Migraine is a neurological condition that typically causes painful headache attacks that occur with additional symptoms, such as sensitivity to light, sound, smell, or touch.
More than just the cause of “really bad headaches,” migraine is a neurological condition that can cause multiple symptoms. While intense, debilitating headaches frequently characterize it, additional symptoms may include:
- nausea
- vomiting
- difficulty speaking
- numbness or tingling
- sensitivity to light and sound
The condition often runs in families and can affect all ages. People assigned female at birth are more likely than people assigned male at birth to be diagnosed with migraine.
The diagnosis of migraine is determined based on clinical history, reported symptoms, and by ruling out other causes. The most common categories of migraine headaches (or attacks) are episodic versus chronic, and then those without aura and those with aura.
People describe migraine pain as:
- pulsating
- throbbing
- perforating
- pounding
- debilitating
It can also feel like a severe, dull, steady ache. The pain may start out as mild. But without treatment, it can become moderate to severe.
Migraine pain most commonly affects the forehead area. It’s
Children are
How long does migraine pain last?
Most migraine attacks last
In migraine with aura, pain may overlap with an aura or may never occur at all.
Migraine symptoms may vary depending on the type of migraine you experience. They also vary depending on which phase of a migraine attack you’re in:
- Prodrome: Symptoms may begin
1 to 2 days before the headache itself. You may experience food cravings, changes in mood or energy, and neck stiffness, among other symptoms. - Aura: About
one-quarter of people with migraine experience aura as part of an attack. These are sensory symptoms (most often visual) that can last 5 to 60 minutes. - Headache: Most people experience head pain that can be severe and can last for hours to days. During this phase, people also experience increased sensitivity to light and sounds, nausea, and dizziness.
- Postdrome: During this phase, you may experience changes in mood, difficulty concentrating, and exhaustion. A mild, dull headache may persist.
The duration and intensity of these phases can vary in different people. Not everyone experiences all the phases. In some cases, an attack can occur without a headache.
Read more: “Signs and Symptoms of a Migraine and How to Manage”
Migraine nausea
Many people experience nausea as a symptom of migraine. Many also vomit. These symptoms may start at the same time as the attack. However, they usually start about an hour after the headache pain begins.
If you only have nausea, you may be able to take your usual migraine medications. Vomiting, though, can prevent you from being able to take pills or keep them in your body long enough to be absorbed.
A doctor may suggest taking anti-nausea or antiemetic medications to help prevent vomiting and improve nausea.
Researchers haven’t identified a definitive cause for migraine. But experts believe a combination of genetics, hormones, and irregular brain activity all play a role. These factors likely contribute to affecting nerve signaling, chemicals, and blood vessels in the brain.
Who’s most likely to get migraine?
Migraine affects about
For example, migraine tends to run in families.
Women are also three to four times more likely than men to experience migraine. While data is limited, research suggests that transgender women who take gender affirming hormone therapy have rates of migraine similar to cisgender women.
Migraine most commonly affects people between the ages of
While migraine triggers can be very personal, commonly reported triggers
- bright lights
- severe heat, or other extremes in weather
- dehydration
- changes in barometric pressure
- hormone changes in people assigned female at birth, like estrogen and progesterone fluctuations during menstruation, pregnancy, or menopause
- excess stress
- loud sounds
- intense physical activity
- skipping meals
- changes in sleep patterns
- use of certain medications, like oral contraceptives or nitroglycerin
- unusual smells
- certain foods
- smoking
- alcohol use
- traveling
If you experience a migraine attack, a doctor may ask you to keep a headache journal. Writing down what you were doing, what foods you ate, and what medications you took before your migraine attack began can help identify your triggers.
Read more: “Top Migraine Triggers”
There’s no cure for migraine, but a doctor can help provide you with the tools you need to manage the condition. These may include lifestyle adjustments and medications to reduce the frequency of attacks and treat symptoms when they occur.
