What is Migraine? 2023
What is Migraine? 2023
The International Classification of Headache Disorders Version 3 lists 2 common headache types. They are called “Primary Headaches” because they are part of normal human suffering and their cause is uncertain. High blood pressure is called “Primary Hypertension” in the same way.
The two Primary headache types are Tension-Type Headache (70% of headache) and Migraine (30% of headache). Less than 1% of all headaches are something else.
Most people live with their Tension-Type Headaches, but Migraine headaches are severe and disabling and they go see the doctor for them.
There is a need for a well thought out definition of what Migraine is for the general public.
Read my Mini Book on Migraine Here.
This is an article by Britt Talley Daniel MD, member of the American Academy of Neurology, migraine textbook author, podcaster, YouTube video producer, and blogger.
Migraine is a primary headache disorder with recurrent moderate to severe headaches which may be one sided, throbbing or pulsing, and associated with nausea, vomiting, sensitivity to light, or sound. As a general rule migraines last 4-72 hours. Migraine headaches are worsened by activity and the affected persons wants to lie down or sleep.
Related questions
Features of Migraine
Thirty percent of persons with Migraine have an aura or warning that comes with the headache, which is usually visual, but may be numbness on one side, or trouble speaking. Sometimes the aura comes with small or even no headache. This is called Migraine with aura.
Migraine attacks may also be generalized instead of being one-sided. They may be located in the temples or behind the eye, on one side. Sometimes they start in the back of the head on one side and then come forward into the front of the head, behind one eye.
Migraine and Tension Type Headaches are 99% of headaches that occur. Tension Type headaches are usually mild to moderate in intensity, bilateral (on both sides of the head), and in the back of the neck and shoulders, or the jaw.
What is the cause of Migraine headaches? Migraine is an inherited, genetic problem that runs through families. For women who have inherited the migraine gene a reduction in estrogen level which occurs during the fourth or last week of the cycle aggravates migraine attacks in 70% of women.
Does migraine start with their first teenage period for estrogen sensitive women? The start of menstruation is termed “menarche.” It may be the time of the first attack of migraine for many women.
Do migraine headaches recur? Migraine is a recurrent neurologic problem of attacks that come for no apparent reason or during menstruation for sensitive women.
What happens to women with menstrually related migraine during their cycle? Their headaches get worse 2 days before or 3 days after the onset of their menstrual bleeding.
What happens to estrogen sensitive migraine women during pregnancy? Migraine for these women usually improves during pregnancy, only to return as a monthly occurring event after the baby is born.
Does breastfeeding improve or worsen migraine attacks? Breast feeding usually defers migraine attacks.
Mother and child
Which is more severe Tension-Type headache or Migraine? Tension-Type headaches are described as “mild to moderate” headaches. On a scale of 1-10 Tension-Type headaches are less than 5. Migraines are described as “moderate to severe” headaches and are 5-10 in severity. Many migraine patients will tell me their headaches are “100,” indicating their extreme severity.
Read more about Tension-Type Headache. Check out my website article at www.doctormigraine.com. Please click here to read.
What is the behavior of people during a migraine attack? Migraine may cause severe, intense, life limiting headache. Migraine headaches put the patient to bed. Migraine headaches are disabling. Persons with Tension Type Headache are usually up and about—working, but Migraine patients are home in bed, missing work and school.
Migraine patient in bed
What happens to migraine headache occurrence with ageing? Migraine improves after menopause and with ageing. Study the graph below.
Prevalence of migraine, reference Dr. Richard Lipton
What is the duration of a migraine headache attack? According to the International Classification of Headache Disorders V 3, Migraine headaches may last from 4 to 72 hours, which is 3 days.
What is the difference between episodic and chronic migraine? Chronic Migraine is defined as 15 headache days a month, 8 of which have Migraine features—severe, one-sided, throbbing, disabling, with sensitivity to light, odors, sound, and nausea and vomiting.
Persons with headaches more than 2 times a week usually have Chronic Migraine. Episodic headaches are less than 8 headaches per month or usually less than 2 per week.
What is the pain of a migraine headache like? The pain of a Migraine headache may be “throbbing, pulsing, hot, severe, like a knife, like being hit in the head with a hammer.”
Are there sexual differences in occurrence of migraine? Migraine headaches occur in women 3 times more than in men. 25 % of women have migraine while 6 % of men have migraine.
How big of a problem are migraine headaches in the world? Migraine is the most frequent medical problem women have, more than overweight, hypertension, diabetes, or arthritis. 12% of the world population has migraine.
Does Migraine have lay names or other names that are used? Migraine has pseudonyms (false names) such as: sinus headache, hungry headache, menstrual headache, nocturnal headache, wake up headache barometric pressure headache, weekend, or holiday headache.
How does Medication Overuse Headache relate to Chronic Migraine?
The usual cause of Chronic Migraine is over treatment. Persons who take Aspirin, Triptans, NSAIDS, Tylenol, Opioid Narcotics, or Barbiturate drugs more than 2 days a week are very liable to develop Chronic Migraine.
Persons who take Aspirin, NSAIDs, caffeine, or Tylenol more than 15 days per month may develop Medication Overuse Headache.
Using Opioid narcotics, Triptans, or Barbiturate drugs more than 10 days per month may result in Medication Overuse Headache.
What are Migraine triggers?
Migraine triggers are life issues that set off or kindle Migraine headaches.
Migraine triggers are:
Stress
Freedom from stress
Estrogen drop which occurs the 3rd week of the normal menstrual cycle
Estrogen based birth control pills or estrogen patches or estrogen intramuscular injections
Sleeping too little
Sleeping too much
Barometric pressure change
Dieting or missing meals.
Please read other related blog articles at www.doctormigraine.com.
Articles on triptans, CGRP drugs, Ajovy, Emgality, Aimovig
Migraine Comorbidities
Migraine Triggers
GammaCore Migraine treatment
Exercise and Migraine
CGRP preventive therapy drugs
Exercise and Migraine
Migraine Comorbidities
The Migraine Timing Cycle
Acute Migraine Treatment
Check out my Big Book on Migraine Here.
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All the best.
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Britt Talley Daniel MD