Identify the warning signs of migraine disorders including visual auras and sensory changes. Learn about the risk factors and specific types like ocular migraine.
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The most recognizable of migraine symptoms is the head pain itself. This pain is usually described as an intense throbbing or pulsing sensation. It is often located on one side of the head, behind one eye, or near the temple, although it can shift sides or affect the whole head. The pain usually worsens with physical activity like walking or climbing stairs.
However, the symptoms extend far beyond pain. Sensory sensitivity is a hallmark of the condition. Photophobia, or sensitivity to light, causes many patients to seek a dark room. Phonophobia, or sensitivity to sound, makes normal noises unbearable. Many people also experience osmophobia, which is a sensitivity to smells.
Common symptoms include:
About 25 percent of people with migraine experience a migraine aura. An aura is a transient neurological symptom that usually happens before the headache begins. It serves as a warning sign. The most common type is a visual aura. This can appear as flashing lights, zigzag lines, or expanding blind spots in your vision.
Aura can also be sensory. You might feel a pins and needles sensation in your arm or leg, which travels up to your face. In rare cases, aura can affect speech, making it difficult to find words or speak clearly. These symptoms typically last between 20 to 60 minutes and resolve completely as the headache starts.
The term ocular migraine can be confusing as it is used to describe two different conditions. Strictly speaking, a retinal migraine (often called ocular migraine) involves repeated bouts of short lasting, diminished vision or blindness in just one eye. This is different from a visual aura which affects both eyes.
Patients with this condition may see twinkling lights or a blind spot that grows larger in one eye. It is caused by a spasm of blood vessels in the retina or behind the eye. It is crucial to see an eye specialist to differentiate this from other serious eye conditions. The vision loss is usually temporary and reversible.
Hemiplegic migraine is a rare and serious type of migraine. The word hemiplegia means paralysis on one side of the body. People with this condition experience temporary weakness on one side of their body as part of their migraine attack. This weakness can affect the face, arm, and leg.
The symptoms can look frighteningly similar to a stroke. Along with weakness, patients may experience confusion, slurred speech, and fever. The paralysis can last from a few hours to several days. Because it mimics a stroke, emergency medical evaluation is essential during the first attack to rule out a clot or bleed in the brain.
Vestibular migraine is a type of migraine where the primary symptom is dizziness or vertigo rather than a headache. In fact, some people with this condition do not have a headache at all during the episodes. The vestibular system includes the parts of the inner ear and brain that process balance.
Patients may feel like the room is spinning, feel off balance, or be extremely sensitive to motion. They might feel carsick easily or feel dizzy when watching moving objects on a screen. These episodes can last for minutes or days and are often triggered by the same things that trigger painful migraines, such as stress, lack of sleep, or certain foods.
The exact cause of migraine is not fully understood, but it is considered a genetic neurological disorder. It is not caused by a psychological issue or stress alone. It involves a hyperexcitable brain that reacts strongly to triggers. When triggered, a wave of electrical activity spreads across the brain, and the trigeminal nerve system releases inflammatory chemicals.
These chemicals irritate the blood vessels and nerves around the brain. Serotonin levels also drop during a migraine, which may cause the trigeminal nerve to release neuropeptides. While the biological mechanism is complex, the result is the inflammation and pain signaling that characterizes an attack.
While the underlying cause is biological, specific triggers can set off an attack. Triggers vary greatly from person to person. Identifying and avoiding triggers is a key part of management. Weather changes, particularly shifts in barometric pressure, are a frequent trigger.
Dietary triggers are well known. Aged cheeses, salty foods, and processed foods can induce attacks. Additives like aspartame and the preservative monosodium glutamate (MSG) are common culprits. Alcohol, especially wine, and highly caffeinated beverages can also trigger migraines.
Common triggers include:
Several factors can increase your risk of developing migraines. Family history is the strongest predictor. If one or both of your parents have migraines, you are much more likely to have them. Age is another factor; while they can happen at any time, the first attack usually occurs during adolescence.
Gender is a significant risk factor. Before puberty, boys and girls are affected equally. After puberty, women are three times more likely to have migraines than men. This is largely due to the influence of estrogen. Women often report that their migraines started with their first period or change during pregnancy and menopause.
The prodrome is the pre headache phase. Recognizing these subtle signs can act as an early warning system, allowing you to take medication before the pain hits. This phase can start 24 to 48 hours before the aura or headache.
Symptoms during this phase are often non specific. You might feel unusually energetic or extremely tired. You might crave sweet or salty foods. Frequent yawning is a very common sign. Some people experience neck stiffness, increased urination, or fluid retention. Mood changes, ranging from irritability to depression or euphoria, are also common.
The postdrome phase occurs after the headache has resolved. It is often described as a migraine hangover. The sudden cessation of pain leaves the body exhausted. This phase can last for 24 hours.
During this time, sudden head movement might cause a brief flare of pain. Patients often report feeling confused, moody, dizzy, and weak. Sensitivity to light and sound may persist. It is important to rest and hydrate during this phase to help the brain recover fully from the electrical storm of the attack.
Send us all your questions or requests, and our expert team will assist you.
Head pain, nausea, and sensitivity to light and sound are the most common features.
No, many people experience migraine without aura.
Yes, vestibular migraine may involve dizziness as the primary symptom.
No, symptoms can vary between attacks and over time.
Stress does not cause migraine but can trigger attacks in susceptible individuals.
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