What are Typical Migraine Symptoms? 2023
Pain in the head is universally thought to be a concerning, very bothersome problem. Most headaches, 99%, in fact are either Tension Type Headache (70%) or Migraine (30%). Only about 1 % of headaches are something else.
Many persons are moderately and some are severely disabled by headaches and these are usually persons with Migraine, because Migraine is more severe and has nausea and the need to lie down while Tension Type Headache is just mild to moderate tight, pressure headaches.
Many persons don’t recognize a definite diagnosis for their headaches. They think “It’s just a headache.”
Many persons mistakenly think they just have tension type headaches and the purpose of this article is to explain what Migraine Symptoms are so that they may know. Hopefully they will have the diagnosis confirmed by a neurologist and negative testing.
Read my Mini Book on Migraine Here.
This is an article by Britt Talley Daniel MD, retired member of the American Academy of Neurology, the American Headache Society, migraine textbook author, podcaster, YouTube video producer, and blogger.
Migraine is a problem of repetitive moderate to severe headache which may be one-sided, throbbing or pulsating, and last from 4 to 72 hours. Along with the headache there may be nausea, vomiting, and sensitivity to light, sound, and smell. Migraine is found in 12% of the world population, being more prevalent in women (25%) than men (6%).
The pain of the headache is made worse by activity so that many persons have to lie down and rest or sleep. About 30% of persons with Migraine may have a visual aura.
Sometimes the aura may come with no headache, especially at the ages of 50 to 70 years old. This is called Migraine sine Migraine, acephalic Migraine, or Silent Migraine.
Other rare migraine with aura symptoms are numbness on one side of the body, usually involving the fingers-hand-arm-cheek and then tongue on one side. Some persons have trouble speaking normally and can’t produce words or mix up words.
Related questions.
What is the cause of Migraine?
Migraine is thought to be due to mixed genetic and familial factors. Certain genes for migraine have been isolated but Migraine is a complicated, multi-genetic medical problem.
What is the pathophysiology of Migraine?
This is not completely understood but during a migraine the Trigeminal nerve is activated causing the ganglia of the Trigeminal nerve and the cerebral artery to release 3 inflammatory neurochemicals—Neurokinan A, Substance P, and CGRP.
These neurochemicals cause the cerebral arteries to dilate and then cause inflammation of the thalamus, the human brain pain center. These chemicals last in the brain 4-72 hours and then drain down into the abdomen to the liver where they are metabolized and next are eliminated from the body in the toilet.
The Migraine Timing Cycle
Why do women have more migraines than men?
Part of the reason has to do with estrogen which female ovaries start to secrete during menarche, the name of the timing of the first menstrual cycle, which occurs between the ages of 10-16. The withdrawal of estrogen during the 3rd week of the female cycle sets off a migraine headache in susceptible women.
Read my article, “Estrogen Associated Migraine,” on my website, www.doctormigraine.com. Please click here to read.
When is Migraine at its worst?
The worst time for Migraine headaches is during female middle-age.
When does Migraine get better?
Migraine usually improves after menopause and age fifty to sixty.
What does the man or woman on the street erroneously call Migraine?
Migraine has pseudonyms or false names that are used which prevents many persons from understanding that the headaches they have are really migraine.
These false names are: sinus headache, menstrual headache, hungry headache, nocturnal headache, one-sided headache, holiday headache or letdown headache, or barometric pressure headache.
What are one-sided Migraine headaches like?
The most common of all Migraine symptoms is that it may be one-sided. Headache with a migraine may be one-sided or generalized and is often in the front of the head in the temple or behind the eyes but sometimes they start in the back of the head and move forward to be behind one eye.
Severe left sided Migraine
How bad do Migraine Headaches get?
Considering pain could be quantified on a scale of 1-10, migraine headaches are usually over 5 and commonly 8-10.
Migraines can last 72 hours?
A single episode of migraine may last 4-72 hours but headaches lasting longer than that are usually caused by overtreatment and the common drugs used for overtreatment are: caffeine, Tylenol, Advil, Aleve, NSAIDS, opiate narcotics, butalbital headache drugs, or triptans.
In the migraine world over treatment may result from using one of the above drugs more than 2 days a week. The principal is that the stronger the drug, like a narcotic, the less amount of the drug is needed to cause daily headaches.
For instance, caffeine or Tylenol or Advil, NSAIDS, or so-called over-the-counter drugs, taken 15 days a month may give daily headaches to some migraine patients.
However, narcotics such as opiate-containing drugs, barbiturate drugs, or triptans may give daily headaches if taken only 10 days a month. This is called Medication Overuse Headache.
How many stages does a Migraine have?
A migraine lasting longer than 72 hours is termed status migrainosus. There are four possible phases to a migraine, although not all the phases are always experienced:
The prodrome, which occurs hours or days before the headache.
The aura, which usually comes before the headache.
The pain phase, also known as headache phase lasting 4-72 hours.
The postdrome, the effects experienced following the end of a migraine attack.
1.Prodrome phase
Prodromal or premonitory symptoms occur in about 60% of those with migraines and may come on from two hours to two days before the start of pain or the aura.
These symptoms may occur in those with either migraine with aura or migraine without aura
and include a wide variety of phenomena, such as:
altered mood
irritability
depression or euphoria
fatigue
craving for certain foods
stiff muscles (especially in the neck)
constipation or diarrhea
and sensitivity to smells or noise.
2.Aura phase
The Migraineur may see a blind spot (Negative scotoma) or Positive scotoma which may be a flickering, scintillating zig zag pattern of images near the center of vision.
Following the visual images there may be a tingling or pins and needles feeling in the fingers of one hand, then the hand, then the forearm, and then the same-side of the cheek or tongue area.
Following this, there may be trouble forming or finding words called aphasia, or dysphasia.
The auras last less than 60 minutes.
3.Pain phase
A typical migraine headache is one-sided, unilateral, throbbing, and moderate to severe in intensity. There may be a gradual onset to peak time of an hour or so. The patient feels worse with being up or physical activity. Commonly there may be neck pain associated with the Migraine which is on the same side in the back of the head as the pain in the front of the head if the pain is one-sided.
The pain phase comes with nausea (90%), vomiting (33%), sensitivity to light, sensitivity to sound, sensitivity to smells, fatigue and irritability.
Many persons want to lie down in a dark, quiet room. There may also be blurred vision, nasal stuffiness, diarrhea, frequent urination, pallor, or sweating. Scalp swelling or tenderness may occur. Elderly persons have fewer associated symptoms other than the headache and nausea.
4.Postdrome
The migraine postdrome may be:
A sore head, especially where the migraine was.
Impaired thinking for a few days.
Feeling tired or “hung over.”
Mood changes.
Gastrointestinal symptoms.
Some people feel unusually refreshed or euphoric after an attack, whereas others note depression and malaise.
Summary
Now that you know what a Migraine really is, get medical help and adequate treatment for your headaches from a primary care doctor, internal medicine doctor, or neurologist.
If over the counter drugs don’t work—see a doctor for that sinus headache which is really a Migraine.
Check out my Big Book on Migraine Here.
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All the best.
Britt Talley Daniel MD