What is a migraine?

St. Joseph's/Candler Neurologist Dr. Hannah Harrison explains this complex neurological disorder and how to treat it

Headaches are common. More than 90 percent of people will experience at least one headache this year.

But for some people, symptoms actually point to a migraine attack, which is not a common headache. Migraine is a chronic and complex neurological disorder that can be disabling. But if you have gotten used to powering through tough headaches, you may not realize that what you are actually dealing with is a migraine attack.

“The data shows that migraine affects one in four households in the United States,” says Hannah Harrison, MD, of St. Joseph’s/Candler Physician Network – Neurology. “So even if you don’t suffer from this disease, it’s likely that someone close to you does. But about one-third of people with migraine go undiagnosed.”

Dr. Harrison hopes more people will ask their doctor about possible migraine symptoms, because while there is no cure for this disease, life-changing treatment is available.

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What Is Migraine?

You may sometimes hear a person complain of having “a migraine” or dealing with “migraines.” This phrasing is common but inaccurate, and can lead to misconceptions about what migraine is. Migraine is a neurological disease with a complex set of symptoms, of which a headache is only one. Other common symptoms include fatigue, nausea, difficulty concentrating and sensitivity to light and sound.

“Some people may have sparse episodes while others have them more frequently,” Dr. Harrison says. “Frequent episodes can make it difficult to work, because your memory and cognitive ability can be affected. Migraine is actually the most common cause of work disability in women under age 50.”

Though it is typically diagnosed more often in women than men, Dr. Harrison emphasizes that anyone can have migraine. Not everyone is able to recognize it, however.

“Migraine is frequently mistaken for a sinus headache,” she says. “Both can cause pain or pressure in the cheeks and forehead. But if your headache is accompanied by nausea or a sensitivity to light or noise, that indicates migraine.”

Mood changes, either before or after the headache, can also occur with migraine. These can range from depression to irritability to euphoria.

If you notice any of these other symptoms accompanying your headaches, talk with your primary care doctor about a referral to a neurologist.

How Is Migraine Treated?

Because of the complexity of migraine, Dr. Harrison uses a tailored approach to treatment for each of her patients.

“Your treatment regimen depends on several factors, including the frequency of the headaches,” she says. “Some patients will need a rescue regimen, meaning medications that bring immediate relief from a migraine attack. Other patients may need regular preventative medications to reduce the frequency or severity of the migraine attacks. And some patients may need both.”

Botox injections remain an effective treatment for patients who experience 15 or more headaches each month. This treatment involves more than 30 small injections around the face, head and neck, and is administered about every 12 weeks. The injections block pain signals and are meant to stop migraine attacks before they start.

Dr. Harrison emphasizes that medication will be most effective if patients maintain healthy lifestyle habits.

“Diet and sleep play a huge role,” she says. “I recommend that patients eat small snacks throughout the day at consistent times, and never skip meals. They should also maintain a regular sleep schedule, going to bed and waking up at the same time each day. Staying hydrated is very important, too. Make these habits a routine—a brain that deals with migraine loves routine. By ensuring that all of these factors are  working together, we can significantly improve your quality of life.”