We still don’t understand what causes migraine.
Current thinking about the source of migraine symptoms reflects advances in technology that help us see how the brain and nervous system work. Previously, the dilation and constriction of blood vessels in the head were thought to be the primary source of migraine pain, and early medications focused on the blood vessels as the principal target for treatment.
Researchers now believe that migraine is a neurological disorder involving nerve pathways and brain chemicals. We know that migraine often runs in families. But genes aren’t the only answer – studies show that environmental factors play an important role, too. Just about everyone has headaches. But contrary to popular belief, migraine is much more than just a bad headache. It’s an extremely incapacitating collection of neurological symptoms that usually includes a severe throbbing recurring pain on one side of the head. However, in 1/3 of migraine attacks, both sides are affected. Attacks last between 4 and 72 hours and are often accompanied by one or more of the following disabling symptoms: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Of course, everyone is different, and symptoms vary by person and sometimes by attack. There are different types of migraines. The type of migraine is usually identified by its predominant symptom. Migraine is a moving target: symptoms can change from one attack to the next, and many sufferers have more than one type. Most people who have a migraine attack begin by treating themselves with over-the-counter medications. Sufferers sometimes consult a doctor as symptoms become more severe and disabling, but more than half of all migraine sufferers are never diagnosed. Migraine is a diagnosis of exclusion – it’s diagnosed by a process of elimination because there’s not yet a test or biomarker to show it’s present. Migraine is diagnosed by analyzing the symptoms, reviewing family history, conducting medical tests, and eliminating other possible causes of the headache. Diagnosis is not always easy, however, as symptoms are often present in other conditions. It’s important to consult a headache specialist if your symptoms are disabling, change, or don’t respond to your usual headache remedies