Headaches and migraines are often interchanged when discussing headache pain, but there are slight differences between the two. A migraine can cause severe throbbing pain or a pulsing sensation, usually on one side of the head; while a severe headache is more constant, steady type pain. Migraines are often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can cause significant pain for hours to days and can be so severe that the pain is disabling.
There are two types of migraines, which are defined by how often headaches happen.
- Episodic migraine: fewer than 15 headache days per month, some of them being migraine.
- Chronic Migraine: 15 or more headache days per month, with headaches lasting four hours or longer, for at least three months, some being migraine.
What are the Signs and Symptoms?
Migraines or headaches usually begin early in a person’s life – childhood, adolescence or early adulthood. Migraines and headaches typically progress through four stages: prodrome, aura, headache and post-drome (although some may not experience all stages).
Prodrome – 1 - 2 Days before a migraine, possible changes that could occur:
- Mood changes, from depression to euphoria
- Food cravings
- Neck stiffness
- Increased thirst and urination
- Frequent yawning
Aura – Before or during a migraine, possible disturbances include:
- Visual disturbances – flashes of light or wavy, zigzag vision
- Touching sensations (sensory) disturbances – like pins and needles sensation
- Movement (motor) disturbances – muscles seem weak
- Speech (verbal) disturbances – slurred or difficult speech
Each of these symptoms usually begins gradually, builds up over several minutes and lasts for 20 to 60 minutes.
Migraine Attack – Usually lasts from 4 - 72 hours During this time one may experience:
- Pain on one side or both sides of your head
- Pain that feels throbbing or pulsing
- Sensitivity to light, sounds, and sometimes smells and touch
- Nausea and/or vomiting
- Blurred vision
- Lightheadedness, possibly followed by fainting
Post-drome – Occurs for about 24 hours after a migraine headache attack. During this time, the following symptoms could occur:
- Sensitivity to light and sound
How are Headaches and Migraines Diagnosed?
A patient’s medical history, physical and neurological exams diagnose a headache disorder. Additional optional lab tests – such as MRIs, blood tests, and Spinal Fluid analyses – help physicians rule out other diseases.
Procedures used to diagnose a migraine are generally used to rule out other possible causes of the symptoms. In addition to a complete medical history and physical examination, some procedures that may be used include:
- Blood tests - Various blood chemistry and other laboratory tests may be run to check for underlying conditions.
- Sinus x-rays - A diagnostic imaging procedure to evaluate for congestion or other problems that may be corrected.
- Magnetic resonance imaging (MRI) - A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
- Computed tomography scan (also called a CT or CAT scan) - A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than standard X-rays.
- Spinal tap (also called a lumbar puncture) - A special needle is placed into the lower back, into the spinal canal, which is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes the brain and spinal cord.
What Happens After Diagnosis?
The CHI Health Neurological Institute multidisciplinary team offers highly trained experts that enable us to offer comprehensive migraine and headache care which begins with the diagnosis and lasts a lifetime. Our goal is to work with the patient to reduce occurrences, manage symptoms and maintain the highest quality of life.
Managing migraines and headaches is an ongoing process, beginning with the very first symptoms and continuing throughout the years. It’s never too soon or too late to think about how to access high quality, comprehensive, interdisciplinary care.