What Are the First Signs of a Migraine?

The exact cause of migraines is still unknown. A combination of certain triggers, such as bright light, and weather changes.

A migraine is a type of severe headache that is often accompanied by nausea or vomiting. External influences and changes in the brain are thought to trigger a migraine, however, the exact cause is still unknown. Experiencing migraines is often inherited and passed on in the family (hereditary), suggesting a genetic component. 

Individuals with migraines are seen to be sensitive to light, sound, and smell. They usually describe the pain as severe throbbing and pulsating in nature (pain in a series of regular beats or rhythm) on one side of the head. According to the American Migraine Foundation (AMF), women are more likely to have migraines than men. 

The first sign of a migraine is severe eye pain associated with a dull headache. Migraines gradually worsen with physical activity. Below are a few other signs that are documented in individuals with migraine:

• Weakness
• Dizziness (spinning of surroundings)
• Vision disturbances
• Sensitivity to light, noise, and smells
• Nausea and vomiting, upset stomach, and belly pain
• Feeling very warm or cold

The exact cause of migraines is still unknown. A combination of certain triggers, such as bright light, and weather changes, along with the abnormal flow of blood to the brain can cause a migraine. Below are a few common causes that can trigger a migraine:

• Stress and fatigue 
• Change in the sleep cycle
• Foods such as aged cheese, alcohol, and food additives like nitrates and monosodium glutamate
• Skipping meals
• Menstrual periods
• Caffeine: Getting too much or withdrawing from it can cause headaches
• Changes in weather, storm fronts, strong winds, or changes in altitude

Migraine symptoms differ from person to person. Generally, migraine headaches last about four hours, but if severe, it can go on for more than three days. Some people may get migraines every few days, whereas others get them once or twice a year.

Aura refers to sensory disturbances, which include flashes of light, blind spots, and other vision changes with or without tingling/funny sensation on hand or face. Migraine with aura is a classic symptom of a migraine headache. 

Most migraines are with or without aura. Several hours before the migraine starts, the individual feels depressed or may have anxiety with or without tiredness. Common and rare types of migraines are:

• Migraine with aura: This is a classic migraine. An aura can start 15 minutes to one hour before the migraine.
• Migraine without aura: This is a common migraine, as the patient may develop severe pain on one side of the head.

Rare types of migraines include:

• Migraine with brainstem aura (silent migraine) 
  • Symptoms start suddenly. 
  • Symptoms may include speech disturbances, ringing in ears, vomiting, dizziness, confusion, or loss of balance just before the headache. 
  • This type of migraine is strongly linked to hormonal changes and mainly affects young adult women. 
• Hemiplegic migraine
  • Symptoms include a short period of paralysis or weakness on one side of the body with temporary numbness, dizziness, or vision changes. 
  • It is an emergency condition, hence the individual should get emergency help from a doctor.
• Ophthalmic migraine (retinal migraine) 
  • This migraine lasts for a few minutes. 
  • Symptoms include dull headache with partial or complete loss of vision in one eye, which may later spread to the rest of the head. 
  • Immediate medical help is necessary with persistent visual disturbances.
• Ophthalmoplegic migraine
  • This type of migraine is a medical emergency, as symptoms include pain around the eye, with paralysis of the muscles around it (droopy eyelid and vision changes). 
• Status migrainosus (chronic/severe migraine). 
  • This is a severe type that can last more than 72 hours. 
  • The pain and nausea are so intense that you may need to go to the hospital.

Sumatriptan is the drug of choice for treating migraine headaches, which would be prescribed by a doctor. Other drugs that help to relieve migraines include: 

• Pain relief and nausea medications: Over-the-counter drugs (acetaminophen, ondansetron, aspirin, caffeine, and ibuprofen) often work well for some people. 
• Preventive medicines: These include seizure medicines, blood pressure medicines, and some antidepressants.
• Biofeedback: This technique helps to relax muscles and reduce stress, which can prevent a migraine attack.
• Transcranial magnetic stimulation: This device, when placed on the back of your head, reduces or stops the pain.