What’s Migraine and Why It Is More than a Headache?

Medically reviewed by Aaron L Weigmann MD., MS Plastic Surgeon August 15, 2024| Written by Zenda Nel

What’s Migraine and Why It Is More than a Headache?

Migraines are more than just a headache. In addition to excruciating headaches, migraines come with additional symptoms that can render one completely incapable.

Migraine is a common neurological disorder that affects more thanone billion individuals across the world. Most of these victims are young adults and females. Migraines are so common that if you don't suffer from migraines yourself, you probably know someone who does.

Sometimes presenting as a blinding headache, migraines are usually accompanied by other issues, such as stress or an inability to sleep.

Distinguishing Between Migraine and Regular Headache

A headache is defined as a pain in the head or face that can feel like a throbbing pressure. A headache can be dull and constant or sudden and sharp. 

Headaches are very common. Most people will have a headache at some point in their lives. Headaches are the most common reason for absences at school and work.

When you get a headache, it may or may not indicate some underlying condition.

a) Headache

Headaches can cause pain in the head, face, or upper neck. Experts distinguish between primary and secondary headaches.

Primary headaches result from conditions that directly cause a headache, such as tension. 

Secondary headaches are a result of medical conditions like a cold.

There are different kinds of headaches, but the most common are tension, sinus, and cluster headaches. 

1. Tension Headaches

Tension headaches are the most common type of headache. It usually starts at the back of the head and then spreads on both sides of the head toward the front. Tension headaches happen due to tension or stress. 

Tension headaches can be an occasional event or a chronic condition.

2. Sinus Headaches

Sinus headaches most often happen when a person has sinusitis caused by congestion and inflammation. Sinusitis is usually the result of a cold, the flu, or allergies, like hay fever.

It is the swelling in the sinus passages that causes pain behind the cheeks, nose, and eyes. With sinusitis, the pain can worsen as you bend down.

3. Cluster Headaches

Cluster headaches have earned a reputation as one of the most severe headaches. They are very rare, so researchers have not had much opportunity to study them in depth. 

These headaches are episodic, with most patients having several attacks a day for weeks or months. The attacks tend to happen at the same time of day, mostly at night. 

Researchers have not yet established the cause of these headaches. However, a sudden release ofhistamine or serotonin in the body may be a factor.

4. Secondary Headaches

Secondary headaches are a symptom of some disease or a health condition. For example, a headache can stem from a viral infection, an injury, or medication overuse. 

b) Migraine

Migraines are more severe than regular headaches. They are classified as primary headaches. In other words, migraines are a health condition and not a symptom of some illness or condition. 

Migraine isdefined as "a type of headache characterized by recurrent attacks of moderate to severe throbbing and pulsating pain on one side of the head."

What is the Difference Between Headaches and Migraines?

Migraines are more than just headaches; they come with additional symptoms, such as nausea, vision changes, sensitivity to light, sound, or smells, dizziness, and extreme fatigue.

Migraine Symptoms and Types

Migraines are categorized according to the symptoms that occur.

1. Migraine with Aura

In addition to intense throbbing headaches on one side of the head, migraine with aura presents with visual disturbances and other neurological symptoms. These symptoms appear about 10 to 60 minutes before the pain starts and don't usually last longer than an hour. 

The visual disturbances may include:

  • Temporary loss of vision
  • Blind spots
  • Spots of circling light 
  • Flashes of light
  • Lines of light that gradually float across the field of vision

In addition to the visual disturbances, the person may experience difficulty speaking, confusion, numbness or tingling in the hands or face, and the body feeling weak on one side. Other symptoms include an increased sensitivity to light, sound, or noise, nausea, and loss of appetite before the onset of pain.

All of these symptoms are not present every time and not for everybody. Also, individuals can experience auras without getting a headache.

2. Migraine without Aura

Migraines without aura are more common. These are painful, throbbing headaches on one side of the head. The pain can appear out of the blue and is accompanied by nausea, increased sensitivity to light, sound, or noise, confusion, mood changes, fatigue, and blurred vision.

These symptoms appear with the headache, which can last up to 72 hours.

3. Silent Migraine

A silent migraine is when someone experiences a migraine aura without a headache. This condition is also referred to as "Migraine aura without headache".

Aura, even in the absence of head pain, can be very debilitating because the aura prevents one from continuing tasks that require good vision, like reading.

4. Abdominal Migraine

Inabdominal migraines, sudden episodes of central abdominal pain are accompanied by acute headaches and migraine symptoms such as hypersensitivity to light and sound, vomiting, and nausea. 

Abdominal migraine is more common among children and seldom diagnosed in adults.

5. Hemiplegic Migraine

Hemiplegic migraine is a rare migraine that causes weakness on one side of the body as part of the aura. This can also include vision problems, tingling, numbness, fever, or fatigue. The weakness usually starts in the hands and can spread to the arms and face. 

The weakness can switch between body sides and in rare cases, both sides of the body can be weak. Motor weakness is the main characteristic of hemiplegic migraine. The condition oftenruns in the family.

