Migraine is more than a headache. It is a neurological condition that can cause recurring attacks of head pain, nausea and sensitivity to light or sound. Some people also experience temporary visual changes, tingling or other symptoms known as aura. Migraine can interrupt work, sleep and family life, but a personalised treatment plan can help many people manage their attacks.
Migraine treatment generally has two goals: relieving symptoms during an attack and, when appropriate, reducing how often attacks happen. The best approach depends on your symptoms, other health conditions, medicines and personal circumstances.
A sudden, extremely severe headache, new one-sided weakness, trouble speaking, confusion, a seizure or a headache after a significant head injury needs emergency assessment. Do not assume a new or unusual symptom is migraine.
What is migraine?
Migraine is a condition involving recurrent episodes, or attacks, with symptoms that vary from person to person. Headache is common, but migraine may occur without head pain. Some people have attacks only occasionally; others experience them more frequently. The pain can affect daily activities and may worsen with movement.
There is currently no cure that works for everyone, but treatment can relieve symptoms and help reduce the burden of attacks. If headaches repeatedly interfere with your life, speaking to a healthcare professional is a useful first step.
What are the common migraine symptoms?
A migraine attack may include throbbing or pulsating head pain, often on one side, although the pain can occur on both sides. Other common symptoms include nausea, vomiting and increased sensitivity to light, sound or smells. Some people also feel dizzy or find it difficult to concentrate.
Symptoms do not look the same for everyone. For example, one person may need to lie down in a dark room, while another mainly notices nausea or visual changes. The pattern can also change over time. Recording what happens during your attacks can help your doctor understand them.
What are the phases of a migraine attack?
Early warning symptoms
Some people notice changes hours or even a day or two before head pain. These may include tiredness, frequent yawning, food cravings, thirst, mood changes, neck stiffness or a need to urinate more often. This early phase is sometimes called the prodrome. You do not need to experience it to have migraine.
Aura
Aura refers to temporary neurological symptoms that occur in some people before or during a migraine attack. Examples include flashing lights, zigzag patterns or blind spots; tingling; and sometimes difficulty speaking. Aura typically develops gradually and usually lasts no more than an hour. Some people have aura without a headache.
A new or unusual visual, speech or weakness symptom must not automatically be labelled migraine, because other conditions can cause similar changes. Seek emergency care for sudden one-sided weakness, speech difficulty or sudden loss of vision. If an established aura lasts longer than an hour, seek urgent medical advice.
Headache and recovery
The headache phase often involves moderate to severe pain, nausea and sensitivity to light or noise. Migraine attacks commonly last from four hours to three days. After the pain eases, some people feel exhausted, light-headed or unable to concentrate for a period. Not everyone experiences every phase.
Migraine vs a common headache: what is the difference?
A tension-type headache and migraine can both cause head pain, but migraine more often includes nausea, sensitivity to light or sound, or symptoms that interfere with daily activity. The pattern, duration and associated symptoms are often more informative than pain intensity alone.
There is no single feature you can use to diagnose yourself with certainty. A doctor will consider your history and examination to identify the likely cause and decide if further tests are needed.
What causes migraine and what can trigger an attack?
The exact cause of migraine is not fully understood. Changes in nerve activity are involved, and migraine can run in families. Triggers do not cause migraine in every person; they are factors some people notice around the time of an attack.
Possible triggers include stress, tiredness, irregular sleep, skipped meals, dehydration, menstrual changes and too much caffeine. Some people notice particular foods or drinks, bright light or changes to their routine. A trigger may not lead to an attack every time, and an apparent trigger can sometimes be an early symptom of an attack instead.
A headache diary can help you and your doctor look for patterns without restricting your diet unnecessarily. Record the date, duration, symptoms, sleep, meals, menstrual cycle if relevant, possible triggers and any medicine taken. Avoid eliminating major food groups without advice from a qualified professional.
How is migraine diagnosed?
Your clinician will usually ask how the pain feels, where it occurs, how long it lasts, whether you experience nausea or aura, and how often attacks happen. They may ask about family history, other medical conditions and medicine use. A physical or neurological examination may also be performed.
Migraine is often diagnosed from the history and examination. Not every person needs a scan. If the pattern is unusual or there are concerning findings, your clinician may recommend further investigations or a neurology referral. Bring your headache diary and previous reports to the appointment.
Migraine treatment: relieving an attack
Rest and supportive care
During an attack, some people find it helpful to rest or sleep in a quiet, darkened room. A cool cloth may also be soothing. Drink fluids as appropriate, particularly if you have not been drinking normally. If you have a medical fluid restriction, follow your care team’s instructions.
