A migraine is a severe headache that is typically accompanied by other symptoms, including nausea or visual disturbances.

Headaches may be caused by a number of conditions, such as disorders of the neck, eyes, brain, jaw, or teeth. Headaches with an underlying medical condition are classified as secondary headaches because they are related to the condition. An example of this would be a headache due to neck injury or sinus infection.

Other headaches are classified as primary because the headache itself is the main medical problem. Contributing factors--sometimes called headache triggers--may include muscle tension, certain foods, medications, dehydration, or changing levels of hormones.

There are several different types of primary headaches, including migraines, cluster headaches, and tension headaches. Migraines are distinguished by the fact that symptoms other than pain occur as part of the headache. Nausea and vomiting, lightheadedness, sensitivity to light, and other visual symptoms typically occur.

Phases of Migraines

Migraines are also unique in that they have distinct phases. Not all individuals experience each phase, however. The phases of a migraine headache may include:

  • Premonition phase: a change in mood or behavior that may occur hours or days before the headache.

  • Aura phase: a group of visual, sensory, or motor symptoms that immediately precede the headache, including hallucinations, numbness, changes in speech, and muscle weakness.

  • Headache phase: period during the actual headache when the sufferer may be sensitive to light and motion and experience depression, fatigue, and anxiety.

  • Headache resolution phase: period when pain lessens but may be replaced with fatigue, irritability, and difficulty concentrating.

Migraine Symptoms

  • Sudden, severe headache that is different from your usual pain
  • Morning headaches
  • Headaches associated with nausea
  • Progressively worsening headaches
  • Fevers along with a stiff neck
  • Loss of vision that persists for several hours or outlasts the headache
  • Pain following a head injury
  • Convulsions, or a change in mental awareness

Diagnosis

Migraine headaches are diagnosed primarily based upon reported symptoms. Tracking and sharing information about your headache with your doctor helps with making an accurate diagnosis. It is helpful to track migraine occurrences (dates and times) and the details associated with migraines. Consider writing down the following information to take to your doctor visit: specific location of your headaches, how your headaches feel, how long your headaches last, any changes in behavior or personality, effect of changes in position on the headache, trouble sleeping, history of stress, and any head trauma.

In addition to the information you provide, your doctor may use computerized tomography (CT) scans, magnetic resonance imagining (MRI), and a spinal tap to confirm a migraine diagnosis. These tests help to rule out other problems such as tumors, infection, or blood vessel irregularities that may cause migraine like symptoms.

Treatment

Migraine classification helps to guide treatment. The categories below help to narrow down the classification process.

  • Migraine without aura: this more common type of migraine does not include an aura phase (symptoms that come just before the headache).

  • Migraine with aura: fewer migraine sufferers have this type of migraine, which is preceded by aura symptoms, such as a flashing light or zigzag lines, usually within 30 minutes before an attack.

The ultimate goal of treatment is to stop migraines from occurring. Adequate management depends on the accurate identification of the type of headache and may include avoiding known triggers, exercising, or taking medications.

See your doctor if you experience unresolved, recurring headaches. Such headaches can be a symptom of a more serious condition.

Medical Reviewer: [Akin, Louise RN, BSN, Sweetwood, Jane RN, MN, CCRN] Last Annual Review Date: 2009-09-27T00:00:00-06:00 Copyright: © 2000-2010 The StayWell Company, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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