How long can migraines last? Migraine is a complex neurological disease that causes frequent episodes of intense headaches.
Significantly, nowadays, this disease affects around 10% of the total world population with recurrent headaches. Also, the estimation is that this disorder occurs at least once in a lifetime to 14%.
It is necessary to note that from the people who suffer from this disease, three-quarters are women. More than 30 million people suffer from at least 1 episode of migraine headaches a year in the United States alone.
In this article, we will review the essential aspects of this disease. You’ll find answers to all of your questions directly from a doctor. After this reading, you’ll end up with a critical understanding of this disease in topics like duration of migraines, what symptoms may be associated, their treatment, and ways to prevent them.
What is a migraine?
First of all, a migraine is a type of headache that can cause severe pain, most often unilateral. The problem usually locates in your forehead and one of your head’s sides, but it can be felt anywhere in the head.
The pain can be throbbing and pulsatile, and it usually intensifies with movement or physical activity. These episodes tend to be recurrent and may become an actual problem for the patient suffering it. It’s also frequently accompanied by nausea, vomiting, and extreme sensitivity to sound and light.
Most doctors agree that in most migraine episodes, there is a specific stimulus causing it. The provocation that causes the headache is called a migraine trigger. Particular food, change in hormone levels, and stressors can be migraine triggers. If the patient identifies which is their trigger, they’ll be able to prevent migraines.
The pain tends to build in a period of 1 o 2 hours when it becomes the most intense. The headache generally lasts between 4 up to 72 hours. You may have heard that an “aura often accompanies migraines.”
A migraine aura is a group of sensitive symptoms that may precede or accompany the headache episode. The aura usually develops over 5 to 20 minutes and lasts less than an hour. The sensitive symptoms of the aura are mostly visual.
Some patients describe seeing shimmering or colorful zigzags in their vision, or even lacking a portion of their sight.
Migraines can be classified, taking into account several factors. In terms of the appearance of sensitive symptoms, you can have migraine with or without aura in terms of the frequency of the headache attacks: chronic migraine (migraine episodes 15 days a month or more) or occasional migraine (less than 15 days a month, but more than once a year).
What are the causes of migraines?
The mechanism that causes this disease is not entirely understood yet. Many theories explain how headaches are produced.
One of the most believed theories states that there is a lack of oxygen in the brain caused by blood vessels’ constriction. Once this happens, there is rebound vasodilation or widening of the blood vessel that actives nerves, causing the headache.
Another theory holds that people who suffer from migraines have brain cells that are easier to excite. These hyperexcitable cells react to weaker stimuli, producing migraines.
Some other theories include the release of substances in the brain. Many of these substances can cause blood vessels dilation or widening, swelling, and the discharge of other different elements in association with headaches.
How many types of migraines exist?
There are also other variants of migraines. The more severe and rare variant is the hemiplegic migraine. It has this name because it can cause muscle weakness in half of the body or total paralysis. Some other symptoms may resemble a stroke, but the principal difference is that the paralysis is temporary.
Another difference with strokes is that the symptoms start gradually and then resolve completely. You may also feel half of your body numb, present dizziness and incoordination, and difficulty maintaining balance.
This type of migraine also has a hereditary component. This means that if you have a parent with this condition, you have a 50% chance of having it. This is known as familial hemiplegic migraine.
Another type of this disease is the menstrual migraine. This type of headache is associated with changes in feminine hormone levels during the menstrual cycle.
More than half of all women experience menstrual migraines. This happens because, when they get their period, the levels of progesterone and estrogen drop.
This drop-in these hormones acts as a migraine trigger. You may usually have it about two days before your period, up to 3 days after it. Menstrual migraines behave much like any other headache and may get better once your hormone levels stabilize.
Retinal migraine, or ocular migraine, is another variant of this condition. Its main characteristic is the loss of vision.
This type may also come with visual auras that can include blind spots in vision or colorful lights or flashes. It is important to note that this vision loss is very short, only for a few minutes and less than an hour.
These vision problems may be present in just one eye at first, and then take up both of your eyes.
Abdominal migraine, wait, what?
There is another term that needs clarification and is the abdominal migraine. Abdominal migraine is not a headache actually, but a stomachache.
It receives that name because the same triggers that cause the stomachache cause a migraine headache. The patients with this condition are mostly kids; it’s very uncommon in adults.
Also, these kids may get migraine headaches when they become adults. The symptoms of abdominal migraines include abdominal pain that can last from an hour to 3 days. Nausea, vomiting, and loss of appetite may be present too.
What is the difference between a migraine vs. tension headache?
A tension headache is a very usual type of headache pain. The problem can be mild or moderate, behind the eyes or in the sufferer’s head or neck.
The cause of tension headaches is mainly muscle contractions in the head and neck regions. Tension headaches manifest themselves with dull head pain and pressure around the forehead.
