Migraine

Migraine: More Than Just a Headache

Migraine is not just a severe headache, but a complex primary neurological disorder affecting millions of people worldwide. It is characterized by recurrent attacks of intense, pulsating, often unilateral pain that significantly worsens with ordinary physical activity. Unlike tension-type headache, migraine is accompanied by a whole range of additional symptoms, making it one of the most exhausting conditions.

Phases of a migraine attack

A classic migraine attack can consist of four phases, although not all are mandatory for every individual:

1. Prodromal phase: May begin several hours or even a day before the pain phase. Symptoms include mood changes, irritability or euphoria, fatigue, yawning, cravings for certain foods.
2. Aura: Occurs in approximately 25% of patients. These are temporary neurological symptoms that usually precede the pain phase and last from 5 to 60 minutes. Most often the aura is visual (flashing zigzags, spots, loss of visual fields), but it can also be sensory (numbness, tingling) or speech-related.
3. Pain phase: This is the attack itself. Lasts from 4 to 72 hours. In addition to intense pulsating pain, characteristic are:
   • Nausea and/or vomiting.
   • Phonophobia (intolerance to sound) and photophobia (intolerance to light).
4. Postdromal phase: After the pain subsides, a person may feel exhausted, "broken", with concentration difficulties for up to a day.

What Happens in the Brain?

It was previously thought that migraine had a vascular nature (spasm, then dilation of vessels). Modern theory suggests it is a disorder of the central nervous system. At its core is a wave of electrical excitation spreading across the cerebral cortex (causing aura), which then activates the trigeminal nerve. This leads to the release of inflammatory substances around the vessels of the brain meninges, causing pain. There is a close link between migraine and hormonal background, described in detail in the article about migraine during pregnancy.