FAQs

The most common symptoms of a migraine attack are throbbing/stabbing/pounding pain that is either slow or sudden onset and which often begins on one side of the head or behind one eye. There might be visual and speech changes, nausea and/or vomiting, light, sound and/or odor sensitivity, and a need to lie down in a quiet, dark room. Migraine attacks generally last for 4 to 72 hours if left untreated, but in some situations they can last for weeks or even months. Migraine is considered to be a spectrum disorder. By that we mean that there is a wide variety of how it presents in terms of frequency, severity of pain, symptoms, age of onset, and responses to treatments.

Cluster headache attacks ramp up to severe pain quickly.  They are accompanied by autonomic symptoms such as red, water eye; congested, runny nose; forehead/facial sweating; eyelid swelling, droopy eye, contracted pupil, and/or restlessness.  The attacks are unilateral and typically last 15 min to 3 hours and occur at least every other day and can happen more than 8 times per day.

Prodrome:Often begins 24-48 hours before the attack phase.  The symptoms of prodrome can warn you an attack is coming. There is some current thought that the prodrome and aura phases do not necessarily come one after the other, and that not everyone appears necessarily to have both. Some of the most common symptoms in the prodrome stage include food cravings, fatigue, high energy, and mood changes.

Aura: Not everyone experiences this phase of migraine.  Aura can vary person to person and can include changes in vision, hearing loss or ringing in the ears, changes in speech pattern including aphasia, hypersensitive to touch, smell, sounds or light, hearing sounds or smelling odors that are not there, vertigo or dizziness or loss of feeling or inability to move a part of the body.  There is a rare type of aura called, Alice in Wonderland, where things seem larger or smaller than they actually are, and there is a distorted perception.

Attack:This part most commonly lasts 4-72 hours.  While it is possible to have migraine attacks without pain, most attacks include pain, which often begins unilaterally and then spread. Frequently the pain begins behind or above one eye, and it can be throbbing, pulsing, stabbing, or pounding. Other symptoms can include dizziness, nausea, vomiting, sensitivity to light/sound/odors, nasal congestion, exercise/movement intolerance, neck stiffness and/or pain, fatigue, speech, cognitive, and mood changes.

Postdrome: Often lasts 1-2 days.  Some patients will feel fatigued, others may feel euphoric. Many also experience what is often described as "brain fog."

Some of the most common migraine triggers are:

Weather-related: e.g. barometric pressure changes, humidity, bright sun, strong wind

Fragrances: perfume, cologne, scented personal care products, cigarette smoke, food scents.

Lighting: Fluorescent lights, flashing or flickering lights, bright lights

Noise: loud noises, sudden noises.

Sleep: Too little, too much, irregular sleep.

Food and drink: Alcohol, dehydration, MSG, matured cheeses, chocolate, caffeine (either too much or too little), & more.

Lifestyle: Stressful situations, lack of relaxation, exercise (either lack of or too much), travel.

Medical conditions: Sinusitis, neck and shoulder pain, sleep disorders, TMJ.

Hormones: Oral contraceptives (can help or trigger), puberty, menstrual cycle, pregnancy, perimenopause, menopause

Discovering your triggers can be a long, frustrating, and challenging experience. An experience that is often drawn out due to the everchanging nature of migraine. An experience made more complex due in part to the Prodrome portion of a migraine attack, where you might crave something and mistakenly then think it is a trigger because it is closely followed by the attack section. In addition, migraine triggers can stack, and not all triggers are the same. There is an app called, N1-Headache which can help you figure out your migraine triggers.

Determining how to manage your triggers can take a while to figure out. Here are some of the questions to consider:

• Do any of your triggers "stack" on top of each other and add to the likelihood of getting a migraine attack?
• What are the consequences of being exposed to a trigger in your life and in the lives of your loved ones?
• How easy is it to avoid or manage the trigger?

Once you know what your triggers are, it is important to discover a balance between avoiding them, minimizing them, and still living your life. For example, if scents are a big trigger for you, you may decide to isolate in order to avoid them; or... you may decide to wear a facemask to minimize the risk

This is the million dollar question! Despite a tremendous growth in research over the past few years, migraine still remainly largely misunderstood. We have been able to determine some of the pathways involved in migraine, but full understanding remains elusive. One thing we do know is that it is highly hereditary. If one parent have migraine then there is a 50% chance their child will inherit it. With two parents, the risk increases to 75!! However, not everyone with migraine has a family member with it and there appear to be other causes such as traumatic brain injury or even viruses.

As mentioned above, migraine is highly hereditary and if you have migraine then there is a 50% chance any of your children will inherit it. However, what we don't know is the level of severity, frequency of attacks, age of onset, and response to treatments. Many people first exhibit symptoms of migraine in childhood, but others start later in life such as after pregnancy. If you are a parent with migraine, be aware of any signs that your child(ren) might be having attacks. Sometimes migraine presents itself differently in your children, and you are your child's best advocate!

Medication overuse headache (MOH), also known as "rebound headaches," can happen when too much abortive medication (either over the counter or prescription) is used for migraine. The name seems to imply fault in the patient, but in fact MOH is due to a failure of treatment to provide appropriate relief both preventively and abortively.