By Dr. Tariq Jagnarine – Family Medicine, Endocrinology / Diabetes
What Exactly Is a Migraine?
A migraine isn’t “just a headache.” It’s a complex brain condition that can bring pounding head pain, vision changes, nausea, and even days of fatigue. Migraines often come in stages, beginning with warning signs (called an aura) and ending with what many call a “migraine hangover.”
They’re surprisingly common, affecting 1 in 7 people worldwide. Women are nearly twice as likely as men to suffer, often between the ages of 18 and 44, though even children can experience them.
Why Do Migraines Happen?
Doctors don’t have all the answers yet, but research suggests migraines may result from:
● Changes in brain chemicals and nerve signals
● Altered blood vessel activity.
● Genetics – family history raises your risk.
Common Triggers
Migraines can be set off by everyday things such as:
● Hormonal shifts – especially around menstruation
● Stress and strong emotions
● Foods and drinks – alcohol, caffeine, chocolate, aged cheese, citrus fruits, and foods with tyramine
● Environmental factors – flickering screens, strong perfumes, smoke, loud noises, bright lights
● Lifestyle habits – lack of sleep, skipped meals, dehydration, poor posture, jet lag, or overexertion.
Who’s at Risk?
Anyone can develop migraines, but they’re more common in people who also live with:
● Depression or anxiety
● Bipolar disorder
● Fibromyalgia or irritable bowel syndrome
● Sleep problems
● Overactive bladder or OCD
How Do Migraines Feel?
Migraines usually unfold in three stages:
1. Before the pain (Prodrome/Aura): Vision changes, pins and needles, confusion, or difficulty speaking.
2. During the attack: Throbbing headache (often one-sided), nausea, vomiting, and extreme sensitivity to light and sound.
3. Afterwards (Postdrome): Fatigue, irritability, and difficulty concentrating for up to 48 hours.
Some people get migraines with aura (flashing lights, zigzags, blind spots) while others get them without aura—the more common type.
Different Types of Migraines
● Chronic migraine: 15+ days a month
● Menstrual migraine: Linked to hormonal cycles
● Hemiplegic migraine: Temporary weakness on one side of the body
● Abdominal migraine: Stomach pain and nausea, often in children
● Vestibular migraine: Severe dizziness and balance problems
● Basilar migraine: Rare, affecting brainstem functions like speech
Getting a Diagnosis
Doctors often use the “5, 4, 3, 2, 1 rule” for migraine diagnosis:
● 5+ attacks lasting 4 hours–3 days
● At least 2 features: one-sided, pulsating, moderate-to-severe, worse with activity
● At least 1 symptom: nausea, vomiting, light or sound sensitivity
Scans may be ordered to rule out other causes.
Treatment Options
There’s no permanent cure—but migraines can be managed.
Medications
● Over-the-counter pain relievers: Ibuprofen, Acetaminophen
● Triptans (e.g., Sumatriptan) to reverse brain changes.
● Antiemetics for nausea
● Newer drugs: Gepants and Ditans
Tip: Don’t overuse painkillers—they can cause rebound headaches.
Home Remedies
● Resting in a quiet, dark room
● Applying cold packs
● Relaxation techniques, acupuncture, or gentle neck stretches
Prevention
If migraines are frequent, doctors may prescribe:
● Topiramate (anti-seizure)
● Propranolol (blood pressure medication)
● Antidepressants
● Botox injections
● Lifestyle tweaks: staying hydrated, sleeping well, and avoiding known triggers.
Migraines may be unpredictable, but they don’t have to control your life. By knowing your triggers, seeking treatment early, and making simple lifestyle adjustments, you can reduce their grip and reclaim your day.
