A migraine is a common neurological condition that causes moderate to intense headaches. Other symptoms associated with migraines include general malaise, nausea, vomiting, burning or prickling throughout the body, and light sensitivity.

Migraines are more common in women, and although they can start to appear in childhood, migraines usually first emerge in adulthood. They can happen at any moment, but they are typically triggered by specific events, like sleeping poorly, having PMS or eating a certain food,

Migraine treatment is carried out by a family doctor or neurologist, who may prescribe medication to relieve discomfort or other related symptoms symptoms as well as prevent flare-ups. Relaxation techniques can also be beneficial for some patients, depending on the type of migraine and the severity of symptoms.

Main symptoms

The most common symptoms of a migraine are:

Intense headache
General malaise
Nausea and vomiting
Dizziness
Burning or prickling throughout the body
Sensitivity to light or noise

A migraine can last for several hours and worsens with activity. The pain can radiate to the face and neck, which can interfere with performance of daily, routine tasks.

Some people may present with signs of a migraine coming on, before it even happens. Read more about migraine symptoms and who is most at-risk do developing them.

These signs can appear 1 to 2 days before a flare-up. Although they can vary from person to person, generally these signs include specific food cravings, excessive fatigue with no apparent cause, irritability and neck stiffness.

Confirming a diagnosis

A migraine diagnosis can be confirmed by a neurologist, who will first assess your symptoms. The doctor will ask you questions about when they appear, how often you experience them, and what can make them worse. He or she may also assess your health history and perform a neurological examination.

The doctor may also evaluate the situations that seem to trigger migraine flare-ups, as well as any medications that you are taking or have taken in the past.

In some cases, the doctor may request an MRI, CT scan or even lumbar puncture if other health conditions with similar symptoms are suspected, like meningitis, cerebral aneurysm or intracranial hemorrhage.

Phases of a migraine flare-up

The majority of migraines occur in 4 phases:

1. Prodrome

This phase occurs 1 to 2 days before the first symptoms of a migraine. It can be identified by changes to energy level, mood, behavior and appetite.

2. Aura

It tends to emerge immediately before the headache (anywhere from 5 minutes to 60 minutes before). It is characterized by changes to vision, especially the appearance of a white fog in the vision field, as well as the appearance of flashing lights.

3. Attack

This is the acute phase of the migraine, in which the intense headache emerges followed by the other symptoms. This phase can last from 3 hours to 3 days.

4. Postdrome

This phase occurs when symptoms start to disappear. It is often described as a hangover, due to excessive fatigue that lasts for days.

Types of migraines

The main types of migraines are:

1. Migraine with an aura

A migraine with an aura is characterized by a migraine that presents with various symptoms several minutes before it actually appears. Although an aura can vary from person to person, some patients may report vision disturbances, like the presence of a white fog, or small flashes of light in your visual field.

In some cases, a migraine aura can occur without the other symptoms appearing. Read more about a migraine aura and how it can present.

2. Chronic migraines

A chronic migraine, or a migraine that lasts for longer than 15 days, is relatively rare.

Although it is not life-threatening, chronic migraines can seriously affect activities of daily living and quality of life. Therefore, treatment should be sought from a neurologist to help relieve symptoms.

3. Migraines during pregnancy

Pregnancy is characterized by significant hormone fluctuations, which can also trigger migraine flare-ups (particularly during the first trimester). Pregnancy-related migraines typically improve in the second trimester, and disappear completely by the third trimester.

4. Menstrual migraine

A menstrual migraine is a migraine that occurs up to 3 days before a period. It is triggered by changes to hormone levels which occur before menstruation. In addition to an intense headache, some other women may also experience PMS, increased fluid retention, irritability, gas and breast pain.

Read more about the different types of headaches and what can cause them.

Main causes

The exact origin of migraines is not well-known, however it is possible that migraines arise as a result of abnormal cerebral activity. This can affect the nervous system, as well as the activity of various neurotransmitters.

Although a precise cause does not exist, there are common situations that typically trigger flare-ups, like:

Mood changes
Changes in sleep pattern
Intense physical activity
Stress and anxiety
Dehydration
Prolonged use of medication
Rapid changes in weather

Certain foods also appear to be a factor that can contribute to the occurrence of migraines in some people. Foods that are most associated with migraines include pepper, coffee, alcohol, chocolate and citrus fruits.

Treatment options

There is no cure for migraines, however there are different types of treatment that can help to relieve symptoms, and reduce the length of a flare-up, like:

1. Migraine medications

The most commonly used medications to relieve symptoms and treat migraine flare-ups are:

Anti-inflammatories and analgesics, like acetaminophen or ibuprofen
Triptans, like naratriptan or zolmitriptan
Antiemetics, like metoclopramide
Corticosteroids, like prednisone or dexamethasone

These medications should always be prescribed by a neurologist, as the medication type and dosing will vary depending on symptoms and their severity.

In some cases, the doctor may indicate the use of medications to prevent the onset or at least reduce the frequency of migraine attacks.

2. Rest and relaxation techniques

Resting in a dark room with little stimuli is one of the best, most natural ways to help relieve symptoms. In addition, good sleep habits also help greatly with treatment.

Some people may experience a reduction in symptom intensity by using relaxation techniques (like meditation, yoga or massage).

3. Acupuncture

Some studies show that treatment of migraines with acupuncture (10 sessions over 5 to 8 weeks) can be a great way to relieve migraines.

4. Migraine diet

When experiencing a migraine, it is recommended that you eat foods that are easy to digest, contain anti-inflammatory properties and help with circulation. Some examples include fish, ginger or chestnuts.

It is also important to avoid foods that could trigger migraines, like coffee, tea with caffeine, processed foods and citrus fruits. Read more about the migraine diet and what to eat and avoid with a migraine.

5. Botox injection

Botox injections into the muscles around the head can be performed by a neurologist in cases where the person has migraines 15 or more days per month and/or that last for four or more hours per day.

This type of treatment can help prevent migraine flare-ups, especially in cases of chronic migraines that do not improve with preventive medications.

Natural treatment

Natural treatment for migraines is based around the use of medicinal plants for relief of symptoms or prevention of flare-ups. These plants can be consumed in the form of supplements (which have the best effect) or tea.

Some plants that are effective in treating migraines include ginger, valerian or tanacetum. Treatment should ideally be directed by a health care provider who specializes in herbal medicine, as treatments should be tailored to the symptoms you present with.

How to prevent migraines

Prophylactic medication is a very common way of preventing future, frequent migraines. Medication that is typically prescribed includes lisinopril, propranolol or topiramate. These medications should be prescribed by a neurologist, and can take up to 3 months to achieve a therapeutic effect.

Because many medications can have side-effects, the doctor may also recommend some lifestyle changes that can help with prevention of migraines:

Avoiding situations that trigger migraines
Partaking in regular exercise, at least 3 to 5 times per week, for 30 minutes
Ensuring adequate hydration by drinking plenty of water throughout the day
Having a healthy, balanced diet with minimal processed foods
Utilizing relaxation techniques like yoga or meditation
Sleeping at least 8 hours per night

In addition to this, there are new studies supporting alternative treatment options for migraines, use of Botox and vagal nerve stimulation. You should see a neurologist to determine which treatment plan would be best for you.