It’s estimated that around one billion people suffer from migraine headaches globally. This volume makes it the third most prevalent illness, behind tooth decay and tension-type headaches. A migraine headache is not your run-of-the-mill pain, however. Instead, it is a neurological (brain) disease that can have severe symptoms.
If you’ve ever had a migraine headache, you know how debilitating and painful they feel. They differ from everyday headaches that tend to pass quickly and easily. Migraines frequently occur due to complex neurological changes in some brain regions. The headaches can last from hours to days and may impact daily activities depending on severity.
Eight Common Symptoms of a Migraine Headache
While symptoms vary from person to person, these are general signs of a migraine:
- intense, pounding headache
- nausea
- vomiting
- trouble speaking
- light sensitivity
- fatigue
- sleep disruptions
- visual disturbances such as bright lines, flashing dots, or lights
Migraines can include any of these symptoms, though a throbbing, pulsing headache happens most frequently. However, migraine sufferers can experience many symptoms, and some may not have a headache. However, most people will notice strange sensations in the days leading up to a migraine.
Four Phases of a Migraine Headache
Changes in the brain can occur a few hours or even days before a migraine. Migraines tend to happen in four phases: prodrome (preheadache phase), aura, headache, and postdrome (migraine aftermath). Nearly 30% of people will experience symptoms before the migraine onset.
- This first phase can last a few hours or days. Not everyone will experience it because it may not occur each time. It’s also called the “preheadache” or “premonitory” phase. Common symptoms include difficulty concentrating, irritability, depression, trouble speaking, sleep disruptions, nausea, fatigue, light and sound sensitivity, food cravings, muscle stiffness, and increased urination.
- Aura: The aura phase may last between five minutes and an hour. Auras impact sensory, motor, and speech functions and are a warning sign of an impending migraine. They typically happen before a migraine but can also occur during or after. Only about 15-20% of people with migraines experience auras. Aura symptoms can include:
- Blind spots in your vision
- Seeing bright, flashing lines, dots, or lights
- Numbness or tingling
- Difficulty speaking or slurred speech
- Ringing in your ears (tinnitus)
- Temporary vision loss
- Seeing zigzagging lines
- Changes in smell or taste
- A “funny” feeling
- Headache: A migraine headache can last anywhere from four to 72 hours. However, the term “headache” is a vast understatement because most people with migraines consider them debilitating. Some people experience it only on one side, but it can affect the head. Other symptoms during this stage include hypersensitivity, speech changes, loss of appetite, nausea, abdominal pain, fatigue, tender scalp, and pale skin. You may also experience dizziness, blurred vision, sweating, and chills.
- Postdrome: The postdrome stage may last for one or two days. It’s sometimes referred to as a migraine “hangover,” and about 80% of migraine sufferers experience it. Symptoms include the inability to concentrate, depression, fatigue, comprehension problems, and euphoria.
What Happens in the Brain During a Migraine Headache
During the prodrome phase, the warning signs of migraine occur due to changes in the hypothalamus. Typically, the hypothalamus keeps our hormones balanced, controls thirst signals, and maintains circadian rhythm. However, brain signals controlling these functions are disrupted because it’s more active during the days leading up to a migraine.
People experience transitory visual, speech, and motor disturbances in the aura phase. These sensations happen due to changes in electrical waves across cell membranes. It can spread quickly across the brain to the visual cortex, affecting blood flow and causing blind spots or other aura symptoms.
During the third or headache phase, changes in the trigeminal nerve occur. This nerve transmits sensory information like touch, temperature, and pain from your face to your brain. It also sends signals to the scalp and blood vessels near the cerebral cortex. When a migraine headache occurs, this nerve becomes overly active, which increases pain sensitivity. Even activities such as bending over or coughing, or sensations like light and sound, can seem excruciating.
What Causes a Migraine Headache?
Even though migraines are pretty standard, it’s still unknown precisely what causes them. Scientists only know that specific nerves in the blood vessels send pain signals to your brain. However, why the nerves respond that way is still a mystery. More research on the brain areas affected during migraines – the brainstem, cerebral hemispheres, and the nerves.
Certain factors such as genetics, gender, and stress can increase your likelihood of migraines. Around 80% of people with migraines have a family history of the disease. Also, women are three times as likely as men to have migraines. Women between 15 and 55 experience migraine headaches more often due to hormonal fluctuations. Finally, heightened emotional stress can trigger a migraine because of increased cortisol.
It’s also been observed that people with migraines tend to have comorbidities such as depression, panic disorder, strokes, and sleep disorders. It’s unclear whether migraines cause these illnesses or vice versa; however, scientists believe genetics plays a crucial role. Still, they haven’t been able to identify any gene in particular that causes migraines.
They know that specific genes control our sensitivity to environmental stimuli, which determines our pain response. Perhaps the neurons in the brains of migraine sufferers respond more strongly to environmental stimuli, leading to increased sensitivity.
These unanswered questions about migraine headache causes warrant more research in the future. However, people who suffer from migraines experience complex changes in their brains.
Final Thoughts on Brain Changes that Occur During a Migraine
Anyone who gets migraine headaches can attest to how unbearable they are. Despite being the third most common illness globally, it’s unclear what causes these painful headaches. Scientists know that changes in specific brain areas, such as the hypothalamus and cerebral hemispheres, can trigger them. However, they’re still unsure what causes the nerves to send pain signals to the brain.
Hopefully, we’ll have more answers on the mechanisms driving these headaches in the future. Knowing the cause would improve treatment plans and perhaps cure migraines altogether. Doctors prescribe pain medications for severe migraines or recommend over-the-counter pain relievers for mild symptoms.
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