Migraine

A migraine is far more than a bad headache — it's a neurological condition involving changes in the brain and its nerve pathways that cause recurring attacks. The pain is often moderate to severe, throbbing, and on one side of the head, and is commonly joined by nausea and sensitivity to light and sound. Attacks can last from a few hours to a few days.

A migraine can unfold in up to four phases, though not everyone gets them all:

• Prodrome (hours to a day before): subtle warning signs like mood changes, food cravings, or neck stiffness.
• Aura (in some people): temporary visual disturbances (flashes, zigzags, blind spots) or tingling, usually before or during the headache.
• Headache: the throbbing pain, often one-sided, with nausea and light/sound sensitivity, typically worsened by activity.
• Postdrome (the "migraine hangover"): feeling drained or foggy for up to a day after.

Migraine without aura is the most common form. Migraine with aura includes the temporary neurological symptoms above. Aura is usually harmless and reversible, but because its symptoms can overlap with more serious conditions, any new or unusual neurological symptoms should be checked by a clinician.

Triggers vary from person to person, but frequent ones include:

• Stress (and sometimes the "let-down" after stress)
• Hormonal changes — many women have migraines tied to their cycle or the menopause transition
• Changes in sleep, skipped meals, and dehydration
• Certain foods and drinks, alcohol (especially red wine), and caffeine changes
• Bright or flickering lights, strong smells, and weather changes

Keeping a headache diary helps identify and avoid your personal triggers.

There's no single test for migraine — it's diagnosed clinically, from your pattern of symptoms and history. A clinician will ask about the nature, frequency, and triggers of your headaches, and may order tests only to rule out other causes when the picture is unusual.

Treatment has two goals — stopping attacks and preventing them.

For an attack (acute treatment): resting in a dark, quiet room, over-the-counter pain relievers, migraine-specific medicines such as triptans or newer gepants, and anti-nausea medication. Taking acute treatment early in an attack works best; using painkillers too often, though, can cause medication-overuse headache.

To prevent frequent attacks: when migraines are frequent or disabling, preventive options include certain blood-pressure or anti-seizure medicines, some antidepressants, and newer CGRP-targeted treatments, alongside lifestyle steps like regular sleep, meals, hydration, and stress management. A clinician can build a plan that fits you.