Mark W. McFarland, DO
Often patients will ask me “How can I know if I’ve ever had a migraine headache instead of just a bad headache?” Here are five simple symptoms to look for in determining whether your headache may indeed be a migraine instead of just a severe headache.
- Headaches are common; migraines are less common, severe migraines rare.
Researchers estimate most everyone (93-95%) has had a headache, and it is one of the most common medical complaints heard throughout the world, regardless of race, geographic location or other demographic factors. There is thought to be a very small part of the population (about 5-7%) who have never had head or face pain. These people are a medical anomaly and their lack of headaches cannot be explained by clinicians.
A clinical diagnosis of migraine headaches, especially severe/debilitating ones is relatively rare, with approximately 12% of Americans being affected. Worldwide, WHO estimates that one in seven adults may have some form of migraine. Women seem to be disproportionally affected due to hormones, but women in the Far East seem to be less affected than those elsewhere in the world.
- A Migraine has Phases
Most of us are familiar with a “normal” headache, which can come on suddenly due to stress, tension, fatigue or may accompany a sinus infection or the flu. Typically, these headaches may throb and cause discomfort, but a few aspirin or ibuprofen easily will put them to bed. They are often gone within minutes to a few hours.
A migraine headache has four distinct phases, which are; 1) Prodrome – characterized by weird cravings, increased urination and yawning and mood swings; 2) Aura – characterized by the patient seeing bright, and or flashing lights and/or zig zag lines, and a feeling of being touched; 3) Headache – throbbing head pain, typically on one side of the head, often with nausea and vomiting, extreme sensitivity to any sensation or movement; 4) Post-drome – a migraine “hangover” characterized by fatigue, weakness, confusion and mental fogginess
- A Migraine can last for Days
A normal headache lasts for hours or possibly a day in severe cases without an underlying medical reason. A migraine can last for days as the patient goes through some or all the phases of the migraine headache.
- Nausea and Vomiting happen often with Migraines, not typically with normal Headaches – Did you know that migraine is the number one clinical reason for the symptoms of nausea and vomiting together? Right after that is the flu, followed by gastro-intestinal disturbances, hangover, and concussion. Normal headaches can be accompanied by nausea, but typically do not involve vomiting. It may surprise you to know that some migraine sufferers actually make themselves vomit, claiming it makes them feel better and their headache stop. Now, there is science that backs up this claim, giving evidence that endorphins are released by vomiting and the act helps to bring about the ending phase of the migraine.
- Physical exhaustion & mental confusion come after the Migraine, but not so much with an average headache – A characteristic of your run-of-the-mill headache is that once your head stops pounding, you usually feel much better and are ready to bounce back to your daily activities. After a migraine, during what is called the Post-Drome Phase or migraine hangover, the patient feels physically drained, exhausted and in a weakened state. Confusion, agitation, sensitivity or brain fog also adds an emotional/mental component to the party. Patients report an intense period of recovery, both mental and physical, is needed after a migraine, like both their brain and body has been run over by a truck. Some patients have difficulty speaking, focusing, reading or learning during this period of recovery. The Pro-drome phase can take hours or days and there is no way of predicting how lengthy or difficult it will be for each migraine episode.