It starts with subtle changes: food cravings, neck stiffness, frequent urination, feelings of fogginess and even euphoria. Then, you might experience nausea, sensitivity to light and sound, and numbness in parts of your body. Next comes a severe throbbing headache that can last a few hours or days. Finally, the headache subsides, and you have a migraine hangover. Migraine causes are still not fully understood, but scientists are making progress and developing new treatments.
According to Discover Magazine, migraines are so debilitating that they are the number one cause of disability in people ages 15 to 49. Current research suggests genetics and environmental factors contribute to this neurological disease. And as researchers continue to learn more about causes, they are exploring new migraine treatments that could provide much-needed relief for an estimated 1 billion people worldwide who experience migraines.
A Wide Range of Experiences
People who don’t suffer from migraines might mistakenly confuse them with severe headaches. However, migraines involve various symptoms and a timeline that can last several days or longer. Generally, migraines include four phases (although everyone does not always experience each phase). Mayo Clinic describes the four stages of a migraine:
- Prodrome: In the days leading up to a migraine, people can experience warning signs such as constipation, fluid retention, mood changes, neck stiffness and frequent yawning.
- Aura: Some people experience a gradual escalation of sensory and motor symptoms such as vision issues, pins and needles sensations and even difficulty speaking.
- Attack: The main event typically involves a pulsing headache and heightened sensitivity to light and sound, often accompanied by nausea and vomiting.
- Postdrome: The days after a migraine attack are similar to a hangover, in which people experience a foggy, drained feeling.
Children and adults can get migraines, although they often start during adolescence and gradually become less frequent and less severe throughout adulthood. Risk factors include genetics, age, sex and hormone changes. A young boy, for example, is less likely to experience migraines than a 30-year-old woman who has a family history of migraine. The American Migraine Foundation reports that migraines affect 1 in 5 women, 1 in 16 men, and 1 in 11 children.
But what causes migraines? Scientists used to think the dilation of blood vessels caused migraines. But during the last few decades, researchers have discovered that migraines are more related to the trigeminal nerve, which is part of the nervous system and transmits a variety of sensations from the head, including pain.
Discover Magazine explains that in the last 20 years, researchers discovered that the pain comes from neuroinflammation of structures in the brain that sense pain. There are many areas of the brain and several types of neurotransmitters, such as serotonin, which help to regulate pain in your nervous system. Another neurotransmitter called calcitonin gene-related peptide (CGRP) appears to be a vital part of the migraine puzzle. People with migraines have more CGRP than average. Plus, scientists conducted experiments that revealed elevated levels of CGRP during migraine attacks.
There is no cure for migraines, but as researchers continue to pinpoint migraine causes, they lead the way for new treatment options. There is now a range of strategies for preventing and treating migraines. Here are a few of the most common treatments:
- Learning triggers and making lifestyle changes to avoid them when possible can help. Some migraines appear to be random, but others are related to triggers such as changes in sleep, food or stimuli. Some people keep a consistent routine to avoid triggering migraines. Plus, people use relaxation techniques and head to a dark room to rest when symptoms begin.
- Pain relievers and migraine relief medications can help to reduce symptoms of mild migraines and make people more comfortable during an attack.
- Medications that were developed for other uses, such as beta-blockers, calcium channel blockers, antidepressants and anticonvulsants can help to prevent migraines.
- Triptans, also called serotonin receptor agonists, are a type of medication that can relieve symptoms by blocking pain pathways in the brain and shrinking swollen blood vessels that develop from migraine attacks, according to Healthline.
- External neural stimulators, Botox (onabotulinumtoxinA) or hand-held machines that zap various nerves may also help.
Today, there are several new options, such as drugs that tighten the blood vessels in the brain, monoclonal antibodies (laboratory-produced molecules) that specifically target CGRP and drugs that target other receptors.
More than 10,000 scientific articles about migraines have been published in the last five years (see: PubMed). This is an active research area that will continue to open pathways for innovative treatments in the future.
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