Migraine - Migraine headache

Low urgency
Very common-

Migraine is a severe headache caused by changes in the calibre of the cranial blood vessels. Migraine is the second most common cause of headache, and the leading cause of disabling headache. It is most common in young women.

Although the exact cause is unknown, it is typically triggered by external stimuli that activate the trigeminal nerve, causing the release of nerve transmitters capable of constricting the blood vessels of the nerve itself and deep within the brain. 

It manifests as a severe headache, usually on one side and with pulsating characteristics. It is usually accompanied by nausea, photophobia, dizziness and other neurological symptoms. 

Sometimes before the pain the person has sensations (prodromes) that indicate that a new attack is about to begin: yawning, euphoria, irritability, inattention, pallor and a compulsive desire to eat sweet foods. Shortly afterwards, there may be an aura phase with visual disturbances, loss of sensation and motor impairment. Finally, after the pain phase, there may be general malaise, tiredness, lack of concentration and drowsiness.

Diagnosis is clinical, by interrogation and physical examination. In severe cases, a scan may be requested to differentiate it from a cerebral vascular accident.

Migraine should be treated early. Initially, it is advisable to remain stretched and at rest. Pain control is based on the use of non-steroidal anti-inflammatory drugs (ibuprofen, naproxen, etc.), triptans (sumatriptan, rizatriptan, etc.) and/or ergotamine. If vertiginous symptoms are associated, antivertiginous drugs should be used alone or in combination with benzodiazepines; vasodilators such as nimodipine have also been shown to be effective.
 
It is essential to regulate lifestyle by avoiding the identified triggers.
Bibliographic references
  1. Urbano-Marquez A., Estruch R. Generalidades. Cefalalgias. Farreras Rozman. Medicina Interna: 1317:1318.
  2. Goadsby, Peter J., Raskin, Heil H. Migrañas y otras cefaleas primarias. Harrison, Principios de Medicina Interna. 19ª Edición. Tomo 1, 2586:2594.
  3. Goadsby, Peter J., Raskin, Heil H. Cefaleas. Harrison, Principios de Medicina Interna. 19ª Edición. Tomo 2,107:111.
Author
Dr. Oscar Garcia-Esquirol
Copyright
© TeckelMedical 2026

Symptoms

    Headache due to stress


    Throbbing headache


    Headache


    Headache with sensitive skin


    Bothered by noise

Symptoms to watch out for

Vomiting
If the pain doesn't go away with either over-the-counter painkillers or those previously prescribed by your general practitioner
Fever (temperature higher than 38 ºC)
Loss of sensitivity and/or motility in limbs
If it is accompanied by seizures

Self-care

Lay in a dark and quiet room.
Avoid caffeine, alcohol, smoking and/or screens.
Take over-the-counter analgesics and check with your general practitioner to discuss other treatments.