If the tension headache happens to be intense, you may confuse it with a migraine. Yet, the pain in the latter is much more intense and has some other symptoms that tension headaches don’t have.
Migraine patients may experience nausea, vomiting, and more severe headaches described as throbbing or pulsatile, on one or both sides of the head. Also, classic migraine, most of the time, comes with aura symptoms instead of a tension headache.
What should you do if your migraine lasts more than 72 hours?
The typical migraine is expected to last between 4 to 72 hours. If a headache in this disease lasts more than 72 hours is called status migrainosus.
Common migraine may turn to status migrainosus if you don’t receive treatment early enough or don’t receive the right treatment. Even if you receive headache medication but abuse it, you may develop status migrainosus.
In the case of status migrainosus, you may need to go to a hospital to receive medication. The patient may receive not only medicines for headache pain but vomiting, too, like metoclopramide and hydration through your veins.
Standard treatment for status migrainosus is dihydroergotamine and another group of drugs called triptans. Dihydroergotamine and sumatriptan act as pain relievers in the case of a severe migraine.
What is a migraine postdrome, and what does it feel like?
The migraine postdrome is the fourth and final stage of this disease. The postdrome is not always present, but it can appear in most cases.
Not all the postdrome are equally intense; the migraine’s intensity does not determine the postdrome’s power.
The symptoms of the postdrome may vary on each person and each migraine attack. The most common symptoms are tiredness, inability to concentrate, bad mood, among others.
Physical symptoms may appear, like weakness, sensitivity to light, nausea, and a stiff neck. Since you can’t know whether or not you’ll have postdrome, it is hard to prevent it. But staying hydrated and trying to be fully recovered from your migraine before returning to your daily activities may help.
Will migraine headaches eventually go away on your own?
Not quite. Although remission may be possible, migraine patients need to be aware that this is a chronic condition. This means that you’ll probably have to deal with migraines for most of your life.
Every person is different, and so is every migraine. This makes it hard to tell what you should do to increase the odds of going into remission.
However, migraine remissions seem to be linked to many factors. Factors like age, the sex of the patient, the appearance of neurological symptoms in migraine attacks, and the number of episodes.
For example, if you’re a male, you’re less likely to suffer from this disease. In case you do, you have better possibilities of going into remission.
If you’re a female, you have more chances to go into remission after the forties because of changes in your hormones after menopause.
Can using birth control pills make your migraines worse?
Although birth control pills are a risk factor in developing migraines, this is not 100% of the cases. Yes, some women may experience an aggravation of the headache events while on birth control. But other women can feel better after they start taking birth control.
Remember that drops in levels on hormones like estrogen and progesterone can be a trigger for this disease. Birth control pills may stabilize the levels of these hormones, preventing headaches.
But if you’re not taking the right dose of birth control or taking a combined pill, you may have migraine aggravation. Sometimes it just takes a couple of months for your body to regulate. But some women may need a switch on the birth control they take or a dose adjustment.
What are the possible complications of migraine headaches?
Although migraine headaches are a benign condition, it can result in further complications like prompting other diseases. The most common complication is status migrainosus.
This happens when a migraine headache lasts more than 72 hours, and the patient needs hospital care. Most of the time, status migrainosus results from a rebound headache after you’ve taken too many medications. Instead of making the migraine better, it gets worse.
Another complication is the migrainosus stroke or migrainosus infarction. One cause for migraines is the contraction or narrowing of the blood vessels in the brain.
Sometimes, these blood vessels can contract so much that blood flood to the brain is interrupted. When this happens, the brain doesn’t receive enough oxygen, and the stroke occurs.
The patients who are most likely to suffer a migrainosus stroke are women on birth control pills, especially if they smoke. Migrainosus infarction is an emergency and needs medical assistance.
Persistent aura without infarction is another form of migraine complication. Sometimes, a migraine’s aura symptoms can stick way longer than usual, even if the headache is not there anymore.
You can have aura almost for as most as a week after the headache attack. The sufferer can also experience other symptoms like weakness or numbness in some parts of the body.
Some other complications may be present as a result of the adverse effect of the medication. Effects like dizziness, nausea, vomiting, anxiety, and serotonin syndrome are not rare with these types of drugs.
We’ll discuss the migraine treatment and its adverse effects later on in the article.
Can migraines be prevented, or the frequency of migraines be reduced?
There are ways to prevent this disease. You won’t get rid of them completely, but the frequency of episodes will be reduced. If you have episodic migraines, you can go for a long time without having an attack with simple tips. If you have chronic migraine, you’ll probably need preventive medication.
The most crucial step to prevent headaches is by identifying your triggers. This way, you’ll just need to avoid those migraine triggers to see an improvement in your health.
This may take a while and a lot of observation. An easy way to identify triggers is by keeping a journal or diary. This way, you can keep track of daily habits that can cause a headache. Habits like how many hours of sleep you’re getting, the foods you’re eating, and stressful moments in the day.
However, if you suffer from more than four headaches a month, you may consider taking preventive treatment.
