Migraine: Possible Causes, Symptoms & Treatment Options

Everyone suffers from headaches from time to time. This can have several causes; they are often quite harmless and easy to solve. You take an over-the-counter painkiller or drink a few glasses of extra water; before you know it, the headache is gone. A migraine is often dismissed this way but is a completely different condition. Of course, you also suffer from headaches, but these often have very different causes and way more symptoms. There are an awful lot of types of migraines and every person is different. One person has a gigantic headache for two days, while another has to lie in bed in a pitch-black room for a week because even the slightest light is intolerable. Diagnosing it can be hard, that’s why it’s important to know what are possible causes, how you recognize the symptoms, and how you can treat this.

3d illustration of headache human, x-ray medical concept.

Different Types of Migraines

About 1 in 7 adults in our country is affected by migraine attacks. When they say I’m suffering from migraine, it doesn’t say much – except that they suffer from severe headaches. Why is that? Well, migraine is just an umbrella term for a neurological disease that is divided into many different types, all with their symptoms, causes, and severity. The types are called:

  • Migraine with Aura (Complicated Migraine)
  • Migraine without Aura (Common Migraine)
  • Migraine without Head Pain
  • Hemiplegic Migraine
  • Retinal Migraine
  • Chronic Migraine
  • Ice Pick Headaches
  • Cluster Headaches
  • Cervicogenic headache
  • Abdominal Migraine
  • Status Migrainosus
  • Menstrual Migraine
  • Basilar Migraine

The aura is a sensory and/or visual warning signal that alerts you that you are about to have a migraine attack. It often occurs 10 to 30 minutes before the attack. These signals can vary from person to person. Some people experience black dots in their vision, and others experience tingling numbness in a part of the body or difficulty speaking. Migraine without Aura means you don’t get these warning signs, which makes this a harder form of migraine to diagnose because it has a lot of overlap with other types. The other mentioned types are diagnosed by how often you have headaches (Chronic migraines), how severe they are (Cluster Headaches), and what kind of pain and symptoms it causes. For example, in Retinal Migraine, the person loses vision in one eye for an indefinite period. This can go on for a few minutes or months.

Medical scientists used to think that the change in blood flow in the brain caused migraine. After more research, they found out that these changes can contribute, but not the main cause of it. Nowadays, most scientists think the main cause is overactive nerve cells sending out trigger signals to the trigeminal nerve, which sends out sensations to your head and face. Once this nerve is triggered, the body releases chemicals, one of them called calcitonin gene-related peptide (CGRP). This causes blood vessels in your brain to swell, which activates neurotransmitters to cause inflammation and pain – also known as migraine.

Woman having terrible headache lying in bed at night, strong migraine, top-view

Triggers of Migraine

About 38 million Americans suffer from this neurological disease. There are a few risk factors that make it more likely to get them. Think of gender – a woman has migraine 3x more than a man. Often patients get their first migraine between 10 and 40 and get better after the age of 50. Family history and possibly other medical conditions, like depression, sleep disorders, and epilepsy are also big risk factors.

There are a few things that trigger migraines. Some you might want to skip if you suffer from migraines or are at risk to get them.

  • Hormone changes
  • Stress
  • Food
  • Skipping meals
  • Caffeine
  • (Big) weather changes
  • Senses
  • Medication
  • Physical activity
  • Smoking
  • Change of sleep patterns

As you can see, there are several things you can control. These include not eating or drinking more products, avoiding loud noises, bright lights, and/or strong smells as much as possible, or quitting smoking. On some, such as hormone or weather changes, you can have little control and will have to learn to live with it. That’s why it’s important to recognize the warning signs, this way you can make sure you’re at a safe place when the symptoms hit you and start treating them immediately.

Headache Is the Most Common Symptom

Migraine equals headache. Everyone knows that, yet many other symptoms accompany a migraine attack.  You already read that there is a type of migraine where you don’t get headaches at all. So this means that when you suffer from this, you don’t get a headache, but you do suffer from many other symptoms associated with migraine. Also, headache is a broad term – literally. You may suffer from a stabbing pain in the middle of your head, or suffer from a throbbing and nagging pain coming from the neck, or pressure behind the eyes and temples that causes a headache.

Cute infographic of Migraine and stages

Warning Signs of Migraine

Before we tell you about migraine signs and symptoms, in good to know that most migraine attacks consist of (4) stages. Every stage has its symptoms. The first stage is called ‘the prodrome stage’ and possible symptoms are: fatigue, nausea, increased urination, constipation, sensitivity to light and sound, etc. The second stage is called ‘the aura stage’ and possible symptoms are: numbness and tingling sensations, visual phenomena, temporary loss of sight, weakness on one side of the body/face, and difficulty speaking.

The third stage is called ‘the attack or headache stage’, symptoms may include: neck pain, stiffness, depression, anxiety, insomnia, nausea and vomiting, and sensitivity to light, smell & sound. The last stage is called ‘the post-drome stage’ and possible symptoms are: depressed or euphoric mood, problems concentrating, fatigue, and lack of comprehension.

We can’t say it often enough. Each person with a migraine is different, so the symptoms or placements may also be different. Some suffer from different symptoms, while others do not suffer at all, for example, ‘the aura stage’. As if the above symptoms were not enough, there are also general symptoms that can come up as a result of migraine headaches, they include:

  • Dizziness
  • Blurred vision
  • Pale skin color
  • Loss of appetite
  • Sweating or getting the chills
  • Tender scalp

Diagnosing Migraine is Key

Living with migraines isn’t fun, and taking painkillers every day to make the symptoms bearable isn’t fun either. When you visit your professional healthcare provider, make sure to tell him or her what kind of symptoms you experience and how severe they are. In case you get them during a special period – like your period, mention this as well. In fact, make sure to write as much as possible down about your headaches. Your healthcare provider might need it. Don’t worry if you forget something. He or she will ask you questions as well.

Oudere zieke zieke vrouw houdt twee pillen bij de hand gieten capsules uit medicijnfles neem pijnstillers supplement medicijn, oude senioren farmaceutische gezondheidszorg behandelingsconcept, close-up view

Possible Treatment Options

After talking about your symptoms, the healthcare provider might order a blood and/or imaging tests – like a CT or MRI – to rule out other causes for your symptoms. Once this is all done and your professional healthcare provider has officially diagnosed you with (any type of) migraine, it’s time to set up the right treatment plan. The main treatment is, prescribed medication. This comes in 2 form, abortive, which means you have to take them at the first sign of a migraine. The other one is preventive, which means you have to take them when your headaches are severe and happening more than 4 times a month. With this form, you have to take medication on a daily basis.

Possible prescribed medication are:

  • Triptans
  • Calcium channel blockers
  • CGRP monoclonal antibodies
  • Beta blockers
  • Antidepressants
  • Anti-seizure medication
  • Steroids
  • Phenothiazines
  • Corticosteroids

In addition to taking medication, the healthcare provider also recommends taking extra vitamins, minerals. Think magnesium or vitamin B2. There are also (natural) home remedies to manage your migraine symptoms, these include:

  • Yoga
  • Scalp massage
  • Cold compress/washcloth to the forehead or neck
  • Dark, cool and stimulus-free spaces
  • Temples massage
  • Meditation
  • Biofeedback