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Migraine Headaches: At a Glance

By The Manual's Editorial Staff,

Migraines are one of the two most common causes of headaches. Tension-type headaches is the other.

When a migraine headache occurs, pulsating or throbbing pain is usually felt on one side of the head, but it may occur on both sides. Physical activity, bright light, loud noises, and certain odors may make the headache worse. The pain is frequently accompanied by nausea, vomiting, and sensitivity to sounds, light, and/or odors.

Migraines are 3 times more common among women. In the United States, about 18% of women and 6% of men have a migraine at some time each year.

Migraines may become chronic. That is, they occur 15 or more days a month. Chronic migraines often develop in people who overuse drugs to treat migraines.

Did You Know...

  • More than half the people who have migraines have close relatives who also have them.

  • After age 50, headaches usually become significantly less severe or resolve entirely.

For a full discussion, see Migraines.

See also Migraine Sufferers.

What Causes Migraines?

Migraines occur in people whose nervous system is more sensitive than that of other people. In these people, nerve cells in the brain are easily stimulated, producing electrical activity. As electrical activity spreads over the brain, various functions, such as vision, sensation, balance, muscle coordination, and speech, are temporarily disturbed. These disturbances cause the symptoms that occur before the headache (called the aura). About 25% of people experience an aura.

The headache occurs when the 5th cranial (trigeminal) nerve is stimulated. This nerve sends impulses (including pain impulses) from the eyes, scalp, forehead, upper eyelids, mouth, and jaw to the brain. When stimulated, the nerve may release substances that cause painful inflammation in the blood vessels of the brain and tissues covering the brain. The inflammation accounts for the throbbing headache, nausea, vomiting, and sensitivity to light and sound.

Possible Triggers for Migraines

  • Estrogen (the main female hormone), when levels increase or fluctuate
  • Birth control pills, which contain estrogen
  • Lack of sleep, including insomnia
  • Changes in the weather, particularly barometric pressure
  • Red wine
  • Certain foods
  • Hunger (as when meals are skipped)
  • Excessive stimulation of the senses (for example, by flashing lights or strong odors)
  • Stress

How Are Migraines Treated?

Migraines cannot be cured, but they can be controlled:

  • Keep a headache diary: Write down the number and timing of attacks, possible triggers, and response to treatment. With this information, triggers may be identified and eliminated or avoided when possible.

  • Learn to relax and manage stress.

  • Take drugs as prescribed by your doctor.

Did You Know...

  • Taking pain relievers or triptans for more than 2 to 3 days each week can lead to daily, more severe migraines, called rebound or medication overuse headaches.

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