Dr. Nabi Darya Vali (AIIMS)MBBS

March 09, 2017

October 14, 2021



Migraine is a neurological condition, typically characterized by a series of repetitive, severe to moderate type of headaches. Migraine is known for causing throbbing pain specifically on one side of the head. It has been observed that a person with severe symptoms of migraine may want to completely take rest in a dark and preferably in a quiet place. In some people, migraine headache may be preceded or accompanied by common auras which include flashes of light, blind spots or tingling in your arm or leg along with nausea and vomiting. Although medications to cure migraine completely is not available, however, certain prescribed medicines, lifestyle changes, can reduce the frequency and severity of migraines.

Types of Migraine

There exist different types of migraines. The International Headache Society has come up with a classification system for migraines. The same classification has also been adopted by the World Health Organisation. The types of migraines are the following:

  1. A common Migraine: This is the highly prevalent type of a migraine, also known as migraine without aura. A common migraine is a type of a headache that can last for anywhere between 4 hours to 72 hours. If the headache continues for over 72 hours then it is known as status migrainosus, which requires immediate medical attention.

  2. A classic Migraine: This type is also known as Migraine with Aura. Sometimes, classic migraine aura can also occur without a throbbing headache which is known as an acephalgic migraine.

  3. A chronic Migraine: This is a severe form of Migraine. A headache usually occurs for more than 15 days in a month and can stretch up to 3 months. A chronic migraine requires medical intervention and a neurologist should be consulted preferably for treatment & prevention.  

  4. Abdominal migraine: In this type, the patient experiences light to severe abdominal pain along with nausea and vomiting during the migraine attack. This is commonly seen in children who have a history of migraine in their family. Unfortunately, some doctors claim that these children may further suffer from bouts of classic migraine during their adult life.

  5. Migraine during pregnancy: Migraine during pregnancy is often not too serious unless the pain is accompanied by symptoms like fever, blurred vision and sharp shooting pain. When conditions like the above arises then it is extremely important for a pregnant woman to take the right treatment for migraine pain. They cannot use the general painkillers (which they could use in normal conditions) and thus they must be extremely careful not to trigger the migraine attack and see a physician instantly.

  6. Migraine in children: Migraine is very common in children. Children experiencing migraine attack looks pale and sick. Vomiting and nausea are common in young children. They tend to avoid light, sound, strong smell and movement. Good sleep is generally enough to bring relief for them.

  7. Familial Hemiplegic Migraine: This is a very rare and is often an inherited condition. Here the patient experiences weakness or paralysis on one side of the body sometimes lasting for days together prior to the commencement of headache or during headache. This type typically requires medical attention.

  8. Basilar Artery Migraine: This type usually affects children and young adults and is characterised by a headache that is originated at the brain stem. Hence, patients experience ache around the back of the head.

  9. A menstrual Migraine: Migraine is a condition that is 3 times more common in women than in men. Many women have reported a strong connection between their menstrual date and the onset of a migraine headache. It is said that the main trigger for a migraine is due to the fluctuating hormones during periods. The fall in the levels of estrogen is believed to be the trigger for migraines. Menstrual migraine is further sub-classified into two types.

  • a) A pure migraine: In this type, migraine headache occurs only around periods 0-5 days of periods and not other times.
  • b) A menstrual-associated migraine: In this type, migraine attack occurs around the time of periods (0-5 days) or anytime during the cycle (1-28 days). Researchers claim that majority of women complain of this particular type of migraine.
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Stages of Migraine

Migraine can start at any age and this condition can be particularly divided into four stages. 

  • Prodrome: is the first stage, having symptoms like constipation, food cravings, hyperactivity, depression, irritability, continuous yawning and feeling of stiffness in the neck.
  • Aura: Prodrome stage is followed by the Aura with the symptoms of viewing different shapes, flashes of light, loss of vision, tingling sensation in arms or legs. After these sensational feelings, the real attack begins.
  • Attack: Pain on one side of the head, which is pulsating as well as throbbing, starts. The attack stage of the disorder has the symptoms of high sensitivity for light and odour, vomiting and nausea. In some cases, vision gets blurred and the patient can also faint.
  • Postdrome: The final and closing stage is known as Postdrome, which is characterized by extreme tiredness. You can also face Vomiting, Nausea, Diarrhoea, Cold hands and feet, Sensitivity to light during migraine pain.

