Migraine is more than a terrible headache that happens now and then. It’s a neurological condition marked by severe, throbbing headaches, as well as vision abnormalities, nausea, vomiting, and excessive sensitivity to light, sound, touch, and smell.
Migraine attacks are episodes of migraine symptoms that can last anywhere from a few hours to many days. Chronic migraine sufferers, on the other hand, may experience symptoms on most days of the month.
It’s likely that you or someone you care about suffers from migraines: According to the Migraine Research Foundation, migraine is the third most common ailment in the world, and roughly one in every four households in the United States has someone who suffers from it.
Experts are continually discovering more about migraines and what causes them. There are factors that raise the likelihood of a migraine episode and factors that make certain persons more susceptible to develop migraine sickness.
Migraine and Genetics
According to Roderick Spears, MD, medical head of neurology at Penn Medicine in Pennsylvania, genetics have a significant impact in migraine.
“If you have migraine, there’s a 75 percent chance you have a first-degree relative who also has migraine. It can be passed down equally from both the mother’s and father’s sides, according to Dr. Spears, who emphasises the importance of family history in migraine with aura.
A person suffering from a migraine with aura will experience visual, sensory, or speech-language symptoms for several minutes to an hour, followed by a headache. Flashes of light or momentary vision loss are common visual complaints. Numbness and tingling are examples of sensory symptoms. Difficulty speaking is one of the speech-language symptoms.
Even though the hereditary component of migraine with aura is strongest, the specific genes involved in that link remain unknown.
“We know the genetic map of specific types of migraine that are quite rare, such as hemiplegic migraine,” Spears says, “but we don’t have a single gene that has been found for common migraine that most people experience.”
According to a study of twins published in the Journal of Psychosomatic Research, several other factors can influence whether or not a person gets migraine. Even monozygotic (identical) twins don’t have the same migraine risk; if one gets it, the other has a 26% chance of getting it, not 100%. According to the same study, nonidentical twins have a 13 percent chance of suffering migraines.
Hormones and Migraine: What Role Do They Play?
“When it comes to migraines, boys and girls have about the same rate, but this changes as they get older, with women having a 3 to 1 ratio. “Estrogen hormones, in particular, play a substantial influence in migraine expression,” explains Spears.
According to the American Migraine Foundation, girls are more prone to have migraines around the time of their first menstrual cycle, with migraine prevalence in women rising throughout childbearing years.
According to Nada Hindiyeh, MD, a headache expert and researcher at Stanford Health Care in Palo Alto, California, migraine is highly common among women during their menstrual period. “There are numerous varieties of migraine, and one of them is linked to the menstrual cycle.”
“We suspect that many women get migraines throughout their menstrual cycle is due to a reduction in oestrogen that occurs just as the cycle begins. According to Dr. Hindiyeh, this is a major migraine trigger.
According to a review published in Current Opinion in Neurology, increasing oestrogen levels during pregnancy and maintaining ovarian oestrogen production after menopause appear to minimise the incidence of migraine attacks.
Migraine and Neurotransmitters
Migraine sufferers are prone to despair and anxiety. According to the American Migraine Foundation, one out of every four migraine sufferers suffers from depression, and one out of every two suffers from anxiety.
Neurotransmitters are substances that convey messages from one neuron (nervous cell) to another, as well as between neurons and muscle cells. Neurotransmitters send out messages that control a range of bodily functions, some of which are linked to anxiety and sadness.
There’s evidence that the neurotransmitters serotonin and dopamine, which control mood, sleep, and hunger, as well as motivation and learning, play a role in migraine.
According to Johns Hopkins Medicine, some specialists believe that migraine discomfort is caused by waves of activity by groupings of excitable brain cells, which could cause neurotransmitters like serotonin to restrict blood vessels.
According to research published in April 2017 in Neurology, PET scans of the brain indicated that dopamine levels decline and fluctuate at different moments during a migraine attack.
According to the authors, physicians and emergency room professionals frequently prescribe dopamine antagonists, which are medications that block overactive dopamine receptors, to persons who suffer from migraines in order to reduce large dopamine swings and thereby reduce migraine symptoms.
The researchers discovered that dopamine levels in migraine sufferers were constant and normal between attacks, but dropped considerably during the attack.
The Difference Between Migraine Causes and Triggers
While the underlying cause of most types of migraine remains unknown — or why one person gets migraine while another does not — the many triggers for a migraine attack are better recognised. The following are some of them:
- Hormone fluctuations, notably in women Allergies
- Changes in weather, stress levels, and food consumption, as well as odours and lack of sleep, are all examples of environmental factors.
- Medications for sexual dysfunction, such as Viagra (sildenafil) and Cialis (tadalafil), contain nitroglycerin and phosphodiesterase inhibitors (tadalafil)
- Dehydration, even mild dehydration, is harmful to your health.
- Caffeine consumption: too much or too little
According to the Migraine Trust, identifying one’s personal triggers can be challenging because a migraine attack can be caused by a combination of factors, and a single trigger may not cause an attack every time it occurs.
