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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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.
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