Migraine is a complex genetic neurological disorder that affects up to 1 in 5 people. It is a spectrum disorder, rendering some completely disabled, while others are able to live fairly normal lives with only the occasional attack. It is an invisible disability, not a temporary condition, nor something that will go away. There is no cure for migraine, however, in most cases, it can be managed.
The research around migraine is rapidly changing, with significant breakthroughs in recent years. We now understand all migraine to have a genetic cause. Some types are caused by a single gene defect, and others are polygenetic or a combination of a number of genes.
At its most basic level migraine is a type of sensory processing disorder, in which the migraine brain overreacts to all kinds of sensory inputs. Migraine physiology is complex, and unfortunately not well understood, but when 'triggered' by a sensory overload, the migraine brain gets over excited and triggers a 'storm' of chemicals that cause the migraine attack. There are three things we know are going on during a migraine attack: pain nerves in the head and the neck are irritated; blood vessels in the head spasm; and, there is inflammation going on in the affected part of the brain. It’s the combination of these three that usually results in the severe and disabling headache and other neurological symptoms.
Typical or common migraine attacks or episodes are characterised by a pulsating or throbbing headache, usually only on one side of the head, which lasts between 4 and 72 hours, with some warning symptoms before, and a ‘migraine hangover’ afterward. However, for many people with migraine the 'attack' phase involved many other symptoms, and some do not have headache at all. Additionally, the attack phase can last longer than 4 days.
Migraine is a very individual disease: some people get the other symptoms of migraine and no headache at all, others have migraine attacks that last for months. There are also a number of different types of migraine attacks you can experience.
Migraine has a lot of comorbidities (other conditions that are more common in people with migraine, but not necessarily caused by migraine. People living with migraine, and particularly those living with migraine with aura, should be aware that the have a higher risk of having a stroke.
People who live with migraine also are at risk of medication overuse headache. This is when overuse of common pain and migraine medications causes rebound headaches, and transforms migraine attacks into constant, unrelenting headache. It is believed this only affects those with migraine.
- Clinically reviewed by: Dr Emma Foster MBBS FRACP PhD