Migraine is a disorder that disrupts the normal functioning of the nerves. Migraine attacks can be overwhelming and cause a lot of pain, distress and disability.1
Over 4.9 million Australians experience migraine at various stages of life, from childhood to older age.1 Fortunately, knowledge about migraine continues to grow and newer treatments are now available that can treat and prevent migraine attacks more effectively.1
Migraine causes headache, but not all headaches are migraine. Other types of headaches such as ‘tension-type headache’ and ‘cluster headache’ may be confused with migraine because some of the symptoms can be similar.1-3
Recording headache symptoms in a migraine diary can help you and your doctor understand what type of headaches you experience.4
Migraine is usually felt as a one-sided throbbing headache that is at least moderately intense and made worse by movement or physical activity.1
Unlike a regular headache, migraine can cause a wide range of physical and sensory symptoms including nausea, vomiting and increased sensitivity to light, sound and smells. Migraine may also last for much longer than a regular headache – from 4 hours up to 3 days.1
Tension-type headache usually affects both sides of the head – rather than just one side – and feels like there is pressure or tightening around the head. The pain is usually mild-to-moderate in intensity and doesn’t get worse if you move around. Tension headaches also generally don’t cause nausea, but some people may become more sensitive to light or sound.2
Tension headaches can last for 30 minutes up to 7 days. If they occur from 1–14 days a month they are described as frequent episodic tension-type headaches. People who have tension headaches on more than 15 days a month are said to have chronic tension-type headache.2
Cluster headaches are a relatively uncommon but an extremely painful type of headache.5 They affect the area around or behind the eye on only one side of the head and occur in cycles, or clusters, of repeated attacks.6 The intense pain of the attack may be accompanied by restlessness and facial symptoms including bloodshot, watery or swollen eyes and nasal congestion.3,5
Each attack generally lasts for 15 minutes to 3 hours.5 Clusters of attacks can occur over several weeks, one or two times a year and often at the same time of year.3 They are more common in men than women and usually occur first in adulthood.3,6
The symptoms of migraine can vary from person to person, but there are symptoms that can distinguish migraine from other types of headache (like tension or cluster headaches).1
Although head pain is usually the worst part of a migraine attack, other symptoms can be equally distressing.1
Two migraine-specific
headache symptoms or more1
One-sided
Moderate-to-severe intensity
Throbbing
Made worse by movement
One non-headache migraine
symptom or more1
Nausea
Vomiting
Sensitivity to light
Sensitivity to noise
Headache that
lasts from 4 hours
up to 3 days1
Other migraine symptoms can include:1
Migraine can also be classified as episodic or chronic, depending on how frequently these attacks occur:
Episodic and chronic migraine can be treated differently. If you have chronic migraine, talk to your doctor about preventive medications. These can be taken to reduce how frequently you experience migraine attacks and are used in addition to any migraine treatments your doctor recommends for acute migraine headache.1
There are two common types of migraine headache: migraine with aura and migraine without aura. An aura is usually experienced as changes in vision, sensation or speech and typically occurs before the onset of migraine headache.1
Menstrual migraine only occurs around your period, either as part of premenstrual syndrome (PMS) or during a period. Menstrual migraine is thought to be triggered by low estrogen levels.1,7
With age, migraine headaches may get less severe, leaving just aura without head pain. If migraine aura starts later in life and is not accompanied by headache, talk to a doctor to rule out other migraine causes.1,8
People with vestibular migraine experience aura symptoms like dizziness, vertigo and disturbances in balance, with or without a headache.1
This type of migraine is long-lasting. It is defined by migraine and headache symptoms that persist for longer than 72 hours.1
This type of migraine commonly affects young children and causes episodes of abdominal pain. Children with abdominal migraine may also have nausea and vomiting, as well as headache.1
People with ocular migraine experience brief attacks of blindness or vision changes in one eye. Episodes are usually short and vision soon returns to normal. Unlike most visual migraine aura, ocular migraine only affects one eye.9
A migraine attack usually has 4 distinct phases. Early warning symptoms may occur up to a day before aura symptoms and headache start. Once they resolve, there is usually a recovery period in which fatigue and sensitivity persist.1,10
Many people have warning symptoms for up to 24 hours before migraine starts. Early warning symptoms can include:1
Around 20% of people with migraine experience auras.10 These are symptoms that occur before or during a migraine attack and commonly include changes in vision, sensation or speech.1,4
Although aura symptoms can be distressing to experience,11 they typically resolve on their own.1 Most individual aura symptoms last for less than an hour, but if physical symptoms occur, they can last for longer periods of time.4
Aura symptoms vary from person to person, but most people who experience aura will have visual symptoms. Common vision changes include:1
Sensory aura symptoms may include feelings of pins and needles or numbness, while speech symptoms can include slurring, mumbling or difficulty finding or saying the right words.4,11
There are also other types of migraine aura (see below) with other symptoms.11
OTHER TYPES OF MIGRAINE AURA
Some people experience different types of aura. These may be particularly distressing as the symptoms can appear quite serious.11
Migraine with brainstem aura11
Brainstem migraine aura typically occurs with other aura symptoms (flashing lights, pins and needles) plus double vision, difficulty speaking, dizziness, ringing in the ears or reduced awareness.
Hemiplegic migraine11
In hemiplegic migraine, there is temporary weakness or even paralysis of one side of the body. These symptoms may appear similar to a stroke but, unlike stroke symptoms (which start suddenly), the symptoms of hemiplegic migraine come on gradually and disappear completely once the migraine attack is over.
Retinal migraine11
Migraine with retinal aura causes temporary problems with the vision of one eye, including flickering/shimmering vision, blind spots, or blindness. This differs from the more common type of visual aura which affects both eyes.
In people who have migraine with aura, aura symptoms may stop up to an hour before head pain starts, or the aura and headache may overlap. The presence of headache is characteristic of migraine. It can last from 4 hours up to 3 days and may be accompanied by nausea or vomiting as well as sensitivity to light, sounds and smells.
The way a migraine attack ends can vary. Sleep and medication can improve attacks for some, while for others the headache must simply burn itself out. After a migraine attack, most people feel quite fatigued and may experience nausea and continued sensitivity to light and sound.