Key takeaways
Migraine is a neurological condition that typically causes painful headaches that occur with additional symptoms, such as sensitivity to light, sound, smell, or touch.
Most migraine episodes last 4 to 72 hours without treatment. Some rare complications of migraine can cause symptoms that last longer.
The diagnosis of migraine is determined based on clinical history, reported symptoms, and by ruling out other causes.
More than just the cause of “really bad headaches,” migraine is a neurological condition that can cause multiple symptoms. While intense, debilitating headaches frequently characterize it, additional symptoms may include:
nausea
vomiting
difficulty speaking
numbness or tingling
sensitivity to light and sound
The condition often runs in families and can affect all ages. People assigned female at birth are more likely than people assigned male at birth to be diagnosed with migraine.
The diagnosis of migraine is determined based on clinical history, reported symptoms, and by ruling out other causes. The most common categories of migraine headaches (or attacks) are episodic versus chronic, and then those without aura and those with aura.
People describe migraine pain as:
pulsating
throbbing
perforating
pounding
debilitating
It can also feel like a severe, dull, steady ache. The pain may start out as mild. But without treatment, it can become moderate to severe.
Migraine pain most commonly affects the forehead area. It’s
usually on one side of the head
but can occur on both sides or shift.
Children are
to experience migraine on both sides of the head.
Migraine symptoms may vary depending on the type of migraine you experience. They also vary depending on which
you’re in:
Prodrome: Symptoms may begin
before the headache itself. You may experience food cravings, changes in mood or energy, and neck stiffness, among other symptoms.
Aura: About
of people with migraine experience
as part of an attack. These are sensory symptoms (most often visual) that can last
.
Headache: Most people experience head pain that can be severe and can last for hours to days. During this phase, people also experience increased sensitivity to light and sounds, nausea, and dizziness.
Postdrome: During this phase, you may experience changes in mood, difficulty concentrating, and exhaustion. A mild, dull headache may persist.
The duration and intensity of these phases can vary in different people. Not everyone experiences all the phases. In some cases, an attack can occur without a headache.
Migraine nausea
Many people experience
as a symptom of migraine. Many also vomit. These symptoms may start at the same time as the attack. However, they usually start about an hour after the headache pain begins.
If you only have nausea, you may be able to take your usual migraine medications. Vomiting, though, can prevent you from being able to take pills or keep them in your body long enough to be absorbed.
A doctor may suggest taking anti-nausea or
to help prevent vomiting and improve nausea.
Researchers haven’t identified a definitive cause for migraine. But experts believe a combination of genetics, hormones, and irregular brain activity all play a role. These factors likely contribute to affecting nerve signaling, chemicals, and blood vessels in the brain.
of people with migraine report that something triggers their migraine attacks. These could be things in their diet, changes in their environment, or other events.
While migraine triggers can be very personal, commonly reported triggers
:
bright lights
severe heat, or other
changes in
in people assigned female at birth, like estrogen and progesterone fluctuations during
,
, or
excess
loud sounds
skipping meals
changes in sleep patterns
use of certain medications, like
or nitroglycerin
unusual smells
traveling
If you experience a migraine attack, a doctor may ask you to keep a headache journal. Writing down what you were doing, what foods you ate, and what medications you took before your migraine attack began can help identify your triggers.
There’s no cure for migraine, but a doctor can help provide you with the tools you need to manage the condition. These may include lifestyle adjustments and medications to reduce the frequency of attacks and treat symptoms when they occur.
Your treatment plan depends on:
your age
how often you have migraine attacks
the type of migraine you have
how severe they are — based on how long they last, how much pain you have, and how often they keep you from going to school or work
whether they include nausea or vomiting, as well as other symptoms
other health conditions you may have and other medications you may take
Your treatment plan may consist of a combination of:
lifestyle adjustments, including
and
over-the-counter and prescription medications
neuromodulation devices
hormone therapy if migraine attacks seem to occur
in relation to your menstrual cycle
alternative care, which may include
, acupressure, or
counseling
Preventive migraine medications
If you have several migraine attacks a month,
can help reduce the frequency. These may be pills you take daily or
you receive every few months. Options include:
, like propranolol
anticonvulsants, like valproate (Depakote) and topimarate (Topamax)
antidepressants, like
and
injections
calcitonin gene-related peptide (CGRP) antagonists
, like erenumab (Aimovig) and fremanezumab (Ajovy)
Abortive migraine medications
Once symptoms begin, you may be able to get relief from
, including:
over-the-counter pain relievers
like
nonsteroidal anti-inflammatory drugs (NSAIDs)
or acetaminophen (
)
, like
(Imirex), eletriptan (Relpax), and rizatriptan (Maxalt)
gepants, like ubrogepant (Ubrelvy) and rimegepant (Nurtec ODT), are an oral form of anti-CGRP medication
ergot alkaloids, like
, though these are older medications
antiemetics, like
, chlorpromazine, and prochlorperazine, to help decrease nausea
Neuromodulation devices
If traditional treatments don’t work, a doctor may recommend
to treat migraine by either increasing or decreasing nervous system activity. Depending on the type, these may work as either preventive or abortive medications. Current options approved by the Food and Drug Administration (FDA) include:
single-pulse transcranial magnetic stimulator, a handheld device that produces a magnetic impulse that affects electrical signaling in the brain
transcutaneous vagus nerve stimulator, a small, noninvasive tool that targets the vagus nerve in the neck via electrical stimulation
transcutaneous supraorbital neurostimulator, a device that simulates the supraorbital nerves with electrical stimulation
multi-channel brain neuromodulation system, a headset that can target multiple nerves in the head
Talk with your doctor about the best neuromodulation treatment for you and your specific type of migraine.