6. Menstrual Migraine

Some women get migraines around the time of their period. These women also tend to get migraines at other times of the month. In addition to pulsating pain on one side of the head, the migraine may present without aura symptoms, but with nausea, vomiting, and hypersensitivity to sound and light.

Stages of a Migraine Attack

A migraine episode can occur in four distinct stages, but the four phases don't necessarily apply to every migraine attack.

1. Premonitory phase

This phase occurs up to 24 hours before the migraine. This phase is a warning that a migraine is on its way. If you are a migraine sufferer, you will be aware of these warning signs. 

They don't all occur at the same time, during every attack, or for everybody, and can include:

  • Puzzling mood changes
  • Hyperactivity and irritability
  • Sensitivity to light, sound, or smells
  • Food cravings
  • Incessant yawning
  • Stiffness of the neck
  • Constipation or diarrhea 
  • Fluid retention
  • Increased urination

2. Aura phase

Auras refers to sensory disturbances that individuals experience before or during migraines. Auras include visual, motor, and sensory phenomena.

a. Visual Auras

These present in one or both eyes:

  • Circling or flashing lights
  • Blind spots that obscure vision
  • Zigzagging lines
  • Blurred vision

b. Sensory Auras 

A sensory aura starts as a tingling or numbness in one arm that moves up the arm, spreading to one side of the face.

c. Motor Auras

Motor auras refer to symptoms that affect cognitive ability and may include slurred speech, difficulty in understanding others, and writing or thinking clearly.

3. Headache phase

This is when the headache itself starts. It can be mild and bearable, gradually getting worse. But it can also be excruciating from the start. 

This phase can be debilitating. The person may only be able to lie down in a dark and quiet room, as noise, light, and activities make the pain worse. Often, the person can't stand any smells, and extreme nausea is common.

4. Postdrome phase

This phase starts when the headache subsides. The headache may be gone, but the person does not recover completely, feeling exhausted, confused, lethargic, and generally unable to resume normal activities for some hours or even days.

Diagnosis

The first step is usually to visit your primary care doctor. Your doctor will gather as much information about your medical history as possible, and will also ask you about the presence of migraine in your family.

The exam will include checking your reflexes, testing your short-term memory, taking your blood pressure and pulse, and examining your head, shoulders, and neck.

Your doctor will diagnose migraine if, in addition to several headache episodes, your headaches

  • Are mostly on one side of your head
  • Are moderate to severe with a throbbing sensation, and 
  • Feel worse when you move about.
  • Make you nauseous
  • Intensify your sensitivity to light and sound

If your doctor suspects that your symptoms are not due to migraine, you may need to see a neurologist for further tests.

These tests may involve an MRI (magnetic resonance imaging) and a CT (computed tomography) scan to find the reasons behind your headaches. The pain could be the result of other factors, such as a brain aneurysm or tumor. 

At the same time, blood tests will help to identify other conditions that may be causing the pain and other symptoms. These tests don't prove or disprove that you have migraine; they pinpoint or rule out other causes of the pain.

Now, all this describes how you may be suffering from migraine. But, it doesn’t answer why you’re suffering. Say, 

What Causes Migraines?

Like I said, migraine is more than a headache. One of the reasons is that we still don’t know the exact cause of migraine. The condition is often linked to genetics. It’s because the risk of migraine is aboutthree times higher for those who have relatives suffering from migraines than otherwise. 

But we’ve figured out that migraine, only these too vary among individuals.  

Here is alist of factors that might trigger an episode: 

  • Stress 
  • Hormonal changes during menstruation, ovulation, and pregnancy 
  • Skipped meals 
  • Weather changes 
  • Excessive or insufficient sleep 
  • Odors 
  • Neck pain 
  • Exposure to lights
  • Alcohol ingestion 
  • Smoking 
  • Sleeping late
  • Heat 
  • Food
  • Strenuous exercise 
  • Sexual activity 

Treatment

Since migraine triggers vary for individuals, the first step to treatment would be identifying your personal triggers and avoiding them. It’s because once a migraine attack hits you; all you can do is wait out the pain or take some painkillers until it runs its due course.  

But there are ways to avoid most migraine attacks and some tips can help you identify aura and how to avoid it. Currently, there’s no precise treatment but you can:

  • Take medication to handle the pain when an episode occurs
  • Try to pinpoint what triggers a migraine and learn to avoid them
  • Try alternative migraine remedies
  • Take supplements
  • Pay attention to your lifestyle and what you eat - jot it down so you know exactly what you did to cause migraine and make some lifestyle changes accordingly.

You can also check out Practical tips on how to deal with migraine here.

Conclusion

Migraines are like colds – these ailments have flummoxed the medical profession for decades. Nobody knows precisely what causes migraines, and there is no cure. Yet, it is a debilitating condition that affects millions of people every day.

What makes migraines so frustrating is the difficulty of pinpointing migraine triggers. Migraine is a genetic neurological disease that has no cure. Maybe the best you can do is to inform yourself of the common migraine triggers and to avoid them.