frequency, and duration of your attacks. If you experience migraine symptoms more than twice per week, your doctor may recommend preventative medication.

Pain-Relieving Medications

There is no effective treatment for migraines other than prevention. The painkiller will lessen the headache’s agony, but for it to be effective, it must be taken as soon as the headache starts. Some of the pain-relieving medications that the physician might prescribe are as below.


Sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt) are two of the most commonly used triptans. These drugs can block the neurotransmitters responsible for pain transmission in the brain.

Triptans are often the first treatment recommended for people with migraines. Some people find that they experience fewer headaches when they take triptans regularly.

Triptans are available as pills, tablets, Aimovig (a device that you breathe into), and Zomig (a device that you puff).

Side effects of triptans can include drowsiness, dizziness, and abdominal pain. These should not be used if you have high blood pressure or a heart condition.

Sumatriptan is the most common triptan and is available as a generic medication. Headache relief is usually seen within thirty minutes of taking a triptan, and the duration of the headache relief is usually about four hours.

Tri-Cyclic Antidepressants

Tricyclic antidepressants offer relief from some of the symptoms of migraine, such as nausea, vomiting, and photophobia. They are usually taken in combination with other medications.

Side effects of tricyclic antidepressants can include weight gain, drowsiness, and dry mouth.

OTC medications

If you experience migraine headaches, you aren’t alone. In fact, migraines are the third most common condition in the world, affecting almost one in seven adults. And while migraines can occur at any age (even children can get them), they most commonly develop between the ages of 15 and 55.

Over-the-counter medications should be part of your migraine treatment plan and work best when taken at the first sign of an oncoming migraine. Painkillers like ibuprofen (Advil, Motrin IB, and others) and migraine relief medicines like acetaminophen (Tylenol) can help relieve pain and reduce the duration of a migraine. If you’re thinking about using a painkiller, be aware that it can interact with other medications you’re taking, so ask your doctor before taking anything.

Some people find that their migraines improve after taking supplements like riboflavin, magnesium, and CoQ10.

Dihydroergotamines (DHE)

Dihydroergotamines (D.H.E. 45, Migranal) work by constricting blood vessels in the brain and stopping the release of neurotransmitters that cause swelling.

Dihydroergotamines are usually available as nasal sprays or in injectable forms. They are most effective when taken at the first sign of a migraine. They should not be used more than three times per day.


For some people, opioid medications, especially those containing codeine, can help relieve migraine symptoms, and your doctor may prescribe these if, for some reason, you cannot take triptans or ergots. While these medications are generally considered safe, they can be addictive, and so they are generally used as a last resort.

These drugs are highly addictive, and so they are generally used as a last resort.


One of the most debilitating types of headaches is a migraine. Migraines are headache attacks that are typically characterized by three or more of the following symptoms: throbbing pain, moderate or severe pain, pain on one side of the head, sensitivity to light and sound, and nausea and vomiting. Thus, antiemetics have a place in migraine to reduce vomiting.

Preventive medicine

In the past, preventive medications have been used to prevent migraines. The class of medications that have this effect is called prophylactic medications. A prophylactic medication helps to prevent a migraine before it starts by stopping the development of the headache.

There are a number of different prophylactic medications, but they all work in different ways.

Some work by constricting blood vessels, others by blocking pain receptors. Some work on the chemicals in the brain to prevent migraines and some work on the proteins that are thought to cause pain during a migraine.

CGRP antagonist

The first new migraine prevention medications to be approved in decades, CGRP antagonists work by targeting a protein that is thought to contribute to pain during migraines.

The protein, called calcitonin gene-related peptide (CGRP), is found in the brain.

While this class of medication is still fairly new, there is growing evidence that it can be effective in preventing migraines. CGRP antagonists are taken as a once-monthly or once-quarterly injection or as a daily pill.


It is well known that beta-blockers can help reduce the frequency and intensity of migraines, but the role of these medications in people with migraines is still being studied.

Beta-blockers are commonly prescribed for high blood pressure, but they can also help reduce both the frequency and intensity of migraines. Your doctor may prescribe atenolol (Tenormin), metoprolol (Toprol XL), or propranolol (Inderal XL).

Some people feel that beta-blockers help to reduce stress hormones and help to keep the heart and blood vessels healthy. Other people feel that beta-blockers just mask symptoms and do not really help. However, the evidence is still inconclusive.

Calcium Channel Blocker

A calcium channel blocker is a medication used to treat hypertension and migraines. In people with hypertension, the medication lowers blood pressure by relaxing blood vessels.

In people with migraines, the medication reduces pain and inflammation by blocking calcium channels in the brain.

