Migraine

Symptoms of a migraine 

The main symptom of a migraine is usually an intense headache on one side of the head.

The pain is usually a moderate or severe throbbing sensation. This sensation gets worse when you move. It can prevent you from carrying out normal activities.

In some cases, the pain can occur on both sides of your head (more usually in children than in adults) and may affect your face or neck.

Additional symptoms 

Other symptoms commonly associated with a migraine include:

• nausea
• vomiting
• increased sensitivity to light and sound – which is why many people with a migraine want to rest in a quiet, dark room

Some people also occasionally experience other symptoms, including:

• sweating
• poor concentration
• feeling very hot or very cold
• abdominal (tummy) pain
• diarrhoea

Not everyone with a migraine experiences these additional symptoms. Some people may experience them without having a headache.

The symptoms of a migraine usually last between four hours and three days. You may feel very tired for up to a week afterwards.

Symptoms of aura 

About one in three people with migraines have temporary warning symptoms, known as an aura, before a migraine. These include:

• visual problems – such as seeing flashing lights, zig-zag patterns or blind spots
• numbness or a tingling sensation like pins and needles–which usually starts in one hand and moves up your arm before affecting your face, lips and tongue
• feeling dizzy or off balance
• difficulty speaking
• loss of consciousness – although this is unusual

Aura symptoms typically:

• develop over the course of about five minutes
• last for up to an hour

Some people may experience an aura followed by only a mild headache or no headache at all.

Types of migraine 

There are several types of migraine, including:

• migraine without aura – the most common type, where the migraine occurs without the specific warning signs
• migraine with aura – where there are specific warning signs, just before the migraine begins (see above)
• migraine aura without headache, also known as silent migraine – where an aura or other migraine symptoms are experienced, but a headache doesn't develop

Some people have migraines often, up to several times a week. Other people only have a migraine occasionally. It's possible for years to pass between migraine attacks.

When to seek medical advice 

You should see your GP if you have frequent or severe migraine symptoms that can't be managed with occasional use of over-the-counter painkillers, such as paracetamol.

 Be careful not to take too many painkillers as this could make it harder to treat headaches over time.

You should also make an appointment to see your GP if you have frequent migraines (on more than five days a month), even if they can be controlled with medication.

This is because you may benefit from preventative treatment.

You should call 999 for an ambulance immediately if you or someone you're with experiences:

• paralysis or weakness in one or both arms and/or one side of the face
• slurred or garbled speech
• a sudden agonising headache resulting in a blinding pain unlike anything experienced before
• headache along with a high temperature (fever), stiff neck, mental confusion, seizures, double vision and a rash
• reduced consciousness
• loss of vision in one eye

These symptoms may be a sign of a more serious condition, such as a stroke or meningitis. They should be assessed by a doctor as soon as possible.

Causes of migraines 

The exact cause of migraines is unknown, although they're thought to be the result of temporary changes in the chemicals, nerves and blood vessels in the brain.

Around half of all people who experience migraines also have a close relative with the condition. This suggests that genes may play a role.

In women, the average age of having migraines for the first time is 18 years old, and in men, it is 14 years old. Women are three times more likely to suffer with migraines as men.

Some people find migraine attacks are associated with certain triggers, which can include:

• starting their period
• stress
• tiredness
• certain foods or drinks

Diagnosing migraines 

There's no specific test to diagnose migraines.

For an accurate diagnosis to be made, your GP must identify a pattern of recurring headaches along with the associated symptoms.

Migraines can be unpredictable, sometimes occurring without the other symptoms. Obtaining an accurate diagnosis can sometimes take time.

Treating migraines 

There's no cure for migraines. A number of treatments are available to help reduce the symptoms.

These include:

• painkillers – including over-the-counter medications such as paracetamol and ibuprofen

Your GP will discuss treatment with you, and may prescribe the following types of medication, if needed, for use during a migraine attack;

• triptans – medications that can help reverse the changes in the brain that may cause migraines
• anti-emetics – medications often used to reduce nausea and vomiting

During an attack, many people find that sleeping or lying in a darkened room can also help.

Preventing migraines 

If you suspect a specific trigger is causing your migraines, such as stress or a certain type of food, avoiding this trigger may help reduce your risk of experiencing migraines.

It may also help to maintain a generally healthy lifestyle, including:

• regular exercise, sleep and meals,
• staying well hydrated
• limiting your intake of caffeine and alcohol

Your GP may prescribe medication to help prevent migraine attacks if:

• your migraines are severe
• you've tried avoiding possible triggers and are still experiencing symptoms

It may take several weeks before your migraine symptoms begin to improve after starting preventative medication.

Outlook 

Migraines can severely affect your quality of life. They can stop you carrying out your normal daily activities. Some people find they need to stay in bed for days at a time.

A number of effective treatments are available to reduce the symptoms and prevent further attacks (see treatment section above).

Migraine attacks can sometimes get worse over time. But research has suggested, for up to four in every five people suffering migraines, they will tend to gradually improve, or stop completely over several years. For one in five, they may get worse.

• Find out more about migraines on the NHS website

More useful links

• How to use your health service