Dr. Balaji B S, Consultant – Neurology & Epileptology, Aster Whitefield Hospital, Bengaluru
Have you ever been caught off guard by a pounding headache so severe that even the dimmest light or softest sound felt unbearable? If so, you might have experienced a migraine. Far more than just a bad headache, migraine is a complex neurological disorder that affects millions globally. Understanding what’s really happening in your brain during a migraine can not only demystify the condition but also help in managing it better.
Here are 8 key things you should know:
- Migraine Is a Multi-Phase Brain Event – Migraine attacks often begin with a prodrome phase—a subtle warning that may occur hours or even days before the headache. Symptoms can include irritability, fatigue, or unusual cravings.
- Cortical Spreading Depression Triggers the Attack – The actual migraine begins with a wave of electrical activity in the brain known as Cortical Spreading Depression (CSD). This wave leads to changes in brain chemistry, the release of inflammatory chemicals, and dilation of blood vessels—causing pain and discomfort.
- Some People Experience Auras – An aura is a sensory disturbance that may include zigzag lines, blind spots, or tingling sensations. It usually lasts 5 to 60 minutes and often signals that a headache is on its way.
- What Causes Migraines? – There’s no single cause, but genetics, brain chemistry, and environmental factors play a major role. Some individuals are simply more sensitive to these internal and external shifts.
- Common Triggers Include:
- Stress: One of the leading contributors to migraine onset
- Diet: Foods like aged cheese, chocolate, and caffeine may trigger attacks
- Sleep Disruption: Both oversleeping and sleep deprivation can set off a migraine
- Hormonal Changes: Especially common in women around menstruation
- Environmental Factors: Bright lights, strong smells, and loud noises can provoke attacks
- Migraines Can Be Treated, Not Cured – There is no permanent cure, but migraines can be effectively managed through two main approaches:
- Acute Treatment: For stopping a migraine as it begins, often using OTC or prescription medication
- Preventive Treatment: For reducing the frequency and intensity of attacks in chronic sufferers
- Prevention Is Key – Helpful preventive strategies include:
- Maintaining regular sleep routines
- Avoiding known triggers
- Hydration and balanced meals
- Engaging in relaxation techniques like yoga or meditation
- New Therapies Are Emerging – CGRP inhibitors are a new class of medications that target specific pathways in the brain linked to migraine pain, offering hope to those who haven’t found success with older treatments.
Living with migraines can be overwhelming, but understanding the science and symptoms behind the condition is the first step to regaining control. Since migraines vary widely from person to person, treatment must be highly individualized. By working closely with a doctor, identifying triggers, and crafting a personalized management plan, it’s possible to reduce the frequency and severity of attacks and significantly improve quality of life.