Migraine Triggers in the Environment
“The migraine brain prefers what we call homeostasis and does not tolerate a lot of change. Changes in weather, light, noise, and even nutrition can all provoke migraine attacks, according to Spears.
According to the National Headache Foundation, the following sorts of environmental stimuli might cause a migraine attack:
- Changes in humidity, temperature, or barometric pressure are all examples of weather changes.
- Extreme cold, extreme humidity, or an extremely dry, dusty environment are all possibilities.
- glare, bright lights, and flickering lights
- Tobacco smoke and carbon monoxide are examples of vapours and fumes.
- Strong odours
- Traveling by automobile, train, or boat can cause motion sickness.
- Changes in routine that have an impact on stress levels, food habits, or sleeping patterns
- Physical exhaustion
Is it possible for a head injury to cause migraines?
“We know that headaches are very common after head trauma,” Spears says. If you have a hereditary tendency to migraine, your post-traumatic headache is more likely to manifest as a migraine-type headache, he says.
“However, there are occasions where people who have never had headaches and have no family history of migraines develop persistent, severe, migraine-like headaches following a head injury. They don’t get them every day, but they’re more likely to get them after a head injury,” Spears adds.
People hospitalised for a mild head injury were more likely than the general population to acquire new headaches or report worsening of existing headaches, according to a study published in The Journal of Headache and Pain in 2018.
Is Migraine Caused by Child Abuse, Maltreatment, or Other Psychological Trauma?
According to Spears, there is evidence that childhood abuse is linked to an increased incidence of migraine later in life. According to a study published in the journal Headache in January 2017, children who have been subjected to emotional abuse as children are more likely to have migraines as adults. Emotional abuse was measured by asking study participants how often their parents or other adult caregivers said things that harmed their feelings or made them feel unloved or unwanted. According to the study, emotional abuse was more closely associated to the chance of future migraine than physical or sexual abuse.
In a previous study, the effects of childhood emotional abuse, emotional neglect, and sexual abuse were examined. It was discovered that, while all of these categories of abuse were linked to an increased incidence of migraine, emotional abuse had the highest link. Emotional abuse was assessed by asking participants how often statements like “People in my family said hurtful, insulting things to me” were true, whereas emotional neglect was assessed by asking participants how often statements like “Someone in my family helped me feel important, special” were true. The frequency with which statements like “Someone tried to coerce or compel me to have unwanted sexual contact” were true was used to determine sexual abuse.
What Are the Chances That Episodic Migraine Will Turn Into Chronic Migraine?
According to Spears, episodic migraine is defined as fewer than 15 headache days per month, whereas chronic migraine is described as 15 or more headache days per month with migrainous symptoms. “There is a 1.5 percent to 3 percent chance of developing from episodic migraine to chronic migraine every year,” he explains.
According to Spears, a review published in March 2019 in the journal Headache looked at 17 research that looked at risk factors for chronic migraine. These factors had the most evidence for causing migraines to evolve from episodic to chronic:
- Acute medication overuse is defined as taking acute drugs three or more days per week to treat a headache.
- Depression
- The frequency of headache days is increasing.
According to Spears, increasing headaches and acute drug misuse can go hand in hand. “For example, if someone gets two headaches per month and notices that it is increasing to one headache per week, then two headaches per week, they may begin to treat those migraines with acute medicine, which leads to more headaches,” he explains.
According to Spears, this can lead to a vicious cycle of more headache days leading to more treatment days. “The more migraines you treat, the more likely you are to develop chronic migraine.”
Migraine and Migraine Attacks: Nonmodifiable Risk Factors
Nonmodifiable risk variables are those that a person has no control over. The following are some of the factors that can cause migraine:
- Migraine is more common in women between the ages of 20 and 45.
- Low Socioeconomic Status According to a study published in Cephalalgia, women with a lower socioeconomic status had a higher risk of migraine and more frequent migraine attacks.
- Injury to the head According to the American Migraine Foundation, the majority of persons who have a concussion get a headache with migraine-like symptoms later.
Migraine Attacks: Modifiable Risk Factors
- Spears advises the following methods for lowering the likelihood of a migraine attack:
- Obesity can be prevented or lost by losing extra weight. Obesity is linked to episodic migraine that progresses to chronic migraine, according to the American Migraine Foundation.
- Caffeine consumption should be limited.
- Keep an eye on the frequency of headaches and whether or not you’re taking any pain relievers.
“The assumption is that if you have two or more [migraine] days per week, you should seek medical attention for your headache to have it checked and possibly put on a treatment plan to keep the frequency down,” Spears adds.
Improving your sleeping habits has also been shown to help reduce the frequency of migraine attacks. Women who followed simple instructions for improving sleep (such as scheduling enough time for sleep; avoiding watching television, listening to music, or reading in bed; practising visualisation to fall asleep faster; avoiding naps; and limiting food and drink in the hours leading up to bedtime) had fewer headaches, and when they did have one, it was less intense, according to a study published in Headache.
Keeping note of your daily habits, such as when and what you eat or drink, when and how much you sleep, and how much physical activity you get, can help you discover migraine triggers and avoid them in the future.
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