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Migraines: Symptoms, Causes, and Treatments

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What’s the difference between a migraine and a headache?

While migraines are a type of headache, they’re not the same as tension or cluster headaches. Tension headaches, for example, typically affect both sides of the head and don’t come with additional symptoms like sensitivity to light or sound. Cluster headaches are rare but cause sudden, intense pain around one eye.

Migraines, on the other hand, often come with associated symptoms such as nausea, sensitivity to light and sound, and sometimes vision changes. They’re also typically more debilitating than tension headaches, making it hard to carry out daily tasks. Many people find themselves confined to bed during a migraine, with symptoms lasting from hours to days.

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What is a migraine?

A migraine is a throbbing headache, usually felt on one side of the head, that can be accompanied by nausea, vomiting, and visual disturbances. Episodes can last a few hours or even several days, leaving you feeling drained for some time afterward.

Migraines can occur occasionally or frequently, depending on the individual. While some people manage their symptoms with home remedies, others may require prescription medication for relief.

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What are the symptoms of a migraine?

Migraines are characterised by intense, pulsating pain on one side of the head that often worsens with movement. Some people experience the pain on both sides of the head or in the neck.

In about one-third of cases, migraines are preceded by aura. This can cause visual disturbances, such as seeing flashing lights or blind spots, and typically starts before the headache itself.

It’s also possible to experience a “silent migraine,” where aura symptoms occur without a headache.

Common migraine symptoms include:

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Nausea and vomiting

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Sensitivity to light, sound, and smells
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Sweating
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Feeling very hot or cold
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Trouble concentrating
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Abdominal pain or diarrhoea

Symptoms of migraine aura include:

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Blurred vision or blind spots

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Seeing flashing lights or patterns
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Pins and needles in the hands, arms, or face
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Dizziness or difficulty speaking
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Fainting (rare)

What causes migraines?

The exact cause of migraines isn’t fully understood, but researchers believe they result from abnormal brain activity that temporarily affects nerve signals and blood vessels in the brain.

Migraines are often triggered by specific factors. Keeping a record of your triggers can help you manage your condition.

Common migraine triggers include:

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Hormonal changes (e.g., during menstruation or pregnancy)

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Stress, anxiety, or depression
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Tiredness or lack of sleep
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Poor posture or tension in the neck and shoulders
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Low blood sugar or dehydration
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Certain foods, such as chocolate, citrus fruits, and aged cheeses
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Alcohol, caffeine, or smoking
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Bright lights, flickering screens, or loud noises
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Climate changes
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Medications, such as the combined contraceptive pill

Tracking your sleep, diet, exercise, and lifestyle can help you identify and avoid your specific triggers.

How are migraines diagnosed and treated?

If recurring headaches are interfering with your daily life, it’s important to speak to a healthcare professional. A doctor or Advanced Clinical Practitioner (ACP) may ask you to keep a migraine diary to track your symptoms and triggers.

Treatment options for migraines include:

  • Resting in a dark, quiet room
  • Over-the-counter painkillers such as ibuprofen or paracetamol
  • Prescription medications for more severe or frequent migraines, including:
    • Triptans, which target migraine-specific pathways in the brain
    • Anti-sickness medication for nausea and vomiting
    • Preventive medication if migraines are frequent or debilitating

Your doctor may also refer you to a specialist for further evaluation if your symptoms are severe or if a clear diagnosis isn’t possible.

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