What is migraine?

Migraine is a common condition that affects the brain. Symptoms can vary depending on the type. It usually involves severe headache, and may also include:

• nausea
• vomiting
• sensitivity to light or sound

Migraine is a complex genetic condition. Migraine is more common in females. It can be triggered by a combination of factors that may be biological and environmental. Triggers are unique to each person but may include:

• food chemicals
• smells
• hormones

'Migraine' is the term used to describe the condition, and 'migraine attacks' are the symptoms you feel during an episode. How often migraine attacks happen differs from person to person. Some people have chronic migraine, with symptoms on most days.

What symptoms are related to migraine?

Symptoms vary depending on the type of migraine you experience. A migraine can be so painful that everyday activities become impossible.

Common symptoms of migraine

You may feel unwell for up to a day beforehand.

Some people get an aura before or during the migraine attack. An aura is a disturbance of vision, speech or sensation that can happen up to an hour before a migraine. You might:

• see flashing lights
• notice blind spots
• have zigzag lines in your vision

Some people find it hard to talk or hear ringing in their ears. The aura goes away by itself.

When the migraine attack starts, it is a severe, throbbing pain usually only on one side of your head. It gets worse with physical activity. It might hurt to see bright lights or hear noises. You might feel sick or vomit. An untreated migraine attack can last anywhere between 4 hours and 3 days.

After the headache goes away, you might feel very tired or unwell, or you might have a burst of energy. You might feel better after sleeping.

Migraines generally occur in 6 phases. You may not experience all these stages or symptoms:

1. Premonitory (warning) phase: Warning signs include mood change, brain fog, nausea, aches and stiffness, increased urination frequency (weeing more often) and speech difficulties.
2. Aura phase: Around 1 in 3 people with migraine may have changes to their vision, numbness, dizziness, confusion, difficulty speaking or abdominal (tummy) pain.
3. Acute or headache phase: Includes headache, nausea, vomiting, nasal congestion (a 'stuffy' nose), neck pain or sensitivity to light, sound and smell.
4. Resolution phase: May be slow or sudden and includes a need for sleep, feeling fatigue or even euphoria (feeling good).
5. Postdrome phase, or migraine hangover: This often includes 'brain fog' (tiredness and difficulty concentrating) and sometimes mood changes.
6. Interictal phase: This is the phase between attacks when you don't have symptoms.

Migraine aura without headache

Some people get an aura without a headache afterwards. They might feel sick or sensitive to light and sound.

Vestibular migraine

In vestibular migraine, the aura involves dizziness and loss of balance (vertigo). It may not go away when the headache starts.

Abdominal migraine

Abdominal migraine involves symptoms of:

• abdominal pain
• vomiting
• diarrhoea
• other gastrointestinal (digestion) upsets

People with abdominal migraine do not always experience headache. It's most common in children, with many children growing out of it by their teens. Children with a history of abdominal migraine may go on to develop other types of migraines with headaches as they get older.

Ocular (retinal) migraine

In ocular migraine, there are changes in your vision — or even temporary total loss of vision — in one eye. It goes away by itself. Vision is normal in the other eye. These symptoms usually happen before a headache, but not always.

Hemiplegic migraine

In hemiplegic migraine, the aura involves muscle weakness. This can last several days or weeks.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes migraine?

Doctors don't know exactly what causes migraine, although genetics have a role. It may be caused by temporary changes in blood vessels and chemicals in the brain.

You may be more likely to get migraine if:

• it is common in your family
• you have experienced abuse
• you have depression or anxiety
• you are living with obesity

Some people find that migraine is triggered by:

• missing meals
• certain foods, such as cheese, chocolate, citrus fruits, alcohol, coffee and food containing monosodium glutamate (MSG)
• too much or too little sleep
• changes in the weather
• hormonal changes, such as around menstruation or menopause
• screen use, bright lights, loud noises or strong smells
• stress and strong emotions

How is the cause of migraine diagnosed?

Your doctor can diagnose migraine by talking to you and examining you. There is no specific test to diagnose migraine. Your doctor may do tests to check for other causes of headache.

Your doctor may refer you to a neurologist — a specialist doctor who diagnoses and treats conditions of the brain, spinal cord and nerves.