Supportive measures do not replace medical assessment when symptoms are severe, new or different from your usual pattern. If vomiting means you cannot keep fluids or medicines down, contact a clinician for advice.
Medicines used during an attack
Depending on your health and the severity of your symptoms, a doctor or pharmacist may recommend an appropriate pain-relief medicine. Other treatments used for some patients include migraine-specific medicines called triptans or gepants and medicines to reduce nausea. Some medicines work best when taken early in an attack, but follow the specific instructions given by your healthcare professional.
Not every medicine is suitable for every person. For example, other medical conditions, pregnancy, kidney problems or interactions with existing medicines can affect your options. Do not take someone else’s prescription, combine medicines without advice or give headache medicine to a child without consulting a clinician.
Avoid frequent use of acute medicines
Using headache-relief medicines too often can lead to medication-overuse headache and make migraine harder to manage. The risk depends on the medicine and how often it is used. If you need acute treatment frequently, keep a record and talk to your doctor rather than increasing doses on your own.
A clinician can review your medicines and suggest a safer plan, which may include preventive treatment. Do not abruptly change regular prescribed medicines without advice.
How can migraine attacks be prevented?
Preventive treatment may be considered when attacks are frequent, disabling, difficult to treat or when acute medication is needed often. Depending on the person, a doctor may discuss medicines from different groups, including certain beta-blockers, antidepressants or medicines also used for epilepsy. Some people may be considered for other specialist treatments.
Preventive medicines are selected individually. Your clinician should explain expected benefits, possible side effects and how long the medicine may take to work. Tell them about pregnancy plans, existing conditions and all other medicines or supplements before starting treatment.
Regular sleep and meal times, appropriate hydration, activity suited to your health, and stress-management strategies may also help some people. Techniques such as relaxation or cognitive behavioural therapy can be discussed with a healthcare professional. Progress may take time, and a diary can help you assess what is useful.
When should you see a doctor or neurologist for migraine?
Arrange a medical appointment if headaches keep returning, are severe, are getting worse, disrupt your usual activities or are difficult to control. Seek advice if attacks happen frequently, regularly occur around your period, or you are using pain relief often. A primary-care doctor can assess you and refer you to a neurologist when specialist input is appropriate.
Before your visit, note how many headache days you have each month, how long attacks last, whether you experience aura and how symptoms affect your work or sleep. Bring your current medicine list and record what you have already tried.
Migraine warning signs: when to seek urgent help
Seek emergency care immediately for a sudden, extremely painful headache; new one-sided weakness or facial drooping; trouble speaking; sudden vision loss; a seizure; confusion or unusual drowsiness; or a headache after a significant head injury. A severe headache with fever and a stiff neck also needs emergency assessment.
Seek urgent medical advice if a migraine attack lasts longer than 72 hours, aura lasts longer than one hour, or you are pregnant or have recently given birth and experience a migraine attack. Your doctor can assess whether another condition needs to be ruled out. Do not drive yourself if you have severe symptoms or impaired vision.
Migraine care in Madhyamgram, Kolkata
If recurring headaches or migraine symptoms are affecting your daily life, contact Vivacity Multispeciality Hospital in Madhyamgram, Kolkata, to enquire about neurology consultation availability. The right assessment and treatment plan depend on your symptoms and medical history. For emergency warning signs, seek immediate emergency care.
Frequently asked questions
Can migraine happen without a headache?
Yes. Some people experience aura or other migraine symptoms without significant head pain. A new or unusual symptom still needs medical assessment.
How long does a migraine attack last?
An attack commonly lasts between four hours and three days, although symptoms and duration vary. Seek urgent advice if an attack lasts longer than 72 hours.
What is migraine aura?
Aura consists of temporary neurological symptoms such as flashing lights, zigzag lines or tingling. It usually develops gradually and lasts no longer than an hour. Sudden weakness, speech problems or vision loss need emergency assessment.
Can stress trigger migraine?
Stress or tiredness may be associated with attacks for some people. Triggers vary, and a headache diary can help identify possible patterns.
Is migraine curable?
There is no cure that works for everyone, but treatments can help relieve symptoms and prevent or reduce attacks. Your clinician can help identify a plan that suits you.
Can taking painkillers too often make headaches worse?
Yes. Frequent use of acute headache medicines can contribute to medication-overuse headache. Discuss your usage with a doctor before changing your treatment.
Do I need a brain scan for every migraine?
No. Migraine is often assessed through your symptoms and examination. A clinician may recommend a scan or other tests if the history or examination raises concern.
Should migraine treatment change during pregnancy?
It may need to. Discuss current medicines and treatment options with your doctor, ideally before pregnancy. Seek urgent medical advice for a migraine attack during pregnancy or after giving birth.
