Migraine or migraine affects approximately 12% of the population. We explain the main characteristics of this disorder.
The exact cause of migraine is unknown at the moment, although there is great interest in discovering the mechanism of migraines. This is not only due to the suffering and disability that they cause in a large part of the population, but also because the economic impact of migraines is high. Migraines cause economic losses of around 27,000 million euros per year in the European community .
- You may also be interested in: “The 12 types of headaches (symptoms, causes and treatment)”
What is migraine?
Migraine is a disease for which we have medical records dating back to ancient Egypt, around 1200 BC. There are descriptions of migraines with auras in manuscripts from the Hippocratic school of medicine, from 200 BC. In the 17th century, trepanation, opening a hole in the patient’s skull to relieve their symptoms. Despite being known about for so long, the cause of migraines remains a mystery.
Modern research points to neural or circulatory disorders, in the brain area, as a possible explanation. There is also evidence that migraines have a genetic component, thanks to twin studies and the fact that if someone in our family has migraines, our own risk of suffering from them increases .
Genetic studies have not been able to find a single gene that causes migraines, but they have linked mutations in several different genes with a higher probability of suffering from them. This makes migraine a possible multifactorial polygenic disease, or what is the same, that several genetic and environmental elements are to blame for its appearance.
Symptoms
Although there are different types of migraine, which we will talk about later in the article, we can describe certain general characteristics of this disease. These do not have to occur in all cases , they are simply the most common symptoms, and they usually last from a few hours to several days:
- severe headache
- light sensitivity
- Nausea
- vomiting
- lethargy
It is also common for migraine to present phases of evolution throughout its attacks. Again, given the wide variety of ways in which migraine manifests, one or more of these phases may not occur:
1. The warning phase, or prodromal
In this phase, mild symptoms are described that “warn” of the proximity of the migraine attack , such as tiredness, the desire to eat sweet foods, strong emotional changes, sensation of thirst or stiff neck. These sensations can last from an hour to a whole day, before the attack moves on to the next phase.
2. The aural phase
Auras are described in the minority of migraine cases, depending on their type. They are neurological symptoms, which can last about an hour before the headache . Among others, the symptoms that are perceived during the aural phase can be visual, such as seeing points of darkness, light, colors or zigzag lines. Vertigo, tiredness, speech and hearing disorders, memory and emotional disorders may also occur…
In adults, the aural phase is prior to the headache, but in children it can occur simultaneously. It is also possible to experience aural symptoms without the typical migraine headache occurring.
3. The main phase, the headache
This is the phase whose symptoms we have previously described as the most common in the different types of migraine. The affected experience an intense headache, of variable severity, which worsens with movement. This headache is usually located on one side of the head, but it is not uncommon for the pain to spread to both sides as this phase progresses .
Nausea, vomiting, and sensitivity to noise or light may also be experienced in this phase.
4. The resolution of the attack
Most migraine attacks subside slowly without a climax, but sometimes the end of the headache is preceded by episodes of vomiting or loud crying. Sleeping can end the migraine attack in some cases, especially in children.
5. The postdromic or recovery phase
After the pain episode ends, patients may experience symptoms similar to those of an alcoholic hangover, which can last up to two days .
The symptoms of this phase can be the opposite of those in the warning phase (for example, if we felt very tired, we may feel full of energy. Or if we lost our appetite, we may find ourselves hungry). They usually consist of nausea, difficulty concentrating, tiredness, and muscle pain.
- It might help you to read this article: 10 effective ways to recover from a hangover
types of migraine
Some of the types of migraine, but not all, are:
1. Migraines without aura
The most common migraine, which represents between 70 and 90% of cases. This type of migraine does not experience the aural phase, and can last between 4 and 72 hours. The usual experience with this type of migraine is that of a headache located in one half of the head, of a pulsating type and that worsens with physical exertion. The frequency of these attacks is between a single attack per year and several weekly attacks.
2. Migraines with aura
Migraines with auras constitute between 10 and 30% of cases. Today it is believed that auras are caused by a disruption in the cerebral cortex, caused by vascular problems in the brain .
This process is known as cortical spreading depression (in English CSD for “cortical spreading depression”) and its study is giving hope to those affected by migraine, since it also seems that this process is related to the typical migraine headaches , being able to give them an explanation to later find a cure or relief from the disease.
3. Menstrual migraines
Although menstruation is usually one of the migraine triggers, there are people whose migraine attacks are strongly linked to menstruation . This is thought to be due to decreased levels of the hormone estrogen during your period, or increased levels of the hormone prostaglandin, also during your period.
Hormonal control therapies are currently being experimented with to palliate or eliminate the symptoms of menstrual migraines.
4. Hemiplegic migraine
A rare type of migraine, where the symptoms mainly affect one half of the body. Those who suffer from it may experience symptoms very similar to those of other migraines, but since they are located only in one of the halves of the body, they are often alarming due to their resemblance to the effects of a heart attack.
Possible causes
Currently, the cause of migraine is not known, although factors that make us more vulnerable to suffering from it are known. Some of these factors, as we have said before, are genetic. But there have also been studies that conclude that there are socioeconomic factors that make us more susceptible to migraines , according to which being in lower socioeconomic classes would make us more prone.
Regardless of the underlying cause, multiple triggers for migraine attacks have been described. These will vary from person to person, but include but are not limited to:
- Stress
- Lack of sleep
- excessive consumption of coffee
- Interruption of coffee consumption
- Hormonal changes
- Environmental changes (sound, light, humidity…)
- The chocolate
- The alcohol
- The cheese.
Migraines are also associated with cardiovascular diseases and psychiatric disorders, such as depression, anxiety or bipolar disorder. Although there is no cure, we can alleviate the symptoms with sound and visual isolation, rest, proper hydration and painkillers .
There are also indications that active living and healthy eating can decrease the frequency and intensity of migraine attacks.
Bibliographic references
- Kowalska, Marta et al. “Molecular factors in migraine.” Oncotarget.
- A. Zabala, H.(2019). Epidemiology and economic impact of migraine.
- Piane, Maria et al. (2007) “Genetics of migraine and pharmacogenomics: some considerations.” The journal of headache and pain vol. 8.6.
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.
