When you get a migraine, you know it—migraines have the power to bring your day to a screeching halt. The nausea and the light sensitivity, along with the searing pain, drive sufferers to retreat to the darkest room (or the darkest cave) and hide beneath a thick quilt until the agony is over.

For those who have never experienced one, it’s hard to imagine what all the fuss is about. Here’s the deal: even though they’re “migraine headaches”, these episodes are so much more than head pain (though you shouldn’t trifle with the disabling pain they do cause). Migraines have a whole host of symptoms that often conform into four stages:

  • Prodrome: The first stage can occur up to two days before the migraine attack. It includes subtle symptoms like constipation, increased thirst, and neck stiffness. Those who deal with chronic migraines may recognize these common symptoms as a warning.
  • Aura: Many people have migraine attacks without the aura stage—dubbed by researchers as the “classic migraine”—but those who do have “aura migraines” experience flashes of light, visual phenomena or vision loss, “pins and needles” sensations, or difficulty speaking.
  • Attack: Left untreated, this stage can last from four to seventy-two hours. The symptoms include (but aren’t limited to): pulsing pain on one or both sides of the head, sensitivity to light and sound, nausea or vomiting, and lightheadedness.
  • Post-drome: The final stage can bring varying moods from elation to weariness to confusion. Many migraine sufferers also experience continued light and sound sensitivities, weakness, and dizziness. This stage can last up to twenty-four hours.

There’s no certain answer to what causes these severe attacks. Many theoretical explanations include a proverbial trail mix of genetic factors, imbalances in serotonin levels, and changes in neural interactions with a pain pathway called the trigeminal nerve. New research suggests that vascular and muscular problems play a strong role in most migraines. This research also found evidence of a potential link between migraines and the ion channels of the nervous system, a theory with real potential for further study. This research into the root causes of migraines could help out down the road to create effective, personalized treatments.

In the mean time, we do know that both triggers and treatments vary widely from one migraine patient to the next. Migraine triggers range from feminine hormonal changes to certain foods (aged cheese, food additives, alcoholic or caffeinated drinks). Stress, sensory stimuli, changes in weather, and physical exertion could also bring on a migraine. Attacks can even be triggered by certain medications like oral contraceptives. Though women are three times more likely to get migraines, these attacks are susceptible to anyone at about any age.

Treatments for migraines often take the form of prescriptions and injections. A vast array of pain medications, ranging from the humble Tylenol to narcotic-containing Opioids to pain-blocking Triptans, provide relief for multiple levels of migraine pain. Anti-nausea medications are also prescribed, like Reglan and Compro, to help ride the migraine’s sickness waves.

Some chronic sufferers are candidates for preventative measures. This regimen may include prescriptions like cardiovascular blockers, tricyclic antidepressants (amitriptyline), anti-seizure drugs (Depacon, Topamax), and some NSAIDs (naproxen). Even Botox injections have been effective in curbing the frequency of chronic migraines (hey, whatever works). Making a pain management plan with your doctor usually requires a bit of trial-and-error before the migraines begin to back off.

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