Symptoms of Migraine

Migraines can begin in childhood, adolescence or early adulthood. A person with migraine may have some or all of these signs and symptoms: Here are some general symptoms

General symptoms of migraine

  • Moderate to severe pain, which usually involves one side of the head or may affect both sides
  • Pulsating or throbbing pain
  • Worsening of pain with physical activity
  • Pain can interfere with the daily activities
  • Nausea with or without vomiting
  • Sensitivity to light and sound

Symptoms of common migraine

  • A throbbing headache on one side of the head.
  • Aversion to light, sound and smell.
  • Feeling extremely drained out (fatigue).
  • Nausea and vomiting.
  • Irritability and mood changes.
  • Inability to focus on work.
  • Worsening condition with movement

Symptoms of classic migraine

  • Flashing lights or hazy spots in vision
  • Numbness or tingling sensation
  • Difficulty in speaking and confusion
  • Smelling a strange odour or ringing in ears
  • Nausea and loss of appetite
  • In extreme cases complete or partial loss of vision

Symptoms of chronic migraine

  • An unbearable headache continues throughout the day
  • Continuous nausea and vomiting.
  • Loss of vision and appetite

Symptoms of Familial Hemiplegic Migraine

  • Paralysis on one side of the body
  • The sudden spinning of the head (Vertigo).
  • Pricking or stabbing sensation
  • Blurred vision and slurred speech
  • Symptoms that are similar to a stroke (pain, vomiting, unconsciousness).

Symptoms of Basilar Artery Migraine

  • Sudden or throbbing pain on one side of the head or both.
  • Partial or total loss of vision.
  • Nausea and vomiting.
  • Dizziness, loss of balance and fainting.
  • Speech disturbance.
  • Decreased muscle coordination.

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Migraine Causes & Risk factors

The exact causes of migraine are yet to be ascertained, but genetics and environmental factors seem to play a major role in the induction of migraine. Medical investigations hint that migraines may be caused by alteration of neurochemicals in the trigeminal nerve, and imbalances in brain chemicals, specifically serotonin. However, here is a list of few known migraine causing agents which trigger the onset of various migraines. 

  • Certain foods/beverages/additives (like aged cheeses, alcohol, smoked meats, caffeine, aspartame, MSG)
  • Stress and anxiety
  • Certain kinds of light (strong headlights, white tube lights, and rotating lights).
  • Certain smells (perfumes, aromatic oils and incenses).
  • A sudden change in temperature up or down by (10 degrees) or a barometric pressure change.
  • Skipping of meals or not consuming enough water leading to dehydration.
  • Hormonal changes (for example in women who get migraines just before or during a menstrual cycle).
  • An infection (sinus infection are known to cause migraines).
  • Getting inadequate sleep.

Risk Factors

Here are some common risk factors which increase the person’s likelihood of suffering from migraines.

  • People with hereditary or family history of migraines
  • People with medical conditions such as anxiety, depression, tumours, irritable bowel syndrome, epilepsy and hypertension.
  • Women in their menstrual cycle age 
  • People with excessive consumption of chocolate and caffeine.
  • People with high-pressure jobs.
  • People who are exposed to heat and sunlight due to occupation or climate reasons.
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Diagnosis of Migraine

A neurologist will diagnose a migraine as a result of his or her evaluation of your medical history, symptoms and medical examination. There are some tests the doctor may ask you to take. Read below

  • Blood tests:
    To check for blood vessel problems, infections, and toxins in the system.
  • Sinus X-ray and eye examination:
    An x-ray of the sinus cave region (behind cheeks, nose, eye sockets) are done to inspect the cause of headaches along with an eye examination.
  • Magnetic Resonance Imaging (MRI) and CT scan:
    To detect tumours, bleeding in the brain, infections, strokes, and other neurological conditions.
  • Spinal Tap:
    Also called lumbar puncture, it helps detect infections in the spinal cord, bleeding in the brain and another underlying condition.

Treatment for migraine

If you've ever had a migraine, then you probably understand why preventing them from happening in the first place is just as important as stopping symptoms after they've already started. That's why migraine treatment generally falls into two categories:

  • Preventive (stopping headaches before they start) and
  • Acute/Abortive (stopping headaches as soon as they occur).

Preventive treatment 

  • Lifestyle changes
  • Medications
  • Other non-drug remedies (non-pharmacologic options such as physical therapy, massage, acupuncture or seeing a chiropractor).
  • Nutritional supplements (magnesium, coq10, or vitamin B2 or B12)

Acute and abortive treatment 

  • Over-the-counter medications: Some are basic pain relievers (like aspirin, ibuprofen, naproxen, and acetaminophen) and others are combos (Excedrin Migraine, for instance, is a mix of acetaminophen, aspirin, and caffeine, and Alka Seltzer is a mix of aspirin and two antacids).
  • Prescription drugs
  • Isolating and hydrating (Retreating to a dark, quiet room, drinking water, and then trying to sleep)

When to contact the doctor:

  • If you're not getting adequate relief from over-the-counter medications and lifestyle changes,
  • if you're taking over-the-counter medications more than 10 to 15 times per month, still no change in headache pattern. 
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Migraine Complications

The complications of migraine range between moderate to severe hence one should not take migraine lightly, and keep medications and pain relief gels and balms handy. You are strongly recommended not to let the migraine progress further and watch out for the below-mentioned conditions.

