Migraine
Migraine
Migraine is a common health condition. It affects around 1 in 5 women and around 1 in 15 men, and it usually begins in early adulthood.
A migraine headache is usually a moderate or severe headache felt as a throbbing pain on one side of the head.
Some people have frequent migraine headaches, occurring up to several times a week. Others only have occasional migraine headaches, and for some, it's even possible for years to pass between attacks.
Common Symptoms
Emergency Warning Signs
Call 999 (emergency) or go to the nearest hospital's A&E right away if you or someone with you suddenly has:
- weakness or paralysis in one or both arms, or on one side of the face
- slurred or garbled speech
- a sudden, agonising headache with blinding pain
- a headache along with a high fever, stiff neck, confusion, seizures, double vision, and a rash
These can be signs of something more serious, such as a stroke or meningitis, so the person should be checked by a doctor without delay.
Contact your doctor or nearest health centre if:
- your migraine attacks are frequent or severe
Ask your doctor about ways to prevent and treat migraine.
Types of migraine
Migraine isn't all the same for everyone. The main types are:
- migraine with aura, where warning signs such as flashing lights appear before the attack begins
- migraine without aura, the most common type, where the attack comes on with no warning signs
- migraine aura without headache, also called silent migraine, where a person has aura or other migraine symptoms but no headache
⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
Medicines Commonly Used
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
When to See a Doctor
Call 999 (emergency) or go to the nearest hospital's A&E right away if you or someone with you suddenly has:
- weakness or paralysis in one or both arms, or on one side of the face
- slurred or garbled speech
- a sudden, agonising headache with blinding pain
- a headache along with a high fever, stiff neck, confusion, seizures, double vision, and a rash
These can be signs of something more serious, such as a stroke or meningitis, so the person should be checked by a doctor without delay.
Contact your doctor or nearest health centre if:
- your migraine attacks are frequent or severe
Ask your doctor about ways to prevent and treat migraine.
Types of migraine
Migraine isn't all the same for everyone. The main types are:
- migraine with aura, where warning signs such as flashing lights appear before the attack begins
- migraine without aura, the most common type, where the attack comes on with no warning signs
- migraine aura without headache, also called silent migraine, where a person has aura or other migraine symptoms but no headache
Causes
The exact cause of migraine is not fully known. Doctors believe it happens when unusual brain activity temporarily affects nerve signals, chemicals and blood vessels in the brain.
Around half of everyone with migraine has a close relative with the condition, which suggests genes play a part.
Migraine triggers
Keeping a diary can help you spot regular triggers. It can be hard to tell whether something is a trigger or simply an early symptom of a migraine attack.
You might not always have a trigger for your headache.
Possible migraine triggers include:
- hormonal changes
- starting your period
- emotional triggers like anxiety, depression and stress
- physical triggers like tiredness, poor posture, neck or shoulder tension and jet lag
- fasting or low blood sugar (hypoglycaemia)
- strenuous exercise, if you are not used to it
- dietary triggers like alcohol, caffeine, chocolate or citrus fruit
- dehydration
- environmental triggers like bright lights, flickering screens, smoking or smoky rooms, loud noises, strong smells or changes in the weather
Medicines can also trigger attacks. Examples include some types of sleeping tablets, the combined contraceptive pill or hormone replacement therapy (HRT). Speak to a doctor if you start having migraine attacks after starting a new medicine.
Some people crave chocolate before an attack begins. This can be an early sign that an attack is coming rather than chocolate being the trigger.
Diagnosis
Diagnosing migraines
There’s no specific test to diagnose migraine. Your GP must identify a pattern of recurring headaches along with the associated symptoms.
Migraine headaches can be unpredictable, sometimes occurring without the other symptoms. Getting an accurate diagnosis can take time.
Your GP might do a physical examination and check your vision, co-ordination, reflexes and sensations. These will help rule out some other possible underlying causes of your symptoms.
Your GP may ask if your headaches are:
- on one side of the head
- a pulsating pain
- severe enough to prevent you carrying out daily activities
- made worse by physical activity or moving about
- accompanied by nausea and vomiting
- accompanied by sensitivity to light and noise
Migraine diary
To help with the diagnosis, it can be useful to keep a diary of your migraine attacks for a few weeks.
Note down details including:
- the date
- time
- what you were doing when the migraine attack began
- how long the attack lasted
- what symptoms you experienced
- what medication you took (if any)
Taking too many painkillers can make migraine difficult to treat. This condition is called medication overuse headache.
Keep a record of what painkillers you take and how often you take them. You shouldn’t take painkillers on more than 10 days every month in the long-term.
It can be helpful to make a note when your start your period, if you have one. This can help your GP identify potential triggers.
Read more about keeping a migraine diary on The Migraine Trust website.
Referral to a specialist
Your GP may decide to refer you to a neurologist (a specialist in conditions affecting the brain and nervous system). They’ll do further assessments and offer treatment if:
- a diagnosis is unclear
- you experience significant migraine headaches that aren’t being controlled by your current treatment
Read about the prevention and treatment of migraine
Complications
Migraine slightly raises the chance of a few other health problems, including:
- stroke
- depression
- bipolar disorder
- anxiety disorder
- panic disorder
Contraceptive pill
If you take the combined contraceptive pill, your risk of an ischaemic stroke goes up. Because of this, doctors usually advise women who get migraine with aura to avoid the combined pill.
If you have migraine without aura, you can usually take the combined pill safely, as long as you don't have other stroke risk factors such as high blood pressure or a family history of heart or blood vessel disease.
If you get aura symptoms and are currently on the combined pill, it's worth talking to your doctor about switching to a different form of contraception.