Migraine

Migraine is a neurological disorder that causes moderate-to-severe headaches. The pain often affects one side of the head, but can affect both. It is generally associated with nausea, light sensitivity and sound sensitivity. Other symptoms may include dizziness, vomiting, and difficulty thinking. In some cases, a migraine attack begins with a period of sensory disturbance known as an aura.

Some people experience occasional migraine attacks, while others develop chronic migraine with frequent headaches. Migraine frequency can increase over time. In some cases, frequent use of pain medications can make migraines worse and lead to medication overuse headache. Attacks are more likely to happen when changes occur in a person's daily routine. These triggers can include lack of sleep, disrupted sleep, skipped meals, and hormonal fluctuations.

Migraine is believed to result from a combination of genetic, environmental, and neurological factors that affect the activity of nerve cells and chemical signals in the brain. Migraine attacks are theorized to occur when the brain exceeds an individual's sensitivity threshold.

Migraine attacks have multiple phases. The initial phase of a migraine attack can start 48 hours before the main headache phase and may cause early warning symptoms. The subsequent pain phase of a migraine attack may be linked to increased activity in the pain pathway of the brain, with heightened blood flow and transmission of pain signals.

Managing migraine includes lifestyle changes to identify and manage possible triggers, and include stress management, improving sleep habits, eating regularly, and exercise. Treatment for acute mild to moderate attacks begins with over-the-counter pain relievers such as ibuprofen and paracetamol. Triptans are recommended as a first-line therapy for moderate to severe attacks. Gepants are also effective, and are used when triptans are ineffective or not suitable. Anti-nausea medications are used for migraine-related nausea. Several medications can help prevent migraines. These preventive medications include gepants, but also beta blockers, anticonvulsants and certain antidepressants. Opioids should not often be prescribed for migraine.

Approximately 14% (1.16 billion) of people worldwide are affected by migraine, making it the third-most disabling condition affecting the nervous system and one of the most common causes of disability. Women experience more and longer migraines than men do, and higher disability related to migraines, beginning in puberty. Migraines often start occurring after the first menstrual period, increasing in frequency over time, peaking during perimenopause, and tending to decrease following menopause. From age 30 to 50, up to four times as many women experience migraine attacks as men.