The exact cause of migraine disease is still being studied but it could be partly genetic. People with migraine often find that others in their wider family also have the condition.
(The Headache Center, US, 2012)
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The exact cause of migraine disease is still being studied but it could be partly genetic. People with migraine often find that others in their wider family also have the condition.
(The Headache Center, US, 2012)
People living with migraine disease have triggers that cause migraine attacks. Learning what triggers your migraine attacks and finding ways to avoid or reduce these triggers is an important part of managing migraine disease.
There are many different trigger factors that may start a migraine attack or episode. Keeping a diary of when you have a migraine episode and what may have started it is a useful way to work out your triggers.
Triggers can include one or more of the following: |
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Some foods such as chocolate, brown vinegar, cheese, citrus fruits, onions and MSG (monosodium glutamate) can be a trigger for some people. Food may be considered a trigger for a migraine episode if an attack occurs within 6 hours of eating and you don't get migraine attacks when you don't eat that food.
Female hormone fluctuations, the oral contraceptive, menopause and pregnancy may affect migraine.
Non-migraine headache is also a common feature of pre-menstrual syndrome.
Some people can feel some warning signs that tell them a migraine might be coming soon. We call these warning signs that can occur days before the headache starts "prodromal symptoms". About 8 in 10 people get prodromal symptoms. Examples of prodromal symptoms include:
Some people have changes in their senses of sight, smell, hearing, and touch. These changes are part of the "aura phase" that people can get just before the headache starts. Only about 1 in 4 people experience an aura. If you’ve never had an aura, this doesn’t mean you don’t have a migraine.
Examples of aura symptoms include:
When the headache starts, it is a strong pain, usually on one side of your head. You may feel sick or vomit (be sick), get tingling around your mouth, have trouble talking or feel dizzy or weak.
Learning the warning signs of a migraine can help you treat it quickly.
The following are common with migraine attacks and don't usually happen during a tension headache:
These symptoms are very particular to migraine disorder. Your doctor may do other tests if they are concerned your headaches may have another cause. However, a migraine attack are not a sign of a stroke or a tumour, and your doctor will reassure you of this.
Migraine disorder can't be cured but you can relieve symptoms during an attack and prevent further attacks. Migraine varies between people and so does the treatment. Some things are commonly known to trigger migraine attacks in some people. Avoiding these triggers can reduce how often and how severe your migraine attacks are.
Medicines for the treatment of migraine is aimed at stopping symptoms and preventing future attacks fall into a few categories:
The type of medicine you need depends on many things, including how often, severe and disabling your migraine attacks are. It may take time to work out the best treatment for you. You may need to try different types or combinations of medicines before you find the most effective ones. Read more about medicines for migraine.
Examples of medicines to treat migraine | |
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Pain relief medicine
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Anti-sickness medicines
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Triptans
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Medication-overuse headache can occur if you use pain relief medicines to treat headaches and migraines over a long time. If you have been using triptans, paracetamol, NSAIDs or opioid medicines regularly for three months or more and you are having headaches more than 15 days per month then you may be experiencing medication-overuse headache. It may feel like a tension-type headache or migraine-like attack.
Medication-overuse headache is sometimes called medication adaptation headache or rebound headache. Headaches often improve within 2 months of withdrawal of the overused medicine, but can feel worse before improvement is seen. If you think you might have medication adaptation headache it is really important to keep a detailed history of your headaches and how often you are taking medicines for the headaches. You can use a headache diary(external link) to help you keep a record of this. You can also talk to your healthcare provider about medicine to prevent migraines. See the section below.
To avoid medication adaptation headache:
Here are some simple measures that you can try to ease your symptoms.
Not all migraine attacks have an obvious trigger, but sudden changes in daily routine can be a trigger. This includes a missed meal, a late night or doing more strenuous exercise than you normally do.
To reduce your chance of having a migraine attack you may find it helpful to make the following lifestyle changes:
Addressing other conditions that may be causing your migraine attacks is also important. These include stress, anxiety, depression, hormonal changes and head or neck trauma. If these are problems, talk to your doctor. They may be able to help you work out how to manage these things.
Cognitive behavioural therapy (CBT), coping strategies and relaxation training are helpful for many people with migraine, especially if attacks are associated with anxiety or stress.
Preventive medicines are taken daily to prevent migraine attacks from happening. They are not used to treat a migraine attack. Medicines to prevent migraine attacks are an option if you:
Preventative medicines aim to reduce how long and severe your migraine attacks are and how often you get them. They can help to reduce disruption to your daily activities that happens with migraine, and reduce overuse of pain relief medicines. They must be taken every day to work well. They may take a few weeks to start working. Read more about preventive medicines for migraine.
You will keep having migraine attacks but will not come to any harm. However, migraine attacks are likely to happen again and again and these can be very disruptive and debilitating.
For videos of people sharing their personal stories, visit Migraine Again(external link).
Migraine Foundation Aotearoa NZ(external link) New Zealand's only not-for-profit supporting people living with migraine in Aotearoa.
Migraine Foundation Aotearoa NZ support group(external link) A Facebook support group for people living in New Zealand to connect with others.
Migraine Down Under(external link) A blog written by a New Zealander living with migraine
Migraine NZ(external link) A patient body advocacy group founded to support and fight for all New Zealanders living with migraine.
Migraine NZ Chat Group(external link) Facebook support group
The following links provide further information about migraine disorder. Be aware that websites from other countries may have information that differs from New Zealand recommendations.
Migraine Foundation Aotearoa New Zealand(external link)
Migraine(external link) Neurological Foundation, NZ
Headache and migraine disease language and image guide(external link) Coalition for Migraine and Headache Patients (CHAMP), Australia, 2018/19
A patient's guide to migraine(external link) Dr Jon Simcock, Medical Adviser, Neurological Foundation, NZ
Living with migraine(external link) The Migraine Trust, UK
Range of topics(external link) American Migraine Foundation, US
Shades for migraine(external link) A global awareness campaign that asks everyone to wear a pair of sunglasses on 21 June to show their support for the 1 billion people living with migraine disease worldwide.
Treating migraine headaches – some drugs should be rarely used(external link) Choosing Wisely, NZ, 2018
Migraines patient guide [PDF, 3.6 MB] Global Healthy Living Foundation, US, 2021
Migraine brochure [PDF, 168 KB] Migraine Foundation NZ, 2022
1. Cafergot tablets to be prohibited 1 May 2020(external link) Medsafe, NZ, 2019
2. The role of triptans in the treatment of migraine in adults(external link) BPAC, NZ, 2014
3. Medication-overuse headache(external link) BPAC, NZ, 2008
4. Headache and migraine disease language and image guide(external link) Coalition for Migraine and Headache Patients (CHAMP), Australia, 2018/19
Choosing Wisely, NZ, 2018
Migraine Foundation NZ, 2022
Global Healthy Living Foundation, US, 2021
Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.
Reviewed by: Dr Helen Kenealy, geriatrician and general physician, Counties Manukau DHB
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