The word migraine comes from the Greek "hemicrania" and means "half-headed", because of the stabbing or pulsating pain that is frequently experienced on one side of the head. Migraines date as far back as 4,000 years ago and are even referred to in biblical texts.
Despite its prevalence, many myths and misconceptions are still associated with migraine, for example many people think that it is only women who suffer; others believe that those affected are simply hypochondriacs. The fact is: hardly anybody takes the disease seriously unless they have suffered from it themselves. Although the pain associated with migraine is excruciating and although it can significantly impair your quality of life, most people who live with migraines suffer in silence.
Although no two migraine patients suffer exactly the same symptoms, migraine has been categorised by the International Headache Society (IHS) in order to distinguish it from standard headache symptoms. The two most common forms of migraine are ‘simple’ migraine, or migraine without an aura and ‘classical’ migraine, or migraine with an aura.
Aura is a medical term used to describe a range of neurological symptoms that can accompany migraine: most commonly these include visual disturbances but they can also be experienced as feelings of numbness or tingling, dizziness or even a sense of imbalance or vertigo.
The majority of migraine patients, about 85 percent, suffer from a migraine without an aura. Symptoms include severe, recurring headaches which occur mostly on one side of the head, but can change sides during an attack, or change sides from one attack to the next, or even spread gradually across the entire head.
In a ‘simple’ migraine, the stabbing, pulsating pain is generally accompanied by nausea, vomiting and an over-sensitivity to light, sound and smells. The attacks can last between four and 72 hours. During a migraine attack the sufferer often has no choice but to lie in a darkened room until symptoms have died down.
For around 15 percent of those affected, the start of the real migraine attack is an aura. This phase is characterised by a range of neurological symptoms (aura symptoms), which usually increase rapidly within five to 20 minutes and last a total of between 30 and 60 minutes.
A migraine attack is divided into four distinct stages, which vary in intensity from one patient to the next and which can change over time.
A migraine attack usually announces itself hours or days beforehand through feelings of tiredness, irritability, euphoria, loss or increased appetite and/or a decreasing ability to cope with everyday pressures.
For around 15 percent of those affected, the start of the real migraine attack is an aura. This phase is characterised by a range of neurological symptoms, including impaired vision, a loss of concentration and speech difficulties, sensory symptoms like pins and needles and a feeling of discomfort down one side of the body. The symptoms usually increase rapidly within five to 20 minutes and last a total of between 30 and 60 minutes.
This stage consists of severe head pain and can be accompanied, in some patients, by other symptoms such as nausea or vomiting and diarrhoea. As everyday sensory stimuli such as sunlight or music make the pain worse, many sufferers retire to a dark and quietened room. Without treatment, this stage can last anything between four and 72 hours.
During this phase, the migraine symptoms slowly retreat, however many patients are completely exhausted, suffer from mood swings and can have difficulties in concentrating for up to two days after the attack.
What the four migraine stages do not include is the fear of new attacks, which many migraine patients experience during the pain-free intervals. At worst this fear becomes a constant companion, leading to an ongoing feeling of anxiety that can interfere with the sufferers family life, relationships, career and spare time.