Migraines are a type of headache that affects up to 12% of adults, according to neurologist Dr Carlos Azaret. As a subclass of headaches, migraine symptoms consist of some unique markers which include more intense and debilitating pain than a traditional headache. Some red flags that you may be experiencing a migraine include pain that often radiates unilaterally, which can often include symptoms like nausea, blurred vision, and more.
What is a migraine?
A migraine is a headache with no obvious secondary causes, according to neurologist Dr Pooja Patel. “They have some common characteristics including light sensitivity, noise sensitivity, nausea/vomiting and, at times, auras,” he says, adding that migraines also tend to last longer and be more intense than other types of headaches.
According to Dr Azaret, there are a few other common migraine symptoms:
- Aura or warning prior to the onset of the migraine, such as visual scotomata (which is a form of vision loss).
- Visual disturbance characterised by flashing or wavy lines in the periphery of the vision.
- Other types of auras may include gastrointestinal symptoms or sensory changes in the limbs (like numbness).
Symptoms of each migraine stage
According to the Migraine Australia, there are usually six phases of migraines, each with its own set of symptoms. Identifying what stage you’re experiencing can go a long way in helping you treat and manage your discomfort.
Prodrome
Migraine symptoms in the time before an aura and headache, known as the prodrome period, can last for a few hours to days.
Prodrome symptoms include:
- Irritability
- Depression
- Yawning
- Increased need to urinate
- Food Cravings
- Sensitivity to light and sound
- Problems concentrating
- Fatigue and muscle stiffness
- Difficulty speaking and reading
- Nausea
- Difficulty sleeping
Aura
An aura is a visual disturbance that a third of person may get with their migraine, according to the Migraine Australia.
Aura symptoms include:
- Visual disturbances (like seeing squiggly lines or circles)
- Temporary loss of vision
- Numbness and tingling on part of the body
- Loss of balance
- Disturbances in the senses
Acute
Per Migraine Australia, migraines typically last from four to 72 hours if untreated.
Symptoms of a migraine attack include:
- Pain, usually on one side of your head or both sides
- Pain that throbs or pulses
- Sensitivity to light, sound, and sometimes smell and touch
- Nausea and vomiting
- Mood shifts
Resolution
This is often an unnoticed phase where a headache is interrupted, which can occur through sleeping.
Postdrome
The time after a migraine attack is called postdrome, and symptoms of a postdrome include exhaustion, confusion, feeling drained, and pain with sudden movements.\
Interictal
This phase describes the time between attacks.
The most common types of migraine
While we just touched on the stages of a migraine, not every migraine feels like one you’ve experienced before. In fact, there are actually three common types of migraines. According to Migraine Australia, the common types are:
Migraine with aura
Symptoms:
- Vision changes that last between 10 and 30 minutes
- Sensory changes (often numbness in one side of the body)
- Slurred or confused speech
- Pain is limited to one side of the head
- Sensitivity to light
- Sensitivity to sound
- Pain that increases with movement
- Nausea and/or vomiting
- Dizziness
- Vision changes
- Nausea
- No head pain
Migraine without aura
Symptoms:
- Pain is limited to one side of the head
- Sensitivity to light
- Sensitivity to sound
- Pain that increases with movement
- Nausea and/or vomiting
Migraine Aura without Headache
Symptoms:
- Dizziness
- Vision changes
- Nausea
- No head pain
In addition to these three common types of migraines, Dr Azaret says there are a few other varieties of note:
- Chronic migraines: Dr Azaret says you qualify as a chronic migraine sufferer if you’re experiencing them at least 15 days per month.
- Ocular migraines: These present with visual symptoms and are frequently unaccompanied by headache according to Dr Azaret.
- Abdominal migraines: Like the name suggests, people who experience these types of migraines will feel severe pain in their stomach.
- Hemiplegic migraines: Dr Azaret says that these types of migraines are usually inherited. If you have a family history of migraines and are experiencing weakness on just one side of your body, your migraine may fall into this category.
- Acute Confusional Migraine (ACM): As indicated by the name, those who suffer from ACM may experience confusion, altered mental status, disorientation, and more.
- Vestibular/Basilar migraines: Dr Azaret says vestibular and basilar migraines are associated with vertigo, dizziness, and sometimes even slurred speech.
Migraine treatments
If your head pain prompts you to see a doctor, Dr Patel says there are a few common things they may suggest you do. “Some lifestyle changes I usually recommend include having a normal sleep schedule and sticking to that routine, adhering to a balanced diet and not skipping any meals, and maintaining proper hydration.” He also says it’s important to understand your own individual triggers and manage the things that cause your migraine symptoms, like chocolate and caffeine withdrawal.
“For those suffering from chronic migraines, we usually start with medications from various classes for prevention of headaches,” Dr Patel adds. “If oral medications are not effective, Botox and newer injectable medications that are CGRP [Calcitonin Gene-Related Peptide] receptor antagonists are offered, which are highly effective. Other peripheral nerve blocks are also offered for management of severe migraines.”
When to see a doctor
Migraines can be severely debilitating and are considered one of the main causes of disability worldwide, according to Dr Patel. “A person should be evaluated in an outpatient setting if migraines are not relieved by over-the-counter medications or they are occurring frequently where you are needing to use over-the-counter medications more than two times per week.”
While most migraines are non-emergent despite the amount of pain they may cause, Dr Patel says that there are some cases where you may need more immediate attention. “If the headache is a thunderclap or the ‘worst’ headache of their life, then emergent medical attention is required to rule out other causes.”
Having a migraine can be a scary experience, but the good news is that there are some ways you can manage your symptoms, and once you identify your external triggers, you may even be able to prevent migraines in the future.
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