Recurrent Migraine Symptoms, Causes & Treatment Options

Chronic migraine is a condition that results in individuals experiencing moderate to severe headaches multiple times a month. [1] It is a very common neurological disorder that affects more than 1 billion individuals worldwide. [2]

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Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is Recurrent Migraine?

Summary

A migraine attack often starts suddenly with a severe, stabbing, or pulsating pain on one side of your head. The headaches can worsen with movement, bright light, or loud noises and may be accompanied by nausea and vomiting. Additionally, each migraine attack typically lasts for 4 to 72 hours if left untreated or not treated successfully. Individuals who experience migraines at least 15 days out of one month will be diagnosed with chronic migraine disorder. [3] Medications recommended for migraine attacks include acetaminophen, non-steroidal anti-inflammatory drugs, aspirin, and triptans. Before taking medications for migraines, you should go see your doctor to make sure the pain you are experiencing is, in fact, a migraine. [1]

Recommended care

Recurrent Migraine Symptoms

Main symptoms

Migraines are associated with severe, pulsating, unilateral pain on one side of the head. People who are experiencing migraines also often complain of nausea, vomiting, dizziness, increased pain with exposure to bright light (photophobia), and increased pain with exposure to loud noises (phonophobia). [3]

  • Unilateral, pulsating quality of pain
  • Nausea and/or vomiting
  • Extreme sensitivity to lights
  • Extreme sensitivity to noises
  • Worsening symptoms with movement

Other symptoms

Individuals who suffer from migraine attacks may also complain of other features that affect their overall daily health and wellness. [3]

  • Lack of appetite
  • Disturbances to bowel function
  • Visual aura: seeing floaters, light flashes, moving patterns, or loss of vision
  • Sensory aura: tingling and numbness that often spreads over one side of the body
  • Weakness
  • Difficulty swallowing

Pre-migraine symptoms

10 to 20% of individuals who experience migraines may experience symptoms up to 2 days before their migraines. [1]

  • Abnormal bursts of energy
  • Neck stiffness
  • Frequent urination

Post-migraine symptoms

A certain percentage of individuals who experience migraines may experience various symptoms after their migraine symptoms have improved. [1]

  • Persistent, but less severe headache
  • Fatigue
  • Nausea
  • Sensitivity to lights
  • Sensitivity to noises
  • Sensitivity to smells
  • Sensitivity to movement

Recurrent Migraine Causes

It is not certain what exactly causes migraines. Some research demonstrates a correlation with migraines and inflammation of brain blood vessels; however, other scientists believe that there is a genetic etiology. Additionally, the way in which the brain manages signals can affect if an individual develops a migraine; if you are stressed, nervous, or tense, you are at more risk for having a migraine. Additionally, irregular eating and sleeping can increase the likelihood of developing a migraine. In adults, women have migraines more frequently than men. Many young women first experience migraines once they start menstruating. This is because migraines in some women may be related to hormonal changes. In children, boys and girls experience migraines at similar rates. It is rare for individuals to develop chronic migraines. 2% of individuals who have experienced a migraine will go on to develop recurrent, or chronic migraines. [1]

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Treatment Options, Relief, and Prevention for Recurrent Migraine

Treatment

Given that the cause of migraines is not entirely understood, there is no cure for the headaches. Treatment for chronic migraines includes lifestyle and medication interventions that help decrease the intensity of the symptoms experienced by the individual. [4] These interventions are described below.

  • Stress management strategies: If you are experiencing recurrent migraines, it is recommended that you exercise regularly, sleep consistently, and practice relaxation techniques. Additionally, eat regularly scheduled meals and drink a lot of water. If you are overweight or obese and have chronic migraines, a weight loss program may be recommended to you by your doctor. [4]
  • Environmental modification: To avoid worsening of your migraine symptoms with light or sound, lay down in a quiet, dark room. You can also put a cold, wet towel on the side of your head that is experiencing the migraine. [4]
  • Pain medications: You can take acetaminophen, non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen when you are experiencing a migraine attack. Use pain medication with caution as if you take these therapies too frequently, the headaches can worsen. Because of this, avoid taking pain medications more than ten days per month. [4]
  • Triptans: If lifestyle modifications and over-the-counter medications do not adequately relieve your migraine symptoms, you can consider a triptan such as sumatriptan, zolmitriptan, or naratriptan for relief. [5]
  • Ergotamine: Additionally, if lifestyle modifications and over-the-counter medications do not adequately relieve your migraine symptoms, you can consider taking ergotamine, a migraine-specific medication. It may help with your acute headache; however, you should not take triptans and ergotamine at the same time. Ergotamine is also associated with side effects including nausea, vomiting, abdominal cramps, sleepiness, and muscle pains. It should be avoided if you have a history of hypertension, coronary artery disease, peripheral vascular disease, stroke, impaired liver function, impaired kidney function, or if you are pregnant. [5]

Prevention

Recurrent migraines can significantly impair your quality of life and ability to perform daily activities. Therefore, it is best to prevent them with lifestyle modifications such as eating well, exercising regularly, and getting enough sleep. [4] Additionally, you should discuss any other health problems that you have with your doctor to see if they might be contributing to your migraines. Several medical conditions can influence your headaches and include but are not limited to asthma, anxiety, depression, hypertension, seizure, diabetes, PMS, and menopause. [6]

If behavioral adjustments do not help reduce the frequency of your migraines, you can ask your doctor about taking a medication that might reduce your episodes; however, keep in mind that each medication is associated with various side effects and may be contraindicated if you have other medical problems. The medication types that are commonly used to prevent migraines are listed below. [6]

  • Beta blockers such as atenolol, metoprolol, nadolol, propranolol, timolol
  • Calcium channel blockers such as verapamil, diltiazem, nimodipine
  • Tricyclic antidepressants such as amitriptyline, nortriptyline, imipramine
  • SSRIs or SNRIs such as fluoxetine, paroxetine, or sertraline

When to Seek Further Consultation for Recurrent Migraine

If lifestyle modifications do not help with your headaches or if you are having migraines multiple days out of a month, you should see a doctor to discuss your symptoms. Additionally, if you are considering taking a therapy to manage your migraines on a frequent basis such as a triptan or ergotamine, you should discuss this with your primary care doctor to ensure that it is safe for you to take either of these medications. If your headaches do not improve with over-the-counter medications, you should also see a physician. Moreover, if you cannot perform your daily activities such as working or sleeping, you should discuss this with a healthcare provider. If you are having negative thoughts related to your migraines that cause you to avoid certain activities that you used to enjoy, you should talk about this with your doctor.

Finally, the following symptoms are considered warning signs to see a clinician immediately: changes to your vision, changes to your speech, change in your mental status, uncontrollable vomiting, or persistent numbness or tingling. [7]