Gregory Dussor, brain researcher, explains why migraine attacks are so complex: “It’s not just pain”
Migraine attacks are more common than you might think. Around 14% of the population experience these painful, throbbing headaches.
Migraine is a common neurological disorder - most commonly known for the sudden attacks which cause severe, throbbing headaches. But there are a whole range of other symptoms related to migraine. Some sufferers experience blurred vision or other visual disturbance ( such as bright flashes of light, called aura), nausea, vomiting, dizziness, tingling sensations... and sometimes even difficulty speaking. For those who are unlucky enough to develop this condition, it’s largely down to family history and genetics.
Who suffers from migraines?
For those who are unlucky enough to develop this condition, it’s largely down to family history and genetics. Roughly 14% of the population experiences migraines. According to a recent study, over one billion people worldwide are affected by the condition. Migraine attacks are most common between the ages of 30 and 50, and tend to affect women more than men.
The condition is linked to inflammation of the meninges (the protective layers around the brain) and irritation of the trigeminal nerve, which is responsible for facial sensation.
Migraine stages
Migraine attacks usually unfold in four distinct stages, each with its own set of symptoms:
1. Prodrome
This early phase can appear 24 to 48 hours before the headache begins. Common signs include:
- Constipation
- Low mood or depression
- Food cravings
- Frequent yawning
2. Aura
Aura is a reversible neurological symptom. It sometimes appears before the pain starts and can affect different senses:
- Vision: flashing lights, bright spots, or zigzag patterns
- Touch: tingling or numbness
- Speech: difficulty finding words or speaking clearly
3. Attack
This is the migraine headache itself. If untreated, it can last 4 to 72 hours. The pain typically:
- Affects one side of the head
- Feels sharp, throbbing, or pulsating
- Starts mild and intensifies over time
- Often centers in the forehead or behind one eye
Other symptoms may include:
- Sensitivity to light, sound, smells, and touch
- Nausea and vomiting
4. Postdrome
After the headache subsides, many people experience:
- Confusion
- Exhaustion or a “wiped out” feeling
What triggers migraines?
There is no one set answer to that as it varies from person to person. Around three quarters of migraine suffers have isolated what brings on their attacks.
Theses can be broken down into six categories: emotional or physical stress, hormonal changes, difficulty getting to sleep, diet (chocolate, cheese, alcohol, coffee), sensory disturbances, and the weather.
Erratic fluctuations in the hormone, estrogen, have been strongly linked into why so many women suffer from migraines but there are still many unanswered questions as to what biological mechanism really causes the disorder.
Gregory Dussor, Professor in the School of Behavioral and Brain Sciences at UT, Dallas believes it “is probably among the most poorly understood neurological disorders, or disorders in general. The entire migraine attack is a very complicated thing. It’s not just pain. It’s a whole series of events that are happening well before a headache ever starts.”
Migraine and the brain’s protective membrane
Dussor has identified one common denominator - the nerve fibres of the meninges– the three thick membranes which protect the brain and spinal cord and the immune cells contained within them. When these immune cells response to changes in the central nervous system, they occasionally overreact, causing inflammation and in turn, a throbbing headache.
But it’s still only one part of the puzzle, as Amynah Pradhan, director of the Center for Clinical Pharmacology at Washington University explained to the BBC. “Ultimately, there may be one common denominator, but there’s multiple paths to migraine,” she explains. “Maybe even more than that, I think within an individual. There are multiple ways to get migraine and everybody’s got a cocktail of things going on.”
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