Migraines: How the Brain Hurts.

“It’s like a hot poker in my eye.”
“I feel as though a train is rushing through my head.”
“If I move a fraction of an inch, I’ll throw up.”

These are the words of migraine sufferers, describing the biggest pain in the head. Also known as vascular headaches, migraines cause intolerable throbbing pain due to a complex cascade of hormonal and biochemical responses in the brain, nerves, blood vessels and blood platelets. The intense pain of a migraine, which is often restricted to one area of the head, is what differentiates it from a simple tension headache. When you have a tension headache, most of the pain is from muscle tension and there is no nausea, sweating, vision problems or numbness that migraine sufferers often experience.

Despite millions of migraine sufferers, we have yet to fully understand exactly what causes migraines. As illustrated above, the migraine process involves the whole body, leading many scientist to believe the root cause to be in the nerve endings throughout the body. Nerve endings sense changes in the internal or external environment, responding to a drop in blood sugar from a missed meal or the hormonal fluctuations of menstruation. Once a change is sense, nerve endings release neurotransmitters called neuropeptides that begin a the cascade of a migraine episode.

Unlike headaches, migraines have four distinct stages called the prodrome, the aura, the headache and the postdrome. The prodrome is the warning stage when some people notice a general feeling of uneasiness, similar to the calm before the storm. At this stage, the migraine can be prevent if the person takes steps to relax and avoid triggers. The aura, which occurs in only 20 percent of migraine sufferers, is the onslaught of sensory disturbances when pain is increased by slight changes in lighting, sounds, smells and even the texture of clothes or bedding. The aura normally last less than an hour then fades to a headache that can last anywhere from an hour to several days. Once the headaches stops, the migraine survivor usually feels fatigued or “hung over” during the postdrome phase.

Migraine headaches are different from other diseases because that have no specific cause and often occur without warning. Common triggers include excessive caffeine, alcohol, or nicotine, as well as bright or flickering lights, noxious odours, high altitudes or changes in barometric pressure. Prescription medications are available however effectiveness varies from person to person. Self-help remedies like cold compresses, deep breathing and applying pressure to acupuncture points also provide effective relief through trial and error.


Migraine by Joan Raymond. Barnes& Noble Books, New York, 2003. Chapter 1, pages 8-24.

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