Your treatment plan depends on:
- your age
- how often you have migraine attacks
- the type of migraine you have
- how severe they are — based on how long they last, how much pain you have, and how often they keep you from going to school or work
- whether they include nausea or vomiting, as well as other symptoms
- other health conditions you may have and other medications you may take
Your treatment plan may consist of a combination of:
- lifestyle adjustments, including stress management and avoiding migraine triggers
- over-the-counter and prescription medications
- neuromodulation devices
- hormone therapy if migraine attacks seem to occur in relation to your menstrual cycle
- alternative care, which may include meditation, acupressure, or acupuncture
- counseling
Preventive migraine medications
If you have several migraine attacks a month, preventive medications can help reduce the frequency. These may be pills you take daily or injections you receive every few months. Options include:
- beta-blockers, like propranolol
- anticonvulsants, like valproate (Depakote) and topimarate (Topamax)
- antidepressants, like amitriptyline and venlafaxine
- Botox injections
- calcitonin gene-related peptide (CGRP) antagonists, like erenumab (Aimovig) and fremanezumab (Ajovy)
Abortive migraine medications
Once symptoms begin, you may be able to get relief from abortive medications, including:
- over-the-counter pain relievers like nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen (Tylenol)
- triptans, like sumatriptan (Imirex), eletriptan (Relpax), and rizatriptan (Maxalt)
- gepants, like ubrogepant (Ubrelvy) and rimegepant (Nurtec ODT), are an oral form of anti-CGRP medication
- ergot alkaloids, like dihydroergotamine (DHE), though these are older medications
- antiemetics, like metoclopramide, chlorpromazine, and prochlorperazine, to help decrease nausea
Neuromodulation devices
If traditional treatments don’t work, a doctor may recommend neuromodulation devices to treat migraine by either increasing or decreasing nervous system activity. Depending on the type, these may work as either preventive or abortive medications. Current options approved by the Food and Drug Administration (FDA) include:
- single-pulse transcranial magnetic stimulator, a handheld device that produces a magnetic impulse that affects electrical signaling in the brain
- transcutaneous vagus nerve stimulator, a small, noninvasive tool that targets the vagus nerve in the neck via electrical stimulation
- transcutaneous supraorbital neurostimulator, a device that simulates the supraorbital nerves with electrical stimulation
- multi-channel brain neuromodulation system, a headset that can target multiple nerves in the head
Talk with your doctor about the best neuromodulation treatment for you and your specific type of migraine.
Read more: “Top Strategies to Try for Migraine Relief”
Is surgery a treatment option for migraine?
Migraine surgery is an emerging treatment option, but there still isn’t enough research to support its widespread use. Researchers are still concerned about high failure rates and lack of information regarding long-term effects. More clinical trials are needed.
You can try a few things at home that may also help remedy the pain from migraine:
- Lie down in a quiet, dark room.
- Massage your scalp or temples.
- Place a cold cloth over your forehead or behind your neck.
The International Headache Society (IHS) classifies migraine into several different types:
- Migraine without aura: This is the most common type. It’s also known as “common migraine.”
- Migraine with aura: Also known as “classical migraine,” about one-quarter of people have migraine with aura. Each aura symptom may last up to 60 minutes. Visual auras are most common, but people may also experience sensory, speech, or motor symptoms.
- Migraine with brainstem aura (MBA): Commonly known as “basilar migraine,” the aura phase features symptoms like vertigo, slurred speech, and tinnitus. However, motor symptoms are absent.
- Hemiplegic migraine: Unlike MBA, this rare migraine type features motor weakness along with other brainstem symptoms. The motor symptoms may last up to 72 hours. This type can often run in families.
- Retinal migraine: In retinal migraine, you experience visual disturbances in one eye for 5 to 60 minutes prior to the onset of a headache. Some people use the term “ocular migraine” to refer to any migraine that causes visual symptoms, which can include retinal migraine or migraine with aura.
