Understanding Migraine Symptoms

by Will Bozeman

Migraines are much more complicated than your average headache. They are a complex neurological condition that has an impact on millions of people worldwide, and they also have the potential to severely impact your quality of life. 

If you suffer from migraine attacks or have seen someone experience one,  you might understand how intense these recurring headaches can be. But what truly sets migraines apart from regular headaches is the wide range of additional symptoms that can accompany them.

So, why is there such a wide range of migraine symptoms? Firstly, there are many different types of migraines, and each type can have its own distinct set of accompanying symptoms. Secondly,  there are certain individual triggers that can provoke a migraine attack, and how your body responds to these triggers also contributes to what symptoms are experienced.

The fact that migraines are such highly individualized experiences is another reason why migraines are so complex. Symptoms can vary from person to person and even from one migraine attack to another, which makes them more difficult to treat. 

To effectively manage migraines or support someone who suffers from them,  it is helpful to have an understanding of the various types and their typical symptoms. Only you can truly understand your migraines. Our goal is to give you the knowledge on how to distinguish them and find the strategies to reduce their severity to improve your overall well-being. 

By understanding the symptoms and how they differ between the numerous types of migraines, you’ll be better prepared to recognize when you might be suffering a migraine attack, how to manage them, and when it might be time to seek medical help. 

In this article, we explore the causes of migraines and outline in depth the symptoms associated with some of the numerous migraines. We also outline some of the strategies available for managing and alleviating symptoms so you can take control of your migraines for good.

Migraine Causes

Migraines have numerous potential causes, which can be multifactorial and different for each person. Although the exact biological mechanisms behind migraine attacks are not fully understood, there are some well-known factors that play a part in causing them.

One significant factor is your family history, as migraines are seen to have a genetic component. If you have a parent who suffers from migraines, your chances of developing them are increased by 50%.

Another aspect is fluctuations in the blood vessel activity within the brain. Sudden changes to these blood vessels can be triggered by changes in the body’s chemicals, hormones, or even external factors. As the brain’s blood vessels are stimulated to narrow or expand, it can falsely activate certain pain receptors that contribute to migraines.

The brain’s chemistry is a very intricate space, and it requires a delicate balance of neurotransmitters like serotonin and dopamine. 

An imbalance of these neurotransmitters can also disrupt the body’s normal pain signals and contribute to the onset of migraines. Imbalances of these neurotransmitters can be influenced by genetics, hormones, medications, or other external factors in your environment. 

Additionally, if the central nervous system becomes more sensitive due to increased levels of stress, illness, or certain conditions, it can further alter the body’s pain signals, causing a migraine attack and its specific set of associated symptoms.

Highlighted below are some particular triggers that are known to further contribute to these underlying mechanisms. These triggers involve both physiological and environmental factors that can ultimately lead to a migraine attack.

Common Migraine Triggers

By recognizing some of the common migraine triggers, you can take steps to understand your own migraines and gain better control over their episodes. While the following list is not exhaustive and individual experiences may vary, these common elements have been identified as triggers to migraines and their debilitating symptoms. 

  • Food and drinks

Common dietary triggers include caffeine, alcohol (particularly red wine), food additives such as aspartame and MSG, and tyramine-rich foods such as aged cheeses and cured meats, citrus fruits, and chocolate. 

These particular foods are thought to trigger a migraine attack due to the presence of specific chemicals or substances that have the potential to influence blood vessels, neurotransmitters, and the sensitivity of the nervous system. 

  • Hormonal changes

Hormone fluctuations, particularly estrogen, can have a real impact on migraines. Meaning events such as the menstrual cycle, pregnancy, and menopause may trigger or even worsen migraines.  

Interestingly, hormonal contraceptives may contribute to migraines in some women but could potentially provide relief for others, depending on an individual’s natural hormone levels. 

  • Stress

During times of increased stress, the brain’s delicate balance of neurotransmitters can be altered, which may contribute to the onset of a migraine. 

Additionally, the difficult emotions that often accompany stress, such as anxiety, can lead to increased muscle tension and even impact the brain’s blood vessels. This combination of factors has the potential to intensify the severity of migraines.

Indirectly, stress can also disrupt your regular sleeping patterns, which alters the body’s natural hormonal balance and triggers a migraine attack. 

  • Sensory stimulation

Environmental factors have the ability to overstimulate our sensory pathways. Bright lights, loud noises, strong smells, and even certain textures might be enough to activate the brain’s sensitive pain-processing neurotransmitters, leading to throbbing pain and other migraine symptoms.

Certain changes in the weather, such as humidity, heat, or storms, may also be a common sensory trigger for a migraine attack.

