A migraine headache is a primary headache disorder lasting from 4 hours to several days. It is the most common cause of recurring headaches where the severity is moderate to severe. Up to 60% of migraine sufferers have symptoms that occur before the actual migraine pain. These symptoms will last anywhere from a few hours to a few days and can include irritability, depression, fatigue, sleepiness, mood changes, loss of appetite, or nausea.
Typical migraine headache symptoms occur sporadically or incidentally, meaning they are intermittent in nature. The pain is typically an intense throbbing, pulsating, or pounding physical pain and often involves only one temple, meaning it is unilateral in nature. About one third of the time the pain is felt on both sides. The unilateral migraines will typically switch sides from one migraine attack to the next, but if the pain always occurs on the same side, one should consider the possibility that it’s a secondary headache or brain tumor.
The physical pain is usually exacerbated by exercise such as running, walking upstairs, or other vigorous activity. Episodes can be accompanied by symptoms other than head pain and can include light sensitivity, visual disturbances, increased sensitivity to smells, abnormal tastes, or auditory (hearing) hallucinations.
Auras occur in roughly 20-25% of migraine sufferers and most often appear just before the headache symptoms, although occasionally during or afterward. Auras will usually last from a few minutes to an hour in length and are temporary neurological disorders that most commonly appear as visual disturbances. However, auras can also affect balance, muscle coordination, and speech. The term for this sensation is “migraine with aura.”
The visual sensations typically occur as flashes of light, but can also be brightly colored lights in a zigzagging pattern which most commonly start in the middle of the visual field and then move outwards. Blind spots, or holes in the visual field, can also be experienced occasionally. Migraine sufferers often find relief lying in a dark quiet room.
Numbness and tingling in various parts of the body are other sensations that can appear with migraines with aura, although they are less common. This is typically a “pins and needles” feeling in the arm and hand on one side and possibly around the mouth or nose on the same side. Problem with speech can also be associated with migraines with aura.
In addition to auras there are other symptoms that can be experienced with migraine pain. These include nausea, vomiting, diarrhea, loss of facial color, and cold hands or feet. It’s not unusual for a migraine sufferer to experience a decrease in energy for about 24 hours after a migraine attack and a recurrence of the headache can occasionally happen during this period.
There are additional symptoms that occasionally accompany migraine, but they happen rarely. Basilar artery migraine can cause vertigo (the sensation of dizziness), ataxia (loss of coordination of the muscles, especially in the arms or legs), and an altered level of consciousness or euphoria (an exaggerated feeling of happiness, confidence, or well-being).
About 3 out of 4 people, or 75%, who experience migraine attacks are women. Migraine commonly begins between the age of puberty and young adulthood and then diminishes after the approximate age of 50. In between these ages migraine attacks will increase and decrease in frequency and severity.
Episodic migraine can often develop into chronic migraine. According to the International Headache Society chronic migraines are migraine headaches that occur at least 15 days per month for at least 3 months.