  • Status Migrainosus: This is a rare and severe complication of a migraine. In this condition, the aura lasts for more than 72 hours, and it is a very painful condition. Some people may even need hospitalization because of the intense pain.

  • Status Infarction: When a migraine is associated with a stroke, it’s called migrainous infarction. This type of migraine headache may last for 1-hour and sometimes the aura can last for more than one hour. In rare cases, the aura is still present even while the headache has disappeared. There could be a possibility of bleeding in the brain, which can be life-threatening.

  • Persistent Aura without Infarction: When an aura lasts for more than a week even after a migraine has ended, it’s called persistent aura without infarction. However, this is less dangerous because there’s no bleeding in the brain.

  • Migralepsy: Migralepsy is a condition where a migraine triggers an epileptic seizure.

  • Stroke: A stroke happens when the blood supply to the brain is impeded or blocked. People with migraines have twice the risk of having a stroke.

  • Mental Health Conditions: Individuals who suffer from migraines have a higher risk of developing major depression, general anxiety disorder (GAD), panic disorder, bipolar disorder and post-traumatic stress disorder (PTSD).

Self-care for migraine

Here are some tips and home remedies for people suffering from this condition. This may be followed along with doctors advice as the following home remedies have minimal side effects and provide instant relief. 

  • Keep your migraine medicines, balms, oils and painkillers handy. Ideally, make a separate box.
  • Stop or limit intake of caffeine
  • Use lavender, peppermint oil to massage your pain areas.
  • Practice daily guided meditation.
  • Take pure ghee (butter) of cow and put 2 to 4 drop in both your nostrils using cotton. It is believed to help in the prevention of this condition.
  • Mix 1/2 glass of spinach juice with 1/2 glass of carrot juice and drink every day on empty stomach. Follow this step for at least 1 to 2 months for maximum benefits.
  • Crush few cabbage leaves. Lie down on your back and apply crushed cabbage leaves on your forehead for 15 minutes. Do not add salt or anything else.
  • Boil chamomile powder in one cup of water. Now filter this water and drink slowly. It will give you instant relief during migraine pain. It is considered one of the best home remedies for migraine. Follow this step for 1 to 2 months for maximum benefits. Do not add salt of anything in water.
  • On the side of the head where you are experiencing migraine pain, put seven drops of mustard oil (sarson ka tel) in the nostril of the same side. It will stop and lessen the intensity of the headache immediately. Follow same procedure 2 – 3 times in a day for 5 days for maximum benefits.
  • Take 2 lemon leaves and crush. Now inhale these leaves. It will give you immediate relief in migraine headache. Its one of best home remedies for migraine.
  • Amla is beneficifor in treating every kind of migraine headache. Eat amla jam or amla powder everyday to avoid migraine episodes.
  • Rub sandalwood and camphor on a clean stone with little water and apply this paste on the forehead. It will give you instant relief.
  • Rub red sandalwood on a clean stone and apply that paste on the forehead.
  • Grind some amla and turmeric and apply that paste on the forehead. It will give you instant relief
  • Rub little saffron with pure butter and inhale that for few minutes.
  • Boil some carrot leaves in water. Allow the water to cool and put few drops of that water inside nostrils and ears. It is believed to be very effective in relieving pain during migraine.

What is Migraine

There are many types of headaches, and all of them lead to feelings of discomfort and pain. A migraine headache specifically can cause severe throbbing pain, and it’s considered the most debilitating type of headache. Significant research conducted on migraine patients suggest that women suffer from migraine three times more than men. Some severe migraine attacks can be sometimes accompanied by visual warning signs or auras. Your physician will help you identify the type of migraine by evaluating the frequency and intensity of the headache in specific time intervals. It is said that the number of times migraine episodes occur determines the type of migraine one is having. Certain migraines occur anytime from once in a year to several times in a week.

Did you know?

  • Some individuals who suffer from migraine frequently can determine factors or triggers that cause their headache bouts such as allergies, stress, light, and some particular foods.
  • Many migraine patients feel when a migraine attack is about to happen, they get a warning symptom before the start of a headache. For example vomiting, nausea, or a flash of lights.
  • Many of those affected by migraine can prevent the severity of an attack by recognizing the warning signs and taking medicines instantly for relief.
  • People who have severe attacks can take preventive drugs to ensure fewer migraine events.


  1. Science Direct (Elsevier) [Internet]; Brazilian Journal of Anesthesiology (English Edition)
  2. ICHD-3 The International Classification of Headache Disorders. [Internet]. International Headache Society. London, United Kingdom. Migraine.
  3. National Health Service [internet]. UK; Retinal migraine
  4. National institute of neurological disorders and stroke [internet]. US Department of Health and Human Services; Migraine Information Page
  5. US Food and Drug Administration (FDA) [internet]; Treating Migraines: More Ways to Fight the Pain

Medicines for Migraine

Medicines listed below are available for Migraine. Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.