  • Medication

There are certain prescription and over-the-counter medications that are known to trigger the onset of a migraine for some people. 

These include medications that dilate or constrict your blood vessels, hormonal medications (the contraceptive pill or hormonal replacement therapy), over-the-counter pain medications (when overused), and medications that affect the central nervous system (such as certain antidepressants, antipsychotics, and sleeping tablets).

This is often very individualized, and not all people who take these medications will experience migraines. 

  • Illness

When our bodies are actively fighting an underlying illness or infection, there are several factors that have the potential to trigger migraines. 

Hormonal imbalances and stress responses that occur from an illness or disease can directly affect our blood vessels, nerves, and brain chemistry, making it more likely for susceptible individuals to experience migraines. 

In addition to these particular triggers, it’s important to recognize that there are many different types of migraines people can experience. With the various types of migraines, each one can present with a unique set of signs and symptoms.

By going beyond just the triggers of your migraines, you can gain a deeper understanding of your migraine type and better navigate your own symptoms and treatment options more effectively.

Migraine Types And Their Symptoms

Migraines are highly individual experiences, and it’s important to recognize that everyone’s migraine journey is likely to be unique. The complex nature of an individual’s migraines means they can present in diverse ways, with different types of migraines presenting their own set of defining symptoms. 

Some individuals may consistently encounter a specific type of migraine, while others may experience different types at different times. For example

Migraine With Aura

A migraine with an aura, also known as a classic migraine, is a type of migraine where some visual disturbances arise before the migraine pain. Auras are often seen as an early indicator to anticipate an impending migraine attack.

The duration of the aura can vary, ranging from a few minutes to potentially several hours. The aura might also present as a range of different visual disturbances, and they can vary from person to person. These symptoms can be unsettling, but it’s important to remember that they are usually reversible and tend to fade away before or shortly after the migraine headache sets in.

  • Aura Symptoms

Visual disturbances that involve seeing flashing or flickering lights, noticing blind spots or areas of reduced vision, experiencing zigzag lines or shimmering patterns, or even having temporary vision loss or blurry vision.

  • Intense head pain

Following the aura is a throbbing headache that is typically localized on one side of the head. This head pain can significantly impact your daily life and last anywhere from a few hours to a few days.

  • Nausea

Nausea and sometimes vomiting are common accompanying symptoms of a classic migraine. This is because the digestive system often becomes more sensitive during a migraine attack.

  • Sensitivity to light and sound

A heightened sensitivity to light (photophobia) and sound (phonophobia) during a migraine attack is not uncommon. Exposure to bright lights or loud noises can intensify the migraine symptoms and cause additional discomfort, often making people want to retreat to dark rooms for relief. 

  • Feeling hyper or cranky

Changes in emotions and behaviors can lead some people to feel hyperactive or irritable. This can result in feelings of restlessness or crankiness.

  • Fatigue

A general sense of fatigue and low energy are also common throughout and after a migraine attack.

Migraine Without Aura

A Migraine without aura is better known as a common migraine. It is the most prevalent type of migraine and doesn’t present with the distinctive aura phase. Although, a common migraine is often associated with many other typical migraine symptoms, such as: 

  • Moderate to severe headache

The major presenting symptom of a migraine without aura is moderate to severe pain that generally affects one side of the head. The pain is usually described as pulsing or throbbing in nature, which can be debilitating and disrupt your daily activities. 

  • Sensitivity to light and sound

Individuals who experience common migraines may also become highly sensitive to light (photophobia) and sound (phonophobia) during an episode. Exposure to bright lights or loud noises can exacerbate migraine symptoms and cause discomfort.

  • Nausea and vomiting

Many people experience gastrointestinal symptoms with a common migraine, including nausea and vomiting. These symptoms accompany the headache, exacerbating the pain and further contributing to overall discomfort.

  • Neck stiffness or pain

Common migraine attacks can sometimes be accompanied by neck stiffness or pain. This discomfort in the neck region may occur concurrently with the headache or act as an early warning sign. 

Beyond the classic and common migraines, there is a wide range of other migraine types that you might experience. Most different migraine types are associated with a unique set of accompanying symptoms. 

Learning about the different types of migraines helps you better comprehend and manage the specific patterns of your own migraines. Below, we provide a list of different migraine types along with their unique signs and symptoms:

Menstrual Migraine

Menstrual migraines tend to occur in a predictable pattern, following the normal hormonal fluctuations of estrogen in the system throughout your cycle. 

Usually, a menstrual migraine will occur within two days directly before menstruation or within the first three days of menstruation. However, the timing can vary for each individual and differ if you suffer from an irregular menstrual cycle. 

