It starts with unusual activity in your brain. This can be localized or global. But it always involves a depletion of sugars. This leads to localized vascodilation – all your tiny capillaries open up to let more blood flow. Then, for reasons I’m not clear on, come inflammation of the protective sacs that surround the brain, called meninges.
The brain itself has no pain receptors, so there is no pain registered by the brain itself. But the meninges have pain receptors and the inflammation causes the severe pain. The pressure caused by the inflammation also causes other symptoms – the sensitivity to light and/or sound, the loss of motor control, the mild cognitive impairment, etc..
The inflammation is localized, which is why the pain seems to be in one particular area.
To my knowledge – which is admittedly a bit dated – we have no idea what that initial brain activity is all about. But we do believe that all migraines begin with unusual brain activity.
Sounds, smells, and hormones can also trigger migraines. I was hospitalized at 6 years old and the doctors discovered an abnormal blood sugar and they told my mom that I’d grow out of them. Well, I did for the most part until I got pregnant. Those hormone changes triggered several more years of migraines.
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