Questions about Migraine Headaches

If migraine headaches are new to you or you know someone who suffers from this debilitating condition, here are some key questions that concern this condition.

What is a Migraine?

A migraine headache is a type of headache that is usually localized at one area of the head and is accompanied by a pronounced sensitivity to light, smell, and/or sound. Other common symptoms are nausea and vomiting. Migraines usually have a gradual onset, get progressively worse, and gradually decrease.  If the migraines are mild to moderate, they are thought of as being dull, deep and steady. When severe, migraines are throbbing or pulsating. Head motion, sneezing, straining or physical exertion can make them worse. If the patient is sensitive to light or sound, they may seek out a dark, quiet place to lie down and recover.

Migraines are more common among women, possibly due to hormonal changes during the menstrual cycle, and may occur infrequently or as often as several times a week. Migraines usually start between the ages of five and 35. Although they are not considered a life-threatening condition, there is no cure for them and migraines can have a debilitating impact on the person’s life.

What are the Symptoms and Types of Migraine?

Migraines are basically categorized either as “migraine with aura” (known as classic migraine) or “migraine without aura” (known as common migraine).

• Migraine with aura: These headaches begin with certain neurological symptoms, the most common of these being visual disturbances, such as a flickering jagged or zigzag line, usually at the side of the visual field. Another frequent symptom is numbness and tingling of the lips, lower face, and fingers of one hand. Some patients experience temporary paralysis on one side of the body. Auras rarely last longer than an hour and are followed by a headache 93% of the time.
• Migraine without aura: About 80% of the people who experience migraine are in this category. This migraine may be preceded by mood changes, fatigue, mental fuzziness and fluid retention. In common migraine, patients also may have diarrhea, increased urination, nausea, and vomiting. This migraine can last for three or four days, depending on the treatment.

Either type of migraine may also be accompanied by nasal congestion, runny nose, tearing, and/or sinus pain or pressure.

Are there Different Forms of Migraine?

Besides being with or without aura, migraine headaches may come in six different forms.

• Hemiplegic migraine: This migraine is marked by temporary paralysis on one side of the body (hemiplegia), impaired vision, and vertigo.
• Ophthalmologic migraine: It is now thought that this may not actually be a migraine, but another neurologic condition entirely. The pain from this rare type of headache is localized around the eye. The headache may be accompanied by a droopy eyelid and vision problems.
• Basilar artery migraine: These migraines occur mostly in adolescent and young women. They result from a spasm to the basilar artery, a major blood vessel at the base of the brain. Symptoms can include vertigo, impaired vision, poor motor coordination, difficulty speaking or hearing, and altered consciousness.
• Benign exertional headache: A type is a vascular headache triggered by physical exertion, such as running, bending and lifting, or even coughing or sneezing. This headache rarely lasts more than several minutes.
• Status migrainosus: This is a rare, sustained and extremely severe type of migraine with pain and nausea so intense that the person may have to be hospitalized.
• Headache-free migraine: A condition characterized by migraine symptoms, such as visual impairment, nausea, vomiting, constipation or diarrhea, but no headache.

How do migraine headaches differ from other types of Headaches?

Sometimes, other types of headaches share some of the same symptoms as migraines but there are other differences that distinguish them from migraine.

• Tension Headaches: Chronic headaches that are associated with stress or fatigue; physical ailments such as arthritis; or psychological distress or depression are known as tension headaches. They may be caused by poor posture, eyestrain, abnormalities of muscles or bones in the neck, misaligned teeth or jawbones, or unusual noise or light conditions. Women seem to have more of these headaches than men and the onset of tension headaches usually begin between the ages of 20-40. Symptoms include muscle tightness in the head and neck, especially in the temple and forehead areas; pressure sometimes described as feeling like a band or vise around the head; and continuous but not throbbing pain.
• Cluster Headaches: These vascular headaches sometimes occur in a cluster of up to four separate attacks a day and have been associated with an increased level of histamine in the blood. Cluster headaches come on quite suddenly and are thought to be one of the most severe and intense headaches. Men are more apt to have these headaches than women and the onset is between ages 20-45. These headaches leave as suddenly as they come and may last from less than an hour to several hours. Patients describe excruciating, stabbing pain, often around one eye, as well as tearing from that eye and a runny nose on the affected side.

Migraines affect millions of people and many have questions about this serious condition. If you have questions about migraine and do not find it answered in this article, contact these nonprofit organizations for more information and help with this subject: Migraine Center, Migraine Disease Basics, Migraine Ask the Doctor, and American Council for Headache Education.

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