Some calcium channel blockers your doctor may prescribe are diltiazem, verapamil, nifedipine, and amlodipine.


Some antidepressants used in the treatment of migraines include amitriptyline (Elavil), fluoxetine (Prozac), and paroxetine (Paxil).

A variety of antidepressants are available to help alleviate migraines. These medications work by increasing serotonin levels, which can reduce inflammation and constrict blood vessels.

Amitriptyline and fluoxetine are two antidepressants that have been shown to help relieve migraines. They increase levels of serotonin, which can reduce inflammation and constrict blood vessels.

While some antidepressants are effective in treating migraines, others might have undesired side effects. These include weight gain, sexual dysfunction, and changes in appetite.


Clinical trials have shown that anticonvulsants can be effective in treating migraine. These medications can help to alleviate symptoms by calming overactive nerves in the brain. If you are considering taking an anticonvulsant for your migraine, be sure to speak with your doctor about the potential side effects and interactions.

Some anticonvulsants your doctor might prescribe are: divalproex-sodium (Depakote, Depakote ER), gabapentin (Neurontin), levetiracetam (Keppra, Levetiracetam), topiramate (Topamax), zonisamide (Zonegran).

Potential side effects of anticonvulsants include weight gain and suicidal thoughts. Always consult with a doctor before starting any new medication, especially if you are pregnant or have a history of mental illness.

Botulinum toxin

The FDA has approved Botox (Botulinum toxin type A) injections in the forehead or neck muscles for the treatment of chronic migraines.

Generally, this therapy is expensive. These injections work by blocking the release of a chemical called acetylcholine. This chemical is responsible for transmitting signals from the nerve endings to the muscles, telling them to contract.

Home Remedies

People who suffer from migraines should also try to relax their minds and bodies, follow a regular exercise routine, and keep a diary of their lifestyle in order to better manage stress.

Some sufferers of migraines may also find it helpful to change their lifestyle in some ways. Having a regular schedule helps you keep stress under control. Therefore, choosing wisely when choosing activities helps you relax when feeling stressed out.

  • Avoiding strenuous activities for at least twelve hours after eating specific foods.
  • Avoid food triggers and limit their dietary choices.

The purpose of this document is to discuss migraine prevention and stress management. – Regular exercise and relaxation techniques can help to reduce the risk of getting migraines.

  • Maintain a diary of headaches, sleep patterns, level of work  and triggers to identify the severity of migraines.
  • Hormonal therapy: Despite the fact that more women are using hormonal contraceptives than ever before, many women still experience migraines. Hormone therapy can offer relief from these headaches, but it is important to discuss your options with your doctor.
  • There are many different types of contraceptives that can help prevent migraines, including birth control pills, testosterone replacement therapy, and intrauterine devices.
  • Lose weight: If you are overweight, losing weight may help reduce the frequency and severity of your migraines.
  • Keeping your head cool and drinking plenty of fluids can help reduce the likelihood of getting a migraine.
  • Vitamins and herbs, such as riboflavin (vitamin B2), coenzyme Q10, and garlic, have been shown to be effective in some cases.
  • Hydration and tepid sponging: Place a cool cloth or ice pack on your forehead, and drink enough fluids to reduce headache.

There is no one-size-fits-all answer when it comes to preventing migraines, but incorporating a few healthy habits can go a long way.

Additionally, try taking preventive measures such as getting enough sleep and avoiding caffeine and alcohol before a headache starts.

It is important to experiment and find what works best for you.

When to see the doctor

  •  If you experience a headache accompanied by nausea or vomiting and additionally have a fever, seek medical attention. Many more serious conditions can result from a headache.
  • If you experience a headache accompanied by onesided numbness and slurring of speech, you might need an urgent CT scan of the brain to exclude stroke.
  • If you experience a headache accompanied by nausea or vomiting, lightheadedness, or confusion, you should seek medical attention.
  • If you experience a headache that has an abrupt onset, like a thunderclap, you might need an urgent imaging of the brain.
  • If the pattern of your migraines changes or your headaches suddenly feel different, you should see your doctor.

You should make an appointment to see your doctor if you experience any changes in your migraines or headaches.


TeleHealthDoc articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Dr. Pallavi Sharma

Dr. Pallavi Sharma is one of Melbourne’s best, well respected cosmetic doctors and aims to provide longstanding anti-aging benefits for her clients. With over 11 years experience in Performing cosmetic procedures, Dr. Sharma has lectured medical professionals regarding cosmetic treatments and is heavily involved in providing up to date cosmetic treatments to her clients and friends.
Related articles