Migraine is a neurological disorder that generally involves repeated headaches. Some people also have nausea, vomiting, and other symptoms.

Most people with migraines do not have any warning before it occurs. However, some people have a visual disturbance called an aura before the headache starts.

See also:

• Headache
• Migraine
• Migraine without aura

A migraine is caused by abnormal brain activity, which is triggered by stress, food, or something else. The exact chain of events is not known. However, it seems to involve various nerve pathways and chemicals in the brain. The changes affect blood flow in the brain and surrounding membranes.

Migraines occur in women more than men, most often between the ages of 10 and 46 years. In some cases, they appear to run in families.

Migraine attacks may be triggered by:

• Allergic reactions
• Bright lights
• Loud noises
• Physical or mental stress
• Changes in sleep patterns
• Smoking or exposure to tobacco smoke
• Missed meals
• Alcohol
• Hormonal fluctuations (related to menstrual cycles or use of birth control pills)

Foods associated with migraine include:

• Foods containing the amino acid tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, some beans)
• Chocolates
• Nuts and peanut butter
• Fruits (avocado, banana, citrus fruit)
• Onions
• Dairy products
• Baked goods
• Meats containing nitrates (bacon, hot dogs, salami, cured meats)
• Foods containing monosodium glutamate (MSG)
• Any processed, fermented, pickled, or marinated foods

True migraine headaches are not a result of underlying brain tumors or other serious medical problems. However, only an experienced health care provider can determine whether headache symptoms represent migraine or some underlying medical condition that requires further tests. This assessment can only be made after a review of a patient's history and a complete neurological exam.

When a migraine begins with visual disturbances (aura), these warning symptoms may occur anywhere from a few minutes to 24 hours before the headache. The visual changes are common in one or both eyes. They may occur in any combination:

• Seeing zigzag lines
• Seeing flashing lights
• Other visual hallucinations
• Temporary blind spots
• Sensitivity to bright light
• Blurred vision
• Eye pain

Other symptoms that may precede or accompany the headache include:

• Loss of appetite
• Nausea
• Vomiting
• Chills
• Increased urination
• Increased sweating
• Swelling of the face
• Irritability
• Fatigue

The headache itself is often described as a "pounding" feeling that starts on one side of the head and may spread to the other side. For many patients, the headaches start on the same side each time. Many patients describe pain behind the eye or in the back of the head and neck.

The headache typically begins as a dull ache that progressively worsens over several minutes to hours to the point of disabling pain. The headache may last several hours to days, during which patients are sensitive to light or sound. Patients often wish to rest in a quiet, dark room.