Headache is the one of the most common reasons people go their doctors. People generally use the word “headache” for what neurologists call tension-type headache, and it is usually a mild to moderate pressure-like pain associated with stress and emotional tension. So, if this is what most people call “headache”, then what is “migraine”?
Migraine is a syndrome of neurological symptoms and pain
Migraine is not just about pain. In fact, there is an unusual type of migraine without pain. If so, what is migraine? It is really made up of repeated episodes of a sequence of neurological symptoms that last from one hour to several days. While people tend to experience migraine differently, overall you can see patterns variably characterized by symptoms such as:
- vague warning signs before the migraine
- auras – mostly visual disturbances, including enlarged blind spots and bright line configurations
- pain on one side or in certain head locations
- nausea
- discomfort with bright lights or loud noises
- Runny nose or tearing
- Neck pain
Migraine is a genetic disease
Around 50% of people with migraine have a first degree relative who also has migraine. That means that some people are predisposed to migraine, and that migraine will manifest under certain conditions.
Real physiological changes happen in the brain
Research has found that a slow electrical wave of ‘spreading depression’ moves across the surface of the brain during a migraine. That could account for the symptoms of the aura, while the pain is linked to a cascade of events leading to expansion of blood vessels, release of inflammatory chemicals, and irritation of nerve endings. Also, serotonin, a brain chemical that transmit messages across cells, is decreased in migraine.
Migraine is not dangerous
Although people with migraine have a greater than normal risk of stroke later in life, that risk is small.
- Even though migraine is associated with unusual activity of the brain cells, it is not a form of epilepsy.
- Even though migraine can be accompanied by short-lasting visual phenomena and other neurological symptoms, it is not a form of stroke.
Summary
Migraine is a neurological condition that is different than a garden-variety ‘headache’. There is a series of physiological changes in the brain that parallel the symptoms, including the pain. Most importantly, there are now effective therapies developed specifically for migraine. So, it is important to ask your doctor if your “headache” is really “migraine”.
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