Other than their predictable timing, symptoms of a menstrual cycle is usually similar to a common migraine and include:

  • Throbbing headache
  • Visual and auditory sensitivities
  • Fatigue and mood changes
  • Nausea and vomiting

Silent Migraine

A silent migraine, also known as an acephalgic migraine, is a unique type of migraine that doesn’t bring about the typical throbbing headache pain along with its other migraine symptoms. While you may not have a headache, silent migraines can still be debilitating and disrupt daily activities. 

Fortunately, silent migraines tend not to last as long as a typical migraine, and their symptoms can include:

  • Aura symptoms
  • Fatigue and mood changes
  • Nausea and vomiting

Vestibular Migraine

The vestibular system controls the body’s balance and spatial orientation, and a vestibular migraine affects this sensitive system. This type of migraine is quite unique and causes various symptoms related to the inner ear and balance, leading to significant discomfort and disruption. Symptoms often include:

  • Throbbing headache
  • Vertigo (dizziness)
  • Sensitivity to motion or movement
  • Nausea and vomiting
  • Aura symptoms
  • Sensitivity to light and sound

Abdominal Migraine

Abdominal migraines are a type of migraine where the associated symptoms primarily affect the abdominal region, often causing intense pain and discomfort. They more commonly occur in children but can also affect adults. An abdominal migraine doesn’t typically come with a throbbing headache but is known to have other identifying symptoms, including:

  • Intense abdominal pain and cramping
  • Gastrointestinal upset (nausea, vomiting, diarrhea) 
  • Fatigue
  • Paling of the skin

Hemiplegic Migraine

Hemiplegic migraines are a rare and complex form of migraine that can involve temporary paralysis or weakness on one side of the body (hemiplegia). This particular type of migraine can be very distressing to those who experience them and can be difficult to manage.

A hemiplegic migraine can last anywhere from a few hours to several days. After the migraine, individuals usually experience a recovery period, where they gradually regain full strength and normal neurological function. A Hemiplegic’s associated symptoms include

  • Hemiplegia
  • Confusion
  • Vertigo (Dizziness)
  • Coordination problems
  • Throbbing headache
  • Aura Symptoms

Ocular Migraine

Ocular migraines are also known as retinal migraines and are a specific type of migraine that primarily impacts your visual system. 

Unlike typical migraines, an ocular migraine has a relatively shorter duration which typically lasts for less than an hour. Their unique symptoms typically manifest through visual disturbances, such as blind or blurred spots, flashing lights, or unusual patterns. 

It’s important to note that ocular migraines typically do not cause permanent visual impairment. The main symptoms associated with ocular migraines include:

  • Aura Symptoms 
  • Temporary vision loss (not permanent) 
  • Headache
  • Dizziness
  • Nausea and vomiting

Migraine with Brainstem Aura

A migraine with brainstem aura is a rare subtype of migraine that involves symptoms that originate from the brainstem. The brainstem is the lower section of the brain that connects to the spinal cord. It is a crucial component of the nervous system and plays a significant role in various bodily functions.

A migraine with brainstem aura may occur concurrently or separately from a classic or common migraine and brings symptoms including:

  • Aura Symptoms
  • Sensitivity to light and sound
  • Vertigo (Dizziness) 
  • Coordination problems
  • Nausea and vomiting
  • Throbbing headache

Status Migrainosus

A migraine attack that is both prolonged and severe, lasting for a period over 72 hours, is described as status migrainosus. One of the defining symptoms of status migrainosus is its relentless persistence that typically does not respond well to standard migraine treatments, making its management quite challenging.

The prolonged nature of this type of migraine can greatly impact an individual’s daily life and is best treated with a specialized management plan. Symptoms often include the prolonged duration of: 

  • Throbbing headache (resistant to treatments)
  • Visual and auditory sensitivities
  • Visual auras
  • Dizziness & vertigo
  • Nausea and vomiting

Ophthalmoplegic Migraine

An ophthalmoplegic migraine is a rare subtype of migraine that specifically affects the nerves responsible for eye movement. Symptoms typically affect the eye muscles’ ability to function and tend to develop gradually over hours or even days, along with a mild headache. 

Compared to a common or classic migraine, ophthalmoplegic migraines can have symptoms lasting for days or even weeks, and it is not unusual to see recurrent attacks within a period of time. Symptoms involve: 

  • Mild to moderate headache
  • Eye-related symptoms, including:
    • Severe eye pain
    • Drooping eyelid (ptosis)
    • Double vision (diplopia)
    • Weakness of eye muscles
  • Nausea and vomiting
  • Visual and auditory sensitivities

When To Seek Medical Advice

If you, or someone you care for experiences migraines, it’s important to be aware of situations where seeking medical advice is important. This includes if you notice any new or severe symptoms, especially if there is a change in neurological function, such as changes in your level of consciousness or ability to complete fine motor tasks. 

