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Migraine

This fact sheet provides information on migraines. Our fact sheets are designed as general introductions to each subject and are intended to be concise. Sources of further support and more detailed information are listed in the Useful Contacts section. Each person is affected differently by migraines and you should speak with your GP for individual advice.



You can download this fact sheet as a pdf pdf file.



What is a migraine?

A migraine is not simply a bad headache. A migraine is an intense headache accompanied by other symptoms such as nausea (feeling sick), visual problems and an increased sensitivity to light or sound.

Migraines commonly last for a few hours but can last up to three days. Some people experience migraines several times a week. Others might only experience attacks every few years.

Around two-thirds of adults who experience migraines are women.

Although migraines are not life-threatening and do not shorten people’s life expectancies, they can significantly damage the quality of people’s lives.

There are two main types of migraine: migraine without aura (sometimes called common migraine) and migraine with aura (sometimes called classical migraine).

Migraine aura

Around one in five people who experience migraines experience an aura before their attack. An aura is a warning sign that a migraine is about to happen. People commonly experience an aura between 20 minutes and one hour before the headache stage of their migraine.

The main symptoms of an aura are visual problems such as blurred vision (difficulty focussing), blind spots, flashes of light, or a zigzag pattern moving from the central field of vision towards the edge.

Other aura symptoms include tingling sensations (pins and needles) in the face, lips and tongue, or in the arms and legs; speech problems such as slurred speech; dizziness; a stiff neck; and, very rarely, loss of consciousness.

What are the symptoms of migraine?

The main symptoms of migraine are an intense, throbbing or pounding headache often affecting the front or one side of the head, nausea (feeling sick) and vomiting (being sick), and an increased sensitivity to light and sound. The throbbing headache is often made worse by the person moving.

Other symptoms of migraine might include poor concentration, feeling hot or cold, perspiration (sweating), and an increased need to pass urine.

People might also experience stomach aches and diarrhoea.

It is common for people to feel tired for up to two or three days after a migraine.

What causes migraines?

We do not know the exact cause of migraine. There seems to be an electrical disturbance in the brains of people who experience an aura before their attack. For all migraine attacks, there appears to be a change in the blood vessels in the brain. However, the exact causes of migraine are likely to be more complicated than problems with the blood vessels.

People with high blood pressure are at a higher risk of experiencing migraines.

Women are more than twice as likely as men to experience migraines. This is due to hormonal factors. Women might find that they experience a migraine just before, or just after, the start of their period. Some women find that oral contraception (the pill) can trigger migraines. It might be that women experience migraines as they approach the menopause, or that hormone replacement therapy (HRT) triggers migraines.

Migraine triggers

There are various factors which might trigger a migraine. Each person is different and you should try to identify which factors might apply to you and try to avoid them. Many people find that they are able to tolerate one of the triggers on its own but a combination of more than one trigger can push them over their threshold and cause an attack.

Emotional triggers

Emotional triggers include

  • stress
  • anxiety
  • anger
  • excitement, and
  • shock.

Physical triggers

Physical triggers include

  • tiredness
  • loss of sleep
  • irregular sleep
  • tension in the neck or shoulders
  • eye strain (for example, after using a computer screen), and
  • dental problems (for example, teeth grinding).

Dietary triggers

Dietary triggers include

  • lack of food (dieting)
  • irregular meals
  • dehydration
  • alcohol
  • caffeine
  • certain foods such as chocolate, cheese and citrus fruits, and
  • certain food additives such as monosodium glutamate (MSG), aspartame (a sweetener), Tyramine and nitrates.

Environmental triggers

Environmental triggers include

  • bright lights
  • loud noise, and
  • smoky environments.

Other triggers

Other triggers include smoking and some sleeping tablets.

What are the treatments for migraine?

Most people find that lying down in a quiet, dark room is helpful. Sleeping (if you are able) can also help. Some people find that their symptoms die down after they have vomited (been sick).

Some people find that pain-relief medication like paracetamol, aspirin and anti-inflammatory drugs like ibuprofen (Nurofen) are effective, especially if they take them at the very first signs of an attack. Most people will have tried these over-the-counter medications before seeing their GP for advice.

If over-the-counter medications do not help you, there are various stronger pain-relief medications your GP can prescribe. You might also benefit from anti-sickness medication.

You might be prescribed general strong pain-relief medication, or drugs like triptans which are a specific migraine medication. Many of these medications are available in different formats to suit individuals (for example, tablets which melt in the mouth, powders which dissolve in water, nasal sprays, or injections).

Some of the medications might not be suitable for everybody. Your GP will discuss your treatment options with you.

If your situation does not improve after treatment, you might be referred to a specialist migraine clinic.

How can I prevent migraines?

One of the best ways to prevent migraines is to try to avoid the things that might trigger your attacks. Most people benefit from trying to get enough sleep, eating regular meals, drinking plenty of water to keep hydrated, and trying to avoid stress.

Keeping a diary of your migraines can be a useful way to record when and where you experience attacks, check for any patterns, and try to identify your triggers. Take the diary when you see your GP. The more information you are able to give them, the better able they are to help you.

If you experience frequent migraines, you might be prescribed medication to help prevent attacks. Your GP will discuss the preventative medication options with you. You might find that this medication reduces the frequency and severity of your attacks but does not stop them completely. If this is the case, you will need to continue your other migraine treatments when you experience an attack.

Useful contacts

Brain and Spine Helpline
0808 808 1000
www.brainandspine.org.uk

Run by neuroscience nurses, providing support and information on all aspects of neurological conditions for patients, their families and carers, and health professionals.

Migraine Action
4th Floor
27 East Street
Leicester LE1 6NB

0116 275 8317
www.migraine.org.uk

Support and information on migraine.

The Migraine Trust
52-53 Russell Square
London WC1B 4HP

020 7631 6970
www.migrainetrust.org

Support and information on migraine.

NHS Choices
www.nhs.uk

NHS Direct
0845 46 47

Medical advice and information on health services.




References

Should you wish to view the references for this publication, please contact hannah.pimble@brainandspine.org.uk

This information was last checked in July 2013. Due for review in July 2014.

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