Conditions guide
Migraine
Migraine is a common neurological condition that causes repeated attacks of moderate to severe headache, often with nausea and sensitivity to light and sound. It is more than an ordinary headache and can interfere with daily life during an attack.
At a Glance
- Migraine is a neurological condition, not just a bad headache.
- Attacks often cause throbbing pain on one side of the head that can last from hours to a few days.
- Some people have an aura, such as visual changes, before or during the headache.
- Migraine is more common in women and often runs in families.
- Diagnosis is usually based on the history of symptoms and a physical and neurological exam.
- Treatment generally includes medicines for attacks, preventive approaches, and identifying triggers.
What It Is
Migraine is a type of primary headache disorder, meaning the headache is the main condition rather than a sign of another illness. Researchers believe it involves changes in how nerves, chemical messengers, and blood vessels in the brain interact, along with genetic factors that make some people more prone to attacks.
A migraine attack can unfold in phases. Some people notice early warning signs (the prodrome) such as yawning, mood changes, or food cravings a day or two before. An aura may follow, then the headache phase, and finally a recovery period (the postdrome) when people often feel drained or foggy.
Migraine is described as episodic when headaches happen on fewer than 15 days a month, and chronic when headaches occur on 15 or more days a month for more than three months, with migraine features on at least eight of those days.
Common Terminology
- Aura
- Temporary nervous system symptoms, most often visual changes such as flashing lights, zigzag lines, or blind spots, that usually develop gradually and last under an hour.
- Prodrome
- The early phase that can begin hours to days before a migraine, with signs like fatigue, neck stiffness, irritability, or food cravings.
- Postdrome
- The period after the headache eases, sometimes described as a migraine hangover, with tiredness or trouble concentrating.
- Trigger
- A factor that may make an attack more likely in some people, such as stress, missed meals, or poor sleep.
- Chronic migraine
- Headache on 15 or more days a month for over three months, with migraine features on at least eight of those days.
- Medication overuse headache
- Frequent headaches that can develop when pain relief medicines are used very often over a long period.
- Photophobia
- Increased sensitivity to light, a common feature during migraine attacks.
Common Causes and Associations
The exact cause of migraine is not fully understood. Genetics plays a strong role, and certain factors are commonly linked with attacks.
- A family history of migraine is one of the strongest known risk factors.
- Hormonal changes, such as those around menstrual periods, pregnancy, or menopause, are associated with attacks in many women.
- Emotional stress, or the let-down period after stress, is a frequently reported trigger.
- Changes in sleep, such as too little sleep, too much sleep, or jet lag, can be linked with attacks.
- Skipped meals, dehydration, alcohol (especially red wine), and changes in caffeine intake are commonly mentioned triggers.
- Sensory factors like bright or flickering lights, loud sounds, and strong smells may trigger attacks in some people.
- Weather changes and changes in barometric pressure are reported by some people with migraine.
Symptoms and Features
The following is a general description of how migraine commonly presents, not a diagnostic checklist. Symptoms vary from person to person and from attack to attack.
- Moderate to severe head pain, often throbbing or pulsing, frequently on one side but sometimes on both.
- Pain that tends to get worse with routine physical activity such as climbing stairs.
- Nausea, and sometimes vomiting, during the attack.
- Sensitivity to light, sound, and sometimes smells.
- Visual aura, such as shimmering lights or zigzag patterns, or less commonly tingling, numbness, or speech changes.
- Attacks that commonly last from about 4 hours to 3 days if not treated.
- Fatigue, difficulty concentrating, or low mood before or after the headache.
Tests and Evaluation
There is no single test that confirms migraine. Clinicians generally rely on the pattern of symptoms and an examination.
- A detailed history, including how often headaches occur, how long they last, what they feel like, and any associated symptoms.
- A headache diary may be used to track attacks, possible triggers, and medicine use over time.
- A physical and neurological exam to check reflexes, strength, coordination, vision, and sensation.
- Brain imaging, such as an MRI or CT scan, is not routine but may be considered when symptoms are unusual or suggest another cause.
- Blood tests or other studies are sometimes used to look for other conditions that can cause headaches.
Treatment Overview
Migraine treatment is usually tailored by a clinician and generally falls into two groups: treating attacks when they happen and reducing how often they occur.
- Acute (rescue) treatments aim to stop or ease an attack and may include over-the-counter pain relievers, triptans, gepants, or anti-nausea medicines.
- Preventive treatments are sometimes considered for frequent or disabling attacks and include certain blood pressure medicines, antidepressants, anti-seizure medicines, CGRP-targeting medicines, and Botox injections for chronic migraine.
- Lifestyle approaches often discussed include regular sleep, regular meals, staying hydrated, physical activity, and stress management.
- Identifying and, where possible, avoiding personal triggers is a common part of management.
- Resting in a dark, quiet room and applying a cool compress are comfort measures many people use during attacks.
- Clinicians often monitor how frequently pain relievers are used because frequent use can lead to medication overuse headache.
- Some non-drug options, such as certain neuromodulation devices, biofeedback, and cognitive behavioral therapy, are also used.
When Professional Care May Be Discussed
Health organizations generally describe certain headache features as reasons for medical evaluation. A sudden, extremely severe headache, often described as the worst headache of one's life, is generally treated as a medical emergency; in the US, people are advised to call 911.
- Headaches that are new, changing in pattern, or becoming more frequent or severe are commonly discussed with a healthcare professional.
- Headache with fever, stiff neck, confusion, or a rash is generally considered to need urgent medical attention.
- Headache with weakness, numbness, drooping of the face, trouble speaking, or vision loss can be a sign of stroke and is generally treated as an emergency.
- Headache after a head injury is generally evaluated promptly.
- Aura symptoms that last longer than an hour or are unlike previous auras are typically discussed with a clinician.
- Headaches that interfere with work, school, or daily life, or that require frequent use of pain relievers, are often reviewed with a clinician.
Questions to Ask a Healthcare Professional
General questions people often find useful to bring to an appointment:
- What features of a headache help tell migraine apart from other types of headache?
- Is a headache diary useful, and what details are most helpful to record?
- When are imaging tests like an MRI generally considered for headaches?
- What is the difference between acute and preventive migraine treatments?
- How does medication overuse headache develop, and how is it usually managed?
- How might hormones, sleep, or diet relate to migraine attacks?
- What headache symptoms are considered warning signs that need urgent care?
Sources
This guide was written in plain language from the following authoritative references.
Last updated October 8, 2026. FreeDoc guides are general educational information and are not a substitute for care from a qualified professional.