Migraine is a painful headache, which is mostly pulsating, or even a persistently throbbing pain, mainly in the morning time, immediately after you wake up from the bed. Migraine is a neuro-vascular disorder that can be caused by drugs, foods and even by genetic inheritance. According to medical reports, women are more prone to migraine attack than men and the reason for this condition is still unknown.
Phases and symptoms

There are four main phases in the attack of migraine, which is broadly classified into four types. They are:

A – Prodrome
B – Aura
C – Pain Phase
D – Postdrome

The Prodrome is an acute phase reaction with intense irritability, fatigue, dizziness and other abnormal symptoms, and it may persist for a short period of some hours and rarely for a day. The Aura is a focal neurological reaction that can cause vision changes, sensory and motor neuronal changes, color changes with decrease in sensations, etc. The next phase in migraine is a pain phase, which is the real migraine attack, and there is a gradual onset of pain and then it will get intense after 2–4 hours of onset. The symptoms of pain phase are vertigo-like reactions with nausea or vomiting, irritability to sound, photosensitivity, delirium, vision changes, sometime diarrhea and localized edema in the frontal portion of the head.


The causes of migraine are tension, stress and mental strain, oral contraceptives, diets such as monosodium glutamate and tyrosine-rich diets, hormonal changes in menarche and in menopause and rarely in pregnancy. The neural pathology cause for migraine attack is cortical spreading depression associated with depolarization and release of inflammatory chemicals that can initiate the pain response and low levels of serotonin; female gender and genetic inheritance can contribute to the pathogenesis of this painful disorder.


Generally, there is no migraine-specific laboratory or radiological diagnosis. But the physical and clinical examination of the patient can be useful to diagnose the cause of the attack and intensity of the migraine. Some of the common symptoms such as nausea, vomiting, photophobia and throbbing headache with irritability to sound can be a symptom of migraine attack. However, the physician needs to do differential diagnosis to rule out the other causes such as cluster headaches with similar symptoms.

Treatment options

The common treatments for the migraine attack are medications such as tricyclic antidepressants and selective serotonin reuptake inhibitors; amitryptiline, beta blockers and calcium channel blockers with sedatives can be helpful to treat migraine attacks. Other NSAIDS such as aceclofenac, diclofenac and aspirin can also be prescribed to reduce the pain. If the medications are not useful, the physician may prescribe surgical intervention to treat migraine.


With the medications and the nutritional lifestyle changes, the episodes of migraine attacks can be considerably reduced or prevented. But still there are chances for the relapses, which are trigger-dependent. But most of the migraine patients respond to drugs and medical management is sufficient to control the attacks.


It is better to prevent the migraine attack than curing the migraine attack. Some of the preventive measures such as avoiding migraine triggers, lifestyle changes and food habit modifications, tension- and stress-free workplace and family environmental setup can dramatically reduce and prevent the incidences of migraine attack.

When to see a doctor

If you experience lack of sleep, throbbing and persistent headache, and sensitivity to light sources, nausea or vomiting, any vision changes or if you experience these problems even after you took the medicines to treat these conditions, you need to consult the doctor immediately.


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