Some drugs commonly used to prevent migraines include:
like topiramate and valproic acid. They can calm the nerves in the brain to prevent attacks.
This mostly includes metoprolol and propranolol. Act like vasodilators even in the blood vessels of the brain, preventing headaches.
Amitriptyline is the best example. They affect the serotonin levels in your brain, a component that may be linked to the appearance of headaches.
These drugs block the action of CGRP (calcitonin gene-related peptide), which is a protein that causes migraine pain. Drugs like eptinezumab, erenumab, and fremanezumab are approved to prevent migraine attacks.
We already mention triptans as drugs that bring pain relief when the headache is already happening. But there is one of them than can prevent migraines. Frovatriptan affects serotonin levels of the brain, preventing headaches.
Another thing that could prevent these headaches is botulinum toxin. Yes, botox injections. Doctors have found that this toxin keeps the brain from sending pain signals. But this type of treatment is only used in patients with 15 or more migraines a month (chronic migraine).
Aside from drugs, changes in lifestyle can still be pretty useful to have milder and fewer attacks. Healthy habits like getting enough sleep, balanced eating, and regular exercise can keep you from having migraine attacks.
What tests are done for people with migraine headaches?
A doctor doesn’t actually need any tests to make the diagnosis of common (without aura) or classic migraine (with aura). Only with an exhaustive interrogatory of your symptoms and medical history can a doctor determine you have this condition.
Most migraine sufferers have normal findings on the physical examination. However, many conditions can cause headaches. Sinus headaches caused by sinus infections, strokes, tension headache, meningitis, and brain tumors are common causes.
Your doctor may want to run some tests to make sure your headache is just a migraine. Some blood tests, X-rays, and CT scans of the head to look for tumors or bleeding may be useful in the differential diagnosis of a headache.
What are the ‘red flags’ that your visual symptoms are not due to a migraine?
Remember that there is a type of migraine called visual migraine. In this type of headache, you can experience visual symptoms.
This is normal, but you should know when to worry about your visual symptoms. It is pretty rare that you completely lose your vision. Instead, visual migraines usually manifest with “positive” symptoms. This means that you may experience shimmering and sparkling that interrupts your vision.
This area of sparkling and shimmering can grow outwards. This is a temporary distortion, so you can start to worry if you lose your vision, and it doesn’t resolve after 30 minutes. The presence or not of a headache does not determine seriousness. You can have visual migraine without a headache.
Seek medical help if you have an episode of visual darkness. You’ll probably need some test to check the possibility of a stroke.
What are some possible side effects of migraine medicine?
Every medication has different side effects. People who suffer from migraines tend to consume different types of medications. You must ask your doctor what side effects you can expect from each medicine. Be careful, combining several drugs at a time since it can aggravate the side effects of medications.
Most of the migraine patients take over the counter medications for headache, like acetaminophen and ibuprofen. This group of drugs is called NSAIDs or non-steroidal anti-inflammatory drugs. The side effects of NSAIDs include stomach ulcers, kidney failure, strokes, and heart attacks.
Another group of commonly used drugs is ergotamines. They are specifically indicated in the case of migraines. But they can have dangerous side effects. Since they help contract blood vessels, they can cause congenital disabilities. They can also cause heart problems. Like every other drug, they can be toxic if you take a higher dose than recommended.
Sumatriptan and almotriptan are part of a group of drugs called triptans. They help your migraine by contraction blood vessels and reducing inflammation. This occurs by increasing serotonin levels in the brain.
The triptans’ side effects are dizziness, nausea, tightness in the throat, and numbness in fingers and toes. If triptans are combined with antidepressants, you may suffer from serotonin syndrome. This is a severe condition that may cause even death.
Nausea and vomit medication
Drugs like metoclopramide and dimenhydrinate are not pain killers. But they can help with nausea and vomiting that migraines produce. But these drugs can make you feel dizzy, drowsy, and with less energy.
Some people experience such intense pain that their doctor may prescribe them opioids. Codeine, morphine, and oxycodone are powerful pain killers. They always need to be prescribed by a doctor. The main side effect of these drugs is the high risk of addiction.
In the case of preventive treatment, we have two groups of medications. CGRP antagonists like erenumab and fremanezumab, are the most effective drugs in preventing migraines.
Of course, they have side effects too. The range of side effects is somewhat wide. It goes from constipation all the way to high blood pressure and hair loss.
The other medications that prevent this disease are the beta-blockers. Metoprolol, atenolol, and propranolol are usually used to control high blood pressure. The side effects can include symptoms like fatigue, depression, dizziness, and sleeplessness.
Do you have a migraine headache?
This tool is a migraine symptoms checker. It gathers the most important sings, symptoms, and risk factors for this disease. Therefore, it would help anybody who uses it to determine the likelihood that their headache is because of a migraine. Also, it is essential to note that this tool is free and would only take you a few minutes.