Overview
A throbbing headache that makes ordinary light and sound feel unbearable, sometimes with strange visual flickers beforehand, is a migraine attack, not just a bad headache. Migraine is often dismissed as something to push through, yet it ranks among the most disabling conditions of any kind worldwide.
Disease Summary
- Category
- Non-Communicable Disease
- Cause
- Not fully understood, but thought to involve the release of pain-producing inflammatory substances around the nerves and blood vessels of the head
- Transmission
- Not applicable; migraine is a non-communicable neurological condition and cannot be spread between people
- Body System
- Nervous System
- Preventable
- Yes
- Curable
- No
Symptoms
Common Symptoms
A typical migraine attack lasts between 4 and 72 hours if untreated.
Throbbing Headache
Often on one side of the head, and typically described as pulsating or throbbing.
Sensitivity to Light and Sound
Ordinary light and noise can feel overwhelming during an attack.
Nausea or Vomiting
Commonly accompanies the headache phase.
Visual Disturbances (Aura)
Some people see flickering lights, zigzag lines, or temporary blind spots shortly before the headache begins.
Worsening with Physical Activity
Routine movement or activity often makes the pain noticeably worse.
Danger Signs
These are not typical of migraine and need emergency medical attention.
Sudden, Extremely Severe Headache
Often described as the worst headache of your life, this needs emergency evaluation to rule out a serious cause.
Headache with Fever and a Stiff Neck
Can indicate a serious infection such as meningitis rather than migraine.
Weakness, Confusion, or Difficulty Speaking
New neurological symptoms alongside a headache need urgent assessment to rule out a stroke.
Headache After a Head Injury
Needs prompt evaluation, particularly if it worsens rather than improves.
Diagnosis
Clinical History
Migraine is diagnosed mainly through the pattern, frequency, and character of headaches, along with associated symptoms like nausea or light sensitivity.
Headache Diary
Recording when headaches occur, how long they last, and possible triggers helps confirm the pattern and guide treatment.
Imaging, When Needed
A CT or MRI scan is not needed for typical migraine, but may be used if certain warning signs are present to rule out other causes.
Laboratory Tests
Clinical Assessment
The primary way migraine is diagnosed. No blood test can confirm migraine directly.
CT or MRI Brain Imaging
Not routinely needed, but used to rule out other causes if certain warning signs are present.
Blood Tests
Not used to diagnose migraine, but may be used to rule out other causes of headache if the pattern is unusual.
Treatment
Acute Treatment
Pain relievers and migraine-specific medications work best when taken early, ideally at the very first sign of an attack.
Preventive Treatment
For people with frequent or severe migraines, regular preventive medication can reduce how often attacks occur.
Prevention
Identify and track your triggers
A headache diary helps reveal patterns, such as specific foods, stress, or sleep changes, that come before an attack.
Keep a regular sleep schedule
Both too little and too much sleep can trigger migraines in some people.
Stay hydrated and eat regularly
Skipping meals and dehydration are common, easily avoidable triggers.
Limit alcohol
Alcohol, particularly red wine, is a common trigger for many people with migraine.
Risk Factors
Higher Risk
These factors are linked to a higher likelihood of experiencing migraine.
- A family history of migraine
- Being female, particularly linked to hormonal changes
- Age between puberty and the mid-40s, when migraine is most common
Common Triggers
These factors can trigger individual migraine attacks.
- Stress
- Hormonal changes, such as during menstruation
- Certain foods, alcohol, or changes in caffeine intake
- Sleep disruption
Related Conditions
Conditions more common in people with migraine.
- Anxiety and depression
- Other headache disorders
Complications
Status Migrainosus
A migraine attack that lasts longer than 72 hours, which needs medical attention.
Medication-Overuse Headache
Frequent use of pain medication to treat headaches can, paradoxically, lead to more frequent headaches over time.
Reduced Quality of Life
Frequent migraines can significantly affect work, school, and relationships, and are linked to higher rates of anxiety and depression.
When to Seek Medical Care
Sudden, Extremely Severe Headache
Needs emergency evaluation.
Headache with Fever, Stiff Neck, or Confusion
Needs urgent assessment to rule out a serious infection.
New Neurological Symptoms
Weakness, difficulty speaking, or vision loss alongside a headache need emergency care.
Headaches That Are Increasing in Frequency or Severity
A changing pattern is worth discussing with a healthcare provider, since treatment may need to be adjusted.
Prognosis
Often Lifelong, But Manageable
Migraine tends to be a long-term condition, though frequency and severity often change over a person’s lifetime.
Frequency Can Often Be Reduced
Identifying triggers and, when needed, preventive treatment can meaningfully reduce how often attacks occur.
Often Improves With Age
Many people experience fewer or milder migraines as they get older, particularly after menopause in women.
Differential Diagnosis
Tension-Type Headache
The most common type of headache, typically felt as pressure or tightness rather than throbbing, and usually milder than migraine.
Bacterial Meningitis
Can cause a severe headache alongside fever and neck stiffness, and needs to be ruled out urgently, since it is a medical emergency.
Cluster Headache
Causes severe, one-sided pain focused around one eye, occurring in clusters over weeks, and is far less common than migraine.
References
World Health Organization (WHO)
World Health Organization fact sheet on migraine and other headache disorders, including prevalence, types, treatment, and barriers to care.
WHO Model List of Essential Medicines, 24th List (2025)
WHO’s list of minimum medicine needs for headache disorders required for a basic health-care system.
WHO Atlas of Headache Disorders and Resources in the World
WHO’s global assessment of the burden of headache disorders and the resources available to address them.
Frequently Asked Questions
Is migraine just a bad headache?
No. Migraine is a distinct neurological condition, not simply a severe headache. It involves specific patterns of pain, sensitivity to light and sound, nausea, and sometimes visual disturbances, and ranks among the most disabling conditions worldwide.
Can migraine be cured?
There is currently no cure, but migraine can often be well managed. Identifying personal triggers and using appropriate treatment can significantly reduce how often and how severely attacks occur.
What is a migraine aura?
An aura is a temporary set of sensory disturbances, most often visual, such as flickering lights or blind spots, that some people experience shortly before a migraine headache begins.
When is a headache an emergency?
A sudden, extremely severe headache, one with fever and a stiff neck, or one accompanied by weakness, confusion, or difficulty speaking, are not typical of migraine and need emergency care.