What is a migraine: diagnosis, causes, migraine test

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A migraine is a headache disorder characterized by severe, recurrent headaches and usually accompanied by other symptoms such as nausea, vomiting and sensitivity to light and sound.1

Some people also experience additional migraine symptoms like dizziness, sensitivity to certain smells, changes in taste, diarrhea, runny nose and tearing eyes.

The length of migraine attacks also varies. You could have a migraine attack that lasts a few hours or several days.2 Sometimes your migraine attacks can be infrequent, happening once in a while, such as every few months or years apart3 or you might experience migraine attacks more regularly.4

Approximately 90% of people with migraines experience moderate to severe pain and around three-quarters of people with migraines find it hard to do everyday activities like taking a shower, exercising or going to work during attacks. For around one-third of people, migraine symptoms are so severe that they require bed rest during attacks.5

How common are migraines?

Migraines rank as the third most common disease in the world after tension-type headaches.6 They affect roughly 12% of adults in the Western world and occur in people of all ages, usually beginning in early adulthood. 

Migraines are generally more prevalent in women than in men and most people affected are aged between 25 and 55. Around 2% of the general population experiences chronic migraines with headaches at least 15 days a month.7

What is a headache and what is a migraine?

Despite what some people think, migraines and headaches are not the same. Watch the video to get a better idea of what is a migraine and migraine’s potential impact on daily life, as well as migraine symptoms and triggers.

Migraine cause

Research is ongoing to determine exactly what causes migraines. It is thought that migraines are a disorder of the central nervous system. fMRI scans have shown that the condition affects brain activity. Migraines also cause temporary changes in transmitter substances, nerves and blood vessels in our brain.8

Evidence suggests that migraine is also a complex genetic disorder.9 It is common for people with a migraine diagnosis to have a history of the condition in their family.

Migraine triggers

Everyone’s experience of migraines are different but there are some common triggers that can bring on migraine attacks in some people.

The factors that trigger your migraines may change as you age and depending on what medication you take to treat your migraines. People often experience one or more triggers for migraine attacks.10

Some examples of common triggers include:

  • Alcohol
  • Caffeine
  • Exercise
  • Certain types of food eg. chocolate, citrus fruits, nuts, MSG
  • Heat
  • Hormonal factors eg. menstruation
  • Bright lights
  • Tiredness
  • Neck pain
  • Dehydration
  • Not eating
  • Perfume
  • Sexual activity
  • Sleep disturbances
  • Sleeping late
  • Nicotine and smoking
  • Stress
  • Certain weather conditions eg. humidity, air temperature

You may find that some things trigger migraine attacks. It can help to pay attention to potential triggers so that you can try to avoid them.

People also find it useful to make a note of their migraine triggers to use when they talk to their doctor about their migraines and when getting a migraine diagnosis.

Migraine diagnosis

Many people suffering from migraines don’t seek medical help and for the people who do, migraines are often underdiagnosed and undertreated.11

If you are experiencing migraine-like symptoms, it’s a good idea to talk to a healthcare professional to get a migraine diagnosis.

To help you get the treatment you need, it is important to be as clear as possible about your experience of migraines, including what symptoms you have and how severe they are.

You might find it helpful to keep a migraine diary to track your symptoms before you go to your doctor’s appointment. This can enable you to describe clearly what you are experiencing and give your doctor a more accurate picture of the problem.

What to expect from a diagnosis

There is no specific migraine test that can be used to diagnose migraines.12

Instead, a migraine diagnosis is made by a healthcare professional using a set of medically-approved criteria to determine how severe your symptoms are.

They will usually try to understand exactly what symptoms you experience, how long they last, what type of pain you have and how much your symptoms impact your daily life.

They might ask you questions to help with migraine diagnosis such as:

  • Whether your headaches are accompanied by nausea
  • Whether you also get sensitivity to light and noise
  • If your headaches are severe enough to prevent you doing normal activities
  • If the pain is throbbing or stabbing
  • If the pain is concentrated in one part of your head


There are no right or wrong answers to these questions, you should simply try to answer as honestly as you can about your personal experience of migraine symptoms.

A healthcare professional might also carry out a physical examination, including testing your reflexes and your coordination and checking your vision.

Getting help for your migraines

It is possible that your doctor will refer you to a specialist like a neurologist for a further consultation.
They might recommend diagnostic tests such as a CT scan or MRI scan.13 However, these are usually only used in very severe cases.

As migraine is a long-term condition, your doctor might book a follow-up appointment to check on the progress of any treatment they have prescribed or to monitor changes in your migraine symptoms. It is important to talk to your doctor about migraines so that you can get the right treatment for your condition.

Take the migraine test 

If you’re not sure whether your symptoms are a migraine or something else, take the migraine test. This is not a migraine diagnosis but it’s a way to learn more about the condition.

References

  1. Yeh, W, Blizzard, L & Taylor, B. What is the actual prevalence of migraine? Brain and Behaviour 2018; 8:e00950.
  2. NHS Choices. Migraine – Causes. http://www.nhs.uk/Conditions/Migraine/Pages/Causes.aspx [Last accessed: June 2021]
  3. NHS Choices. Migraine. http://www.nhs.uk/Conditions/Migraine/Pages/Introduction.aspx [Last accessed: June 2021]
  4. Migraine Research Foundation. Migraine fact sheets. http://migraineresearchfoundation.org/about-migraine/migraine-facts/ [Last accessed: June 2021]
  5. Lipton, R. B. et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 2007; 68(5):343-49.
  6. Steiner, T et al. Migraine: The Seventh Disabler. Headache 2013; 53:227-29.
  7. Schwedt, T. J. Chronic Migraine. BMJ 2014;348.
  8. The Migraine Trust. More than ‘just a headache’. https://www.migrainetrust.org/about-migraine/migraine- what-is-it/more-than-just-a-headache/ [Last Accessed: June 2021]
  9. Cutrer, F.M. Pathophysiology of Migraine. Seminars in Neurology 2010; 30(2):120-30.
  10. Peris, F. et al. Towards improved migraine management: Determining potential trigger factors in individual patients. Cephalagia 2016; 37:452-63.
  11. Radtke, A & Neuhauser, H. Prevalence and Burden of Headache and Migraine in Germany. Headache 2009; 49:79-89.
  12. NHS. Migraine - Diagnosis. https://www.nhs.uk/conditions/migraine/diagnosis/ [Last accessed July 2021]
  13. Friedman, D. et al. Utilization, Diagnosis, Treatment and Cost of Migraine Treatment in the Emergency Department. 2009; 49:1163-1173.
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