What Is a Migraine?

As many as 37 million Americans have migraine symptoms: Throbbing pain, nausea, vomiting, and sensitivity to light and sound. Here's what you can do about migraines.

A migraine is a type of headache, but it's no ordinary headache. The estimated 37 million people in the United States who get migraines experience throbbing pain, nausea, vomiting, and sensitivity to light and sound.

The pain and other symptoms can last from a few hours to several days. If you get one of these headaches, you may not be able to work or do anything else until it finally fades away.

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How do I know if I have migraine?

About 1 in 4 people who get migraines have an early warning when one of these headaches is about to start. What they experience is called an "aura."

Aura is a collection of sensory symptoms, which can include:

• Flashes of light
• Sparks, zig-zags, or dots of light in your vision
• Tingling on one side of your face or in one arm or leg
• Difficulty speaking clearly

Even people who experience auras don't get them with every migraine. When these visual phenomena do happen, they last for about 20 to 60 minutes.

Prodrome is a collection of subtle symptoms that start a day or two before a migraine. You might notice changes like:

• Shifts in your mood
• Food cravings
• An increased need to urinate
• Constipation
• A stiff neck

Once the migraine starts, it can cause symptoms like:

• Throbbing or pulsing pain in your head that can be severe
• Nausea and vomiting
• Sensitivity to light, noises, and smells
• Dizziness
• Fatigue

What should you do if you get migraine?

You don't have to suffer through the pain and other symptoms of frequent migraine attacks. Good treatments are available, yet fewer than 5 percent of people who have migraine have seen a doctor, received the right diagnosis, or received treatment that might help.

To get treated for migraines, see your primary care doctor or a neurologist, a specialist who treats conditions of the brain and spinal cord. The doctor will ask about your symptoms, as well as your personal and family medical history. They'll also examine you.

You might need an imaging scan to rule out other, less common causes of these headaches, such as an infection or tumor.

• Magnetic resonance imaging (or MRI) uses strong magnets and radio waves to take detailed pictures of your brain.
• Computed tomography (or CT) scan uses a computer to combine a series of x-rays taken from many angles of the brain into one.

What treatments are available?

Migraine medicines fall into two categories. Preventive medicines help you avoid these headaches. Acute medicines stop a migraine once it starts.

Preventive medicines include:

• High blood pressure medications such as beta-blockers, calcium channel blockers, and angiotensin II blockers
• Anti-seizure medications like topiramate (Topamax, Qudexy XR, among others)
• Tricyclic antidepressants like amitriptyline (Elavil)
• Botulinum toxin (Botox) injections
• Calcitonin gene-related peptide receptor (CGRP) monoclonal antibodies such as erenumab-aooe (Aimovig), fremanezumab-vfrm (Ajovy), and galcanezumab-gnlm (Emgality)

Acute medicines include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin)
• Aspirin plus caffeine (Excedrin Migraine)
• Triptans such as rizatriptan (Maxalt, Maxalt-MLT) and sumatriptan (Imitrex, Tosymra)
• CGRP antagonists like Rimegepant (Nurtec ODT) and ubrogepant (Ubrelvy)
• Lasmiditan (Reyvow)
• Dihydroergotamine (D.H.E. 45, Migranal)

What you can do

• Talk to your doctor about what might be triggering your migraines, and how to treat them. Along with medication, a few simple changes to your daily routine might be enough to lessen or even prevent these headaches:
• Try to get a full 7 to 9 hours of sleep; go to bed at the same time each night and wake up at a consistent time each day.
• Don't skip meals.
• Try to do some type of aerobic exercise (walking, swimming, dancing) on most days.
• Keep a food journal to learn whether any of the foods in your diet (such as chocolate, aged cheeses, or caffeine) trigger your migraines.
• Practice deep breathing, meditation, or another relaxation technique for at least 10 minutes a day to control stress.

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