You can try a few things at home that may also help remedy the pain from migraine:
Lie down in a quiet, dark room.
Massage your scalp or temples.
Place a cold cloth over your forehead or behind your neck.
Migraine without aura: This is the most common type. It’s also known as “common migraine.”
Migraine with aura: Also known as “classical migraine,” about one-quarter of people have
. Each aura symptom may last up to 60 minutes. Visual auras are most common, but people may also experience sensory, speech, or motor symptoms.
Migraine with brainstem aura (MBA): Commonly known as “
,” the aura phase features symptoms like vertigo, slurred speech, and tinnitus. However, motor symptoms are absent.
Hemiplegic migraine: Unlike MBA, this rare migraine type features motor weakness along with other brainstem symptoms. The motor symptoms may last up to 72 hours. This type can often
.
Retinal migraine: In retinal migraine, you experience visual disturbances in one eye for
prior to the onset of a headache. Some people use the term “
” to refer to any migraine that causes visual symptoms, which can include retinal migraine or migraine with aura.
Silent migraine: The IHS officially calls this “
,” which accurately describes the symptoms. According to the American Migraine Foundation,
may be more common in people who start getting migraine
.
Vestibular migraine: This term doesn’t necessarily refer to a type of migraine but more to
vertigo that occurs with migraine
. Vertigo is a sensation that the world is spinning around you.
Abdominal migraine: Unlike typical migraine, abdominal migraine affects your abdomen rather than your head. It
affects children.
Some people living with migraine have more than one type of migraine.
Doctors diagnose migraine by listening to your symptoms, taking a thorough medical and family history, and performing a physical exam to rule out other potential causes.
Imaging scans, like a
or
, can rule out other causes, including:
abnormal brain structures
If a doctor diagnoses you with migraine, a few may help you prevent a migraine attack. Some may work better for you than others:
Learn the foods, smells, and situations that trigger your migraine attacks and avoid them when possible.
. Dehydration can lead to both dizziness and headaches.
Avoid skipping meals when possible.
Focus on
. A good night’s sleep is important for overall health.
.
Make it a priority to
.
Invest time and energy in developing
.
.
Children can have many of the same types of migraine as adults.
Until they’re older teens, children may be
to have symptoms on both sides of the head. It’s rare for children to have headache pain in the back of the head. Their migraine attacks tend to last
.
Some migraine variants, like
, are more common in children. Children who have abdominal migraine are
to develop more typical migraine symptoms as adults.
For some pregnant people, migraine attacks improve during pregnancy but
due to sudden hormonal shifts.
Migraine attacks during pregnancy need special attention to make sure that the cause of the attack is understood. A 2022 study linked migraine attacks with a
higher chance of adverse pregnancy outcomes, such as
and
.
Certain migraine medications, including aspirin,
during pregnancy. If you have migraine during pregnancy, work with your doctor to find ways to treat your migraine that won’t harm your developing baby.
The frequent and recurring use of migraine medication can sometimes cause
(previously called rebound headaches).
When determining how to manage migraine, talk with a doctor about the frequency of your medication intake. Also, make sure to discuss alternatives to medications.
Migraine and tension headaches, the most common type of headaches, share some similar symptoms. But migraine may feature many symptoms not seen with tension headaches. Migraine and tension headaches may also respond differently to the same treatments.
Both tension headaches and migraine can have:
mild to moderate pain
a steady ache
pain on both sides of the head
Only migraine can have these symptoms:
severe, debilitating pain
pounding or throbbing
an inability to do your usual activities
pain on one side of the head
nausea with or without vomiting
an aura
sensitivity to light, sound, or both
Sometimes, the symptoms of migraine can mimic those of a
. It’s important to seek immediate medical attention if you or a loved one has a headache that:
causes slurred speech or drooping on one side of the face
causes new leg or arm weakness
comes on very suddenly and severely with no lead-in symptoms or warning
occurs with a fever, neck stiffness, confusion, seizure, double vision, weakness, numbness, or difficulty speaking
has an aura where the symptoms last longer than an hour
is accompanied by loss of consciousness
If headaches are getting in the way of your daily life, and you’re unsure if they’re a migraine symptom, it’s important to talk with a doctor. Headaches can be a sign of other issues, and while migraine can feel debilitating at times, treatments are available.
The sooner you start to talk about your symptoms, the sooner a doctor can get you on a treatment plan that may include medication and lifestyle changes.