What Is the Main Cause of Migraine?

Reviewed on 8/19/2021

It is not known what causes migraines, but genetics and environment are factors. The main triggers of migraines include stress, poor sleep, hormones, caffeine, alcohol, weather changes, certain foods, dehydration, bright lights, certain smells, and medication overuse.
It is not known what causes migraines, but genetics and environment are factors. The main triggers of migraines include stress, poor sleep, hormones, caffeine, alcohol, weather changes, certain foods, dehydration, bright lights, certain smells, and medication overuse.

A migraine headache is a neurological disorder that causes severe head pain along with sensitivity to light, sound, or smells.

The cause of migraines is