what distinguishes a migraine from a ‘bad headache’, and how come sometimes a sufferer can throw up and all symptoms instantly go away? What’s happening there? Some sort of release of pressure?
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Common headaches are caused by pressure on the membrane covering the brain (the meninges): the brain tissue itself has no pain receptors. A migraine is caused by vascular spasms within the brain structure, so the brain thinks part of it is dying from lack of oxygen. Symptoms vary depending on where the spasm is, but nausea is common. Vomiting can then cause a rush of blood to the head due to raised blood pressure, which then convinces the brain it is no longer hypoxic.
The crazy thing about migraines is that the medical community writ large knows alarmingly little about them. I’ve suffered from migraines for around 30 years and other than “If you can figure out a trigger, avoid it”, I’ve gotten very little out of any doctor or neurologist.
The most helpful discussion I had was actually with an optometrist, who associated my astigmatism with increased light sensitivity and migraines caused by flashes/bright lights.
I’ve also had two thunderclap headaches, one of which resulted in a trip to emergency and a spinal tap to see if I was suffering a massive hemorrhage.
I get prodromal scintillating scotomata, C-shaped areas of flickering black and white that travel over the visual, field slowly getting larger. I see it with both eyes, so I assume that some sort of wave is going over the visual cortex.
What is it that makes them move and expand?
As a long-term migraineur, I’ve done a fair bit of reading on the neurological process. Unfortunately, there still isn’t a ton of research. A migraine is a neurological episode, not too dissimilar from epilepsy.
A normal headache is a result of vasodilation in the brain (blood vessels expand, applying force to the tissue). The cause of a normal headache can be many fold, from lack of sleep, bad food, stress and tension etc. Whatever the trigger, it causes the release of signal compounds that then cause blood vessels to dilate.
In a migraine, a similar process occurs: something causes the release of chemicals that cause inflammation in the brain. The difference with a migraine is that the cause is a change in the brains chemical situation.
Something triggers an episode that rapidly and dramatically changes the environment in the brain. This can result in a depolarization wave that travels across the lobes in a cascade (this is where it’s similar to epilepsy). I believe that large-scale change is what triggers the release of inflammation signals. I suspect what makes migraines so bad is simply the scale of the release, it’s a lot instead of a little.
The depolarization of the neurons appears to be what causes the aura people get (in my case, something called scintillating scotoma, which manifests as a fuzzy region in the vision). It’s interesting to note that the more intense the aura is, the more painful the migraine is.
Some research suggests that it works on a point system. Different things you do award points (eating the wrong food, lack of sleep, stress etc), and once you get enough points, you get a migraine. This is why some people may swear that eating something triggers them, but not every time.
30yr vet here, started around 4-6 yrs old. Diet ended up being huge for me. I’m allergic to nearly any preservative nitrate/ites sulfate/fites. Kept sugar to a minimum for my 20s now I’ve taken it a step further.
I’ve been in ketosis or balancing to keep myself 1 day away from it for a while now, with good results. Grandmal seizure people can release the same proteins that our new mono clonal antibody treatments target. So I’m doing the seizure diet, ketosis or ketogenic. There’s been a notable reduction for me. This diet isnt for everyone, I happen to slip keto much faster than some friends that tried with me and my energy skyrockets.
Food tracking, sleep tracking, any data you can build can help you gain personal insights.
Not really an answer to your question but just interesting info from my point of view.
I have had occasional, maybe 3 or 4 a year, migraines for 35+ years, intense pressure and unable to lie down when they happen, can’t even touch my head it hurts so much, vomiting and pacing for hours.
2 years ago diagnosed with gallstones, I can no longer eat foods with a high fat content, so no more cheese or chocolate for example, as a side effect not had a single migraine since.
I’ve had really intense headaches since I was a young child. I didn’t know if they were migraines or not, because I didn’t know the difference. When I was in my late 20s I had my first auras, a smeary checkmark in my upper vision field. That would last for hours and followed by excruciating migraines. Over the years, I found if I took painkillers as soon as they started, I could avoid or diminish the headache part. The time between auras and the headache shortened as well. The type of aura changed too, I’ve had the fuzzy, the black spots, the ones where I didn’t see faces. Recently it’s happened that my whole perception is changed, like looking at a shattered mirror. My headaches decreased significantly when I went through menopause, and I rarely get them now, but they do tend to cluster. My triggers are perfumes, or other strong scents, bright or flashy lights, red wine. Maybe others I don’t know about. Sometimes they were so bad I could only lay in a dark room and cry, it felt like a drill was boring into my eyeball from the temple and it was just going to explode. I don’t have any answers, just sharing my experience. Thanks for reading.
When I get migraines, it’s not just the pain and tension and light/sound sensitivity. I have trouble forming words and responding to people. I start to forget things and sometimes I have have tingling and numbness in my fingers and face. I’ve heard migraines have more in common with seizures than headaches.
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