Migraine Headaches

What is a migraine headache?

This often severe, throbbing type
of headache is different from other types of headaches. Symptoms other than pain can
occur with a migraine headache. Nausea and vomiting, lightheadedness, sensitivity to
light (photophobia), and other visual changes are common. A migraine headache may last
from 4 to 72 hours.

Migraines are also unique in that
they have distinct phases. But not all people have each phase. The phases of a migraine
headache may include:

  • Premonition phase. A change in mood
    or behavior may occur hours or days before the headache.
  • Aura phase. About one-third of people
    who have migraine headaches describe having an unusual “feeling” or aura before the
    headache. The aura phase includes visual, sensory, or motor symptoms that occur just
    before the headache. Examples are hallucinations, numbness, changes in speech, visual
    changes, and muscle weakness. Migraine sufferers may or may not have an aura before
    the start of the headache.


  • Headache phase. This is the period
    during the actual headache. Throbbing pain occurs on one or both sides of the head.
    Sensitivity to light and motion is common. So, too, are depression, fatigue, and
  • Headache resolution phase. Pain
    lessens during this phase. But it may be replaced with fatigue, irritability, and
    trouble concentrating. Some people feel refreshed after an attack, while others do

Headaches are classified as with or without aura.

What causes migraine headaches?

Experts are not certain what causes a migraine headache. Many experts think an imbalance in brain chemicals, such as serotonin, and changes in nerve pathways are involved. Migraines may also run in families suggesting a genetic link.

What are the symptoms of migraine headaches?

These are the most common symptoms
of migraine headaches:

  • Throbbing, severe headache pain with a
    specific location either on one side or both
  • Nausea and vomiting
  • Lightheadedness
  • Sensitivity to light or sound
  • Visual changes, such as a flashing
    light or even lack of sight, for a short period of time
  • A change in mood or behavior hours or
    days before the headache
  • Depression, fatigue, or anxiety
  • Fatigue, irritability, and
    trouble concentrating as the headache goes away

These symptoms may look like other
health problems. Always see your healthcare provider for a diagnosis.

How are migraine headaches diagnosed?

Migraine headaches are diagnosed
based on your symptoms and a physical exam.

Tracking and sharing information
about your headache with your healthcare provider helps with the diagnosis. Write down
the following:

  • Time of day when your headaches
  • Specific location of your
  • How your headaches feel
  • How long your headaches last
  • Any changes in behavior or
  • Effect of changes in position or
    activities on the headache
  • Effect of headaches on sleep
  • Level of stress in your life
  • Details about any head trauma, either
    recently or in the past

If you have unusual symptoms or
the findings from your exam aren’t normal, your healthcare provider may want you to have
other tests or procedures. These can rule out underlying diseases or health problems.
These tests include:

  • Blood tests. Various blood chemistry
    and other lab tests may be used to check for underlying health problems.
  • Sinus X-rays. This X-ray checks for
    congestion or other problems linked to the headaches.
  • MRI. This test uses a combination of
    large magnets, radio waves, and a computer to make detailed images of organs and
  • CT scan. This test uses X-rays and
    computer technology to make images of the body or head. CT scans show more detail
    than standard X-rays.
  • Spinal tap (lumbar puncture). A
    special needle is placed into the lower back, into the spinal canal, which is the
    area around the spinal cord. The pressure in the spinal canal and brain can then be
    measured. A small amount of cerebrospinal fluid (CSF) can be removed and sent for
    testing to check if there is an infection or other problems. CSF is the fluid that
    surrounds the brain and spinal cord.