Keeping a migraine diary can help you understand when you get migraine attacks and what triggers them. This may help your doctor diagnose migraine, and may also help you avoid triggers and prevent attacks.

You can find diaries and apps to record your headaches on the Migraine and Headache Australia website.

Your diary should record:

• the number of days you have a headache
• how severe your headache is
• any other symptoms you have
• any potential triggers

When should I see my doctor?

If you get severe headaches, see a doctor to find out what's causing them and how to treat them.

If you have a diagnosis of migraine, see your doctor again if your headaches change or get worse.

When to seek urgent care

Occasionally, headaches can be a symptom of something more serious. See your doctor immediately if you experience a:

• severe headache that begins suddenly
• headache that gets progressively worse over the course of several weeks
• morning headache with nausea that doesn't go away
• headache that starts following an injury to your head
• headache that gets worse when you are lying down
• headache that starts when you cough

If you are pregnant and have migraine, speak to your doctor for advice.

• fever
• neck stiffness
• confusion or a change in personality
• blurred or double vision
• loss of balance
• a seizure

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How is migraine treated?

There are many ways to manage migraine — to prevent attacks and to treat an attack once it starts. Talk to your doctor about a migraine management plan. This may involve lifestyle changes and medicines.

Self-care at home

During a migraine attack you can try to:

• rest in a quiet, dark room
• sleep
• put a cold pack on your forehead or a hot pack on your neck and shoulders
• gently stretch your neck

Medicines for migraine

If you feel the symptoms of a migraine attack starting, you may be able to stop the attack by taking pain-relief medicines. The earlier you take them, the more likely they are to work.

You may need a combination of medicines, such as:

• anti-inflammatory medicines (NSAIDs) — for example, aspirin or ibuprofen
• triptans — this is a group of medicines that are especially good at treating migraine pain
• anti-nausea medicines

Some of these medicines are available over the counter from a pharmacy, while others need a prescription. Talk to your doctor or pharmacist about the best options for you.

It's important not to take pain-relieving medicines too often since this can make things worse and lead to 'medication overuse headache'. If you need to take medicine several times a month, talk to your doctor about preventive treatment options.

What are the complications of migraine?

Complications of migraine include:

• medication overuse headache
• development of chronic (long-term) migraine
• higher chance of cardiovascular disease

The symptoms of migraine can make it challenging to get through daily life. It can become hard to work, care for others and take care of yourself. Migraines can lead to:

• depression and anxiety
• problems sleeping
• chronic pain
• thoughts of suicide

If you, or someone you know, is having suicidal thoughts and is in immediate danger, call triple zero (000). For help and support, call Lifeline on 13 11 14.

Can migraine be prevented?

There's no known way to prevent yourself from developing migraine, but you can help prevent a migraine attack.

Preventing migraine attacks

There are some lifestyle changes and complementary therapies that may help prevent migraine attacks. These include:

• avoiding any triggers
• getting enough sleep
• eating a healthy diet and maintaining a healthy weight
• getting regular exercise
• acupuncture
• reducing stress through relaxation techniques, such as yoga and meditation, or psychological therapies such as cognitive behavioural therapy
• taking dietary supplements such as magnesium, riboflavin or coenzyme Q10

It's best to maintain a healthy weight, as living with obesity can increase your chance of having a migraine attack.

If you get migraine attacks on more than 2 to 4 days a month, your doctor might suggest you try a preventive medicine to reduce the chance of attacks in future.

There are many different medicines that can reduce how often you get a migraine attack and how severe they are. They can be used for other health problems as well — some lower blood pressure, while others treat depression or epilepsy. You do not need to have these other health problems to take them for migraine.

If medicines don't help, you might try a series of injections of onabotulinum toxin A into your head and neck.

Resources and support

Visit Headache Australia or Migraine Australia to learn more about headache and to join an online support group.

You may want to join the Migraine Warrior Support Network.

Check out the ANZ Headache Societ's tips for managing migraine.

For mental health support call one of the following:

• Lifeline provides crisis counselling, support groups and suicide prevention services. Call 13 11 14, text 0477 13 11 14 or chat online.
• Suicide Call Back Service provides support if you or someone you know is feeling suicidal. Call 1300 659 467.

Languages other than English

The Pain Management Network has translated resources in many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

For mental health support, 13YARN has free and confidential crisis support. Call 13 92 76.