What is Migraine

A migraine is a neurological disorder characterized by recurring, moderate-to-severe headaches that typically cause a throbbing or pulsating pain on one side of the head. Attacks usually last from 4 to 72 hours and are commonly accompanied by nausea, vomiting, and increased sensitivity to light and sound. 

Key Symptoms

Migraine symptoms can vary in intensity and are typically broken down into four phases, though not everyone experiences all of them: 

• Prodrome: Subtle, early warnings for few hours before the headache, such as mood swings, fatigue, food cravings, or neck stiffness.
• Aura: Sensory disturbances that occur before or during the headache, such as seeing flashing lights, zigzag lines, blind spots, or feeling numbness and tingling in the face or limbs.
• Attack (Headache): The primary throbbing head pain, usually confined to one side, and accompanied by extreme sensitivity to sensory inputs like light (photophobia) and sound (phonophobia).
• Postdrome: A "hangover" phase after the headache resolves, leaving the individual feeling drained, dizzy, or unable to concentrate.

Types of Migraine

• Migraine without aura: The most common type, occurring without prior warning signs. Almost 85% of all maigraines
• Migraine with aura: Includes sensory or visual disturbances (e.g., flashing lights, blind spots, or tingling) that precede or accompany the headache.
• Chronic migraine: also known as Chronic daily headache. Frequent headaches that occur on 15 or more days a month for at least three months

Common Triggers

Migraine attacks are highly individual, but common factors that provoke episodes include:

• Stress: The most widely reported trigger.
• Hormonal fluctuations: Changes during menstruation, pregnancy, or menopause. Also women taking hormonal preparations.
• Environmental factors: Bright lights, loud sounds, strong smells, or changes in barometric pressure.
• Diet and sleep: Skipping meals, certain foods (like aged cheeses or processed meats), alcohol (red wine), caffeine withdrawal, and irregular sleep schedules.

Management and Treatment

Treatment relies on both acute relief (to stop an attack in progress) and preventive strategies:

• Acute medications: Includes over-the-counter pain relievers (like ibuprofen, naproxen or acetaminophen) and prescription drugs specifically designed for migraines, such as triptans.
• Preventive medications: Includes beta-blockers, antidepressants, anti-seizure medications, or newer treatments like gepants.
• Lifestyle modifications: Tracking and avoiding personal triggers, maintaining regular sleep and eating habits, and managing stress

• Non drug treatment like external wearable devices. These FDA-cleared devices are a popular and effective way to abort or prevent migraine attacks without the risk of medication overuse headaches: CEFALY: A headband that uses gentle electrical impulses to stimulate the trigeminal nerve, often used for both acute treatment and daily prevention. Nerivio: An FDA-cleared, non-painful wearable device worn on the upper arm that uses remote electrical neuromodulation to treat attacks. gammaCore: A handheld device that provides non-invasive vagus nerve stimulation (nVNS) to relieve or prevent cluster headaches and migraines.