It is also important to see a healthcare professional if you notice the migraine attacks becoming more frequent, more intense, or start interfering with your day-to-day life. Noting a change in the pattern or triggers of your migraines also gives warrant to consulting a doctor. 

If you are diagnosed with any other underlying health conditions, such as cardiovascular issues or neurological disorders, and you experience migraines, it’s especially important to seek medical advice. 

Additionally, if you are taking medicines for your migraines and have any concerns or questions regarding their effectiveness, or possible interactions, it’s always a good idea to consult with a healthcare professional. 

Remember, seeking medical advice can help you gain a comprehensive understanding of your migraines and access personalized treatment options that can help you better manage and reduce the impact of migraines on your overall well-being.

Diagnosis Of Migraines

When doctors diagnose migraines, they will rely heavily on assessing and piecing together the symptoms that you can describe. They evaluate and ask questions about the characteristics of the headaches, such as their nature, frequency, and any other accompanying symptoms. 

Identifying potential triggers is also important, in addition to gathering information about relevant family history. They are likely also to conduct a physical examination or order additional tests such as blood tests or CT scans to help to rule out any other possible causes or conditions.

Because the diagnosis of a migraine relies so heavily on the thorough assessment of symptoms, a Dr may ask you to complete a migraine diary to help them differentiate between certain types of migraines or other headache conditions. Clearly documenting the certain characteristics and symptoms of your headaches, such as timing, how long they last, associating symptoms, and their severity, may help come to a conclusive diagnosis. 

Getting a migraine diagnosis and help you achieve an accurate diagnosis and develop an appropriate, personalized treatment plan that works for you.

Common Treatments For Migraines

When it comes to treating migraines, there are various approaches that can be considered, which often depend on the severity and frequency of migraine attacks. It is important to prioritize the use of the least invasive treatments that effectively relieve your symptoms, to help avoid unnecessary overmedication.

Over-the-counter pain relief, such as ibuprofen or acetaminophen, can be helpful with symptoms of mild to moderate migraines. While more specific prescription medications can be prescribed for migraines that are more severe or frequently occurring. 

Prescription medications for migraines can include triptans or ergotamines, which are taken at the onset of a migraine attack and work by constricting the blood vessels and blocking certain pain pathways in the brain. Additionally, there are anti-nausea drugs, anti-seizure medications, and antidepressants that can be prescribed to reduce the frequency and severity of migraines. 

There are many alternative treatment options for those who do not respond well or prefer non-pharmacological treatments. These include acupuncture, reflexology, or external trigeminal nerve stimulation (e-TNS) therapy, among many others. 

e-TNS is an emerging field in migraine treatment that has been well supported by evidence to indicate its effectiveness as an affordable option. Unlike some other treatments, e-TNS is considered to be generally well tolerated and free from negative side effects.

By working closely with a licensed healthcare provider, you can develop a personalized treatment plan that effectively manages your migraines and minimizes their impact on your daily life.

In addition to medical interventions, incorporating different lifestyle approaches can be beneficial in preventing the occurrence of migraines altogether.

Can Migraines Be Prevented?

Incorporating healthier lifestyle habits can be key in preventing migraines and reducing their impact on your life. Simple changes such as establishing a regular sleep routine, practicing effective stress management techniques, and doing some form of exercise regularly may make a significant difference.

Additionally, maintaining a balanced diet and staying hydrated may help identify and manage migraine triggers that are specific to you. It can be helpful to maintain a more consistent daily routine and limit your intake of caffeine, refined sugar, and alcohol. 

By adopting some healthy daily practices in your life, you can proactively reduce the frequency and severity of migraines, leading to an improved overall quality of life. 

Additionally, by working closely with healthcare professionals, you can develop a comprehensive strategy that combines lifestyle modifications with appropriate medical treatments, providing you with better control over your migraines and enhancing your well-being.

Understand Your Migraine To Treat Its Symptoms Effectively

Having a deep understanding of your migraine is the key to effectively treating its symptoms. By familiarizing yourself with the different types of migraines, recognizing your specific triggers, and being aware of the warning signs and accompanying symptoms, you can tailor your treatment and management approach.

Whatever treatments you choose to help manage your migraines, be it through over-the-counter pain relievers, prescription medications, lifestyle modifications, or alternative therapies, finding the right combination that works for you is going to ensure you have the best possible outcome.

By seeking guidance from your healthcare provider, you can gain access to the knowledge and support needed to take control of your migraines and find effective relief from your symptoms. An accurate diagnosis and a proactive management plan can lead you toward improved overall well-being and a better quality of life.

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