What is migraine?
Migraine is a condition that causes attacks (episodes) of headaches. Other symptoms such as feeling sick (nausea) or being sick (vomiting) are also common. Between migraine attacks, the symptoms go completely.
Who gets migraine?
Migraine is common. About 1 in 4 women and about 1 in 12 men develop migraine at some point in their lives. It most commonly first starts in childhood or as a young adult. Some people have frequent attacks - sometimes several a week. Others have attacks only now and then. Some people may go for years between attacks. In some people, the migraine attacks stop in later adult life. However, in some cases the attacks continue (persist) throughout life.
What are the types and symptoms of migraine?
There are two main types of migraine attack:
• Migraine attack without aura - sometimes called common migraine.
• Migraine attack with aura - sometimes called classic migraine.
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Migraine without aura
This is the most common type of migraine. Symptoms include the following:
• The headache is usually on one side of the head, typically at the front or side. Sometimes it is on both sides of the head. Sometimes it starts on one side, and then spreads all over the head. The pain is moderate or severe and is often described as throbbing or pulsating. Movements of the head may make it worse. It often begins in the morning, but may begin at any time of the day or night. Typically, it gradually gets worse and peaks after 2-12 hours, then gradually eases off. However, it can last from 4 to 72 hours.
• Other migraine symptoms that are common:
• Feeling sick (nausea).
• Being sick (vomiting).
• Not liking bright lights or loud noises, so that you may just want to lie in a dark room.
• Other symptoms that sometimes occur:
• Being off food.
• Blurred vision.
• Poor concentration.
• Stuffy nose.
• Hunger.
• Diarrhoea.
• Tummy (abdominal) pain.
• Passing lots of urine.
• Going pale.
• Sweating.
• Scalp tenderness.
• Sensations of heat or cold.
Phases of a typical migraine attack
A migraine attack can typically be divided into four phases:
• A warning (premonitory) phase occurs in up to half of people with migraine. You may feel irritable, depressed, tired, have food cravings, or just know that a migraine is going to occur. You may have these feelings for hours or even days before the onset of the headache.
• The aura phase (if it occurs).
• The headache phase.
• The resolution phase when the headache gradually fades. During this time you may feel tired, irritable, depressed, and may have difficulty concentrating.
Less common types of migraine
There are various other types of migraine which are uncommon, and some more types which are rare. These include:
Menstrual migraine. The symptoms of each attack are the same as for common migraine or migraine with aura. However, the migraine attacks are associated with periods (menstruation). There are two types of patterns. Pure menstrual migraine occurs with migraine only around periods, and not at other times. This occurs in about 1 in 7 women who have migraine. Menstrual-associated migraine occurs with migraines around periods and also at other times of the month. About 6 in 10 women who have migraine have this type of pattern. Treatment of each migraine attack is the same as for any other type of migraine. However, there are treatments that may prevent menstrual migraines from occurring. See separate leaflet called Migraine Triggered by Periods .
Abdominal migraine. This mainly occurs in children. Instead of headaches, the child has attacks of tummy (abdominal) pain which last several hours. Typically, during each attack there is no headache, or only a mild headache. There may be associated with sickness (nausea), being sick (vomiting), or aura symptoms.
Commonly, children who have abdominal migraine switch to develop common migraine in their teenage years.
Ocular migraine. This is sometimes called retinal migraine, ophthalmic migraine or eye migraine. It causes temporary loss of all or part of the vision in one eye. This may be with or without a headache. Each attack usually occurs in the same eye. There are no abnormalities in the eye itself and vision returns to normal. Important note: see a doctor urgently if you get a sudden loss of vision (particularly if it occurs for the first time). There are various causes of this and these need to be ruled out before ocular migraine can be diagnosed.
Hemiplegic migraine. This is rare. In addition to a severe headache, symptoms include weakness (like a temporary paralysis) of one side of the body. This may last up to several hours, or even days, before resolving. Therefore, it is sometimes confused with a stroke. You may also have other temporary symptoms of:
• Severe dizziness (vertigo).
• Double vision.
• Visual problems.
• Hearing problems.
• Difficulty speaking or swallowing.
Important note: see a doctor urgently if you get sudden weakness (particularly if it occurs for the first time). There are other causes of this (such as a stroke) and these need to be ruled out before hemiplegic migraine can be diagnosed.
Basilar-type migraine. This is rare. The basilar artery is in the back of your head. It used to be thought that this type of migraine originated due to a problem with the basilar artery. It is now thought that this is not the case, but the exact cause is not known.
Symptoms typically include headache at the back of the head (rather than one-sided as in common migraine). They also tend to include strange aura symptoms such as:
• Temporary blindness.
• Double vision.
• Dizziness.
• Ringing in the ears.
• Jerky eye movements.
• Trouble hearing.
• Slurred speech.
Unlike hemiplegic migraine, basilar-type migraine does not cause weakness. There is an increased risk of having a stroke with this type of migraine. Important note: see a doctor urgently if you develop the symptoms described for basilar-type migraine (particularly if they occur for the first time). There are other causes of these symptoms (such as a stroke) and these need to be ruled out before basilar-type migraine can be diagnosed