Migraine, Episodic and Chronic
A complex neurologic condition characterized by associated features such as moderate-to-severe headache, light sensitivity, sound sensitivity, nausea, and/or vomiting. Considered chronic when an individual has more than 15 headache days per month for more than 3 months.
The “root cause” of migraine is actually genetic! An individual with migraine was actually born with the genetic makeup for this condition. This can often be confusing, as many people don’t start to experience the symptoms/signs of having migraine until later in life. When and how migraine chooses to present itself is different for everyone. Think of migraine as initially just floating beneath the surface, not causing any symptoms and completely out of eyesight. At some point, migraine will break through the surface and will then start to cause identifiable breakthrough migraine attacks. The reason for migraine coming to the surface can vary widely and can include things such as puberty, illness, injury, etc. Many times, there is no clear reason for migraine to start to break through (which can be equally frustrating).
As of 2019, the estimated prevalence of migraine was thought to be about 1.1 billion people globally being affected by migraine.This translates to about 12% of the population having migraine. This condition typically affects women more often than men, and estimates are about 1 in 5 women are diagnosed with migraine.
The earliest phase of a migraine attack can start hours to days before the actual headache part of the episode. This is formally known as the “prodrome” phase. This can be any number of symptoms including yawning, food cravings, increased urination, fatigue, etc. The second phase is known as the migraine “aura.” Less than a third of patient’s with migraine will experience an aura, so you may not experience this phase of a migraine attack. This can be visual symptoms or sensory changes (such as numbness/tingling). The third phase, and the most well known phase, is the acute headache phase of a migraine. This typically involves a headache of moderate to severe intensity with associated light and sound sensitivity and/or nausea or vomiting. This typically lasts anywhere from 4 to 72 hours, but can be longer. The final phase of the migraine attack is known as the “post-drome,” which many people refer to as their “migraine hangover.” Much like the prodrome phase, this can last for hours to days, and occurs after the acute headache pain has resolved. This can involve a variety of symptoms including fatigue, irritability, etc. Many people will describe it as not feeling back to 100%. These different phases do not have to be linear and are often thought to overlap with each other over the course of the migraine attack.
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