- Silent migraine: The IHS officially calls this “typical aura without headache,” which accurately describes the symptoms. According to the American Migraine Foundation, silent migraine may be more common in people who start getting migraine after age 40.
- Vestibular migraine: This term doesn’t necessarily refer to a type of migraine but more to vertigo that occurs with migraine. Vertigo is a sensation that the world is spinning around you.
- Abdominal migraine: Unlike typical migraine, abdominal migraine affects your abdomen rather than your head. It mostly affects children.
Some people living with migraine have more than one type of migraine.
Read more: “Your Guide to the Different Types of Migraine”
Chronic vs. episodic migraine
Doctors often classify migraine as chronic or episodic migraine.
According to IHS criteria, doctors diagnose chronic migraine when you experience headaches at least 15 days each month for more than 3 months. On at least 8 of those days, the headache had to have features of a migraine.
Episodic migraine is the diagnosis when you have fewer than 15 headache days in a month.
Doctors diagnose migraine by listening to your symptoms, taking a thorough medical and family history, and performing a physical exam to rule out other potential causes.
Read more: “What Happens During a Migraine Diagnosis?”
If a doctor diagnoses you with migraine, a few may help you prevent a migraine attack. Some may work better for you than others:
- Learn the foods, smells, and situations that trigger your migraine attacks and avoid them when possible.
- Stay hydrated. Dehydration can lead to both dizziness and headaches.
- Avoid skipping meals when possible.
- Focus on quality sleep. A good night’s sleep is important for overall health.
- Quit smoking.
- Make it a priority to reduce stress in your life.
- Invest time and energy in developing relaxation skills.
- Exercise regularly.
Read more: “How to Avoid a Migraine Attack Before It Happens”
Children can have many of the same types of migraine as adults.
Until they’re older teens, children may be
Some migraine variants, like abdominal migraine, are more common in children. Children who have abdominal migraine are likely to develop more typical migraine symptoms as adults.
Read more: “Overview of Migraine in Children”
For some pregnant people, migraine attacks improve during pregnancy but worsen following delivery due to sudden hormonal shifts.
Migraine attacks during pregnancy need special attention to make sure that the cause of the attack is understood. A 2022 study linked migraine attacks with a 26% higher chance of adverse pregnancy outcomes, such as preeclampsia and preterm or early delivery.
Certain migraine medications, including aspirin,
The frequent and recurring use of migraine medication can sometimes cause
When determining how to manage migraine, talk with a doctor about the frequency of your medication intake. Also, make sure to discuss alternatives to medications.
Migraine and tension headaches, the most common type of headaches, share some similar symptoms. But migraine may feature many symptoms not seen with tension headaches. Migraine and tension headaches may also respond differently to the same treatments.
Both tension headaches and migraine can have:
- mild to moderate pain
- a steady ache
- pain on both sides of the head
Only migraine can have these symptoms:
- severe, debilitating pain
- pounding or throbbing
- an inability to do your usual activities
- pain on one side of the head
- nausea with or without vomiting
- an aura
- sensitivity to light, sound, or both
Sometimes, the symptoms of migraine can mimic those of a stroke. It’s important to seek immediate medical attention if you or a loved one has a headache that:
- causes slurred speech or drooping on one side of the face
- causes new leg or arm weakness
- comes on very suddenly and severely with no lead-in symptoms or warning
- occurs with a fever, neck stiffness, confusion, seizure, double vision, weakness, numbness, or difficulty speaking
- has an aura where the symptoms last longer than an hour
- is accompanied by loss of consciousness
If headaches are getting in the way of your daily life, and you’re unsure if they’re a migraine symptom, it’s important to talk with a doctor. Headaches can be a sign of other issues, and while migraine can feel debilitating at times, treatments are available.
The sooner you start to talk about your symptoms, the sooner a doctor can get you on a treatment plan that may include medication and lifestyle changes.