by Cynthia M. Johnson, MA
Migraine is a headache disorder. They may happen many times a week or once every few years. Sensations called auras may come before a migraine headache.
Migraines can be so severe that they get in the way of daily activities.
The exact cause is not known. Genes may play a role. Some things that may trigger a migraine are:
Migraines are more common in people under 50 years of age. They are also more common in women.
Things that may raise the risk of migraines are:
Migraines happen in these phases:
A warning may come before a migraine. A person may have these symptoms in the hours or days before a headache:
Auras often last about 15 to 30 minutes. Visual auras are the most common type. A person may have:
Migraine pain may start within an hour of an aura ending. Problems may be:
Migraines usually last 4 to 72 hours. They often go away with sleep. After the headache, a person may have:
The doctor will ask about symptoms and past health. A physical exam will be done. The diagnosis is often made based on symptoms. Other tests may be done to rule out other problems.
The goal of treatment is to ease headaches to improve function and quality of life. Using cold compresses and trying to sleep in a dark, quiet room may help.
Other options are:
The doctor may advise these medicines to ease migraine pain:
Regular use of some over-the-counter medicines may cause a rebound headache.
The doctor may advise these medicines to prevent migraines in people who get them a lot:
Therapy may be used to reduce the length and frequency of headaches. Methods may be cognitive behavioral therapy, biofeedback, or relaxation methods.
Procedures that may be done are:
Some people may have surgery when other methods do not help. Some migraines are triggered when a nerve in the head is stimulated. Surgery can be done to find the nerve and turn it off. This may make the headaches go away or make them happen less often.
It is not clear how to prevent migraines from ever happening. Migraine events may be prevented by:
American Headache Society
The National Migraine Association
The College of Family Physicians of Canada
Migraine in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/migraine-in-adults . Updated November 8, 2018. Accessed April 3, 2020.
Migraine information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Migraine-Information-Page. Updated December 31, 2019. Accessed April 3, 2020.
Migraine prophylaxis in adults. EBSCO DynaMed website. Available at: https://www.dyname... . Updated March 5, 2020. Accessed April 3, 2020.
Reese O, Lukas RV, et al. Challenge case report: increasing frequency of migraine. Practical Neurology. 2020. Available at: https://practicalneurology.com/articles/2020-jan/challenge-case-report-increasing-frequency-of-migraine/pdf. Accessed April 2, 2020.
Silberstein SD, Holland S, et al. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012 Apr 24;78(17):1337-1345.
Last reviewed February 2021 by EBSCO Medical Review Board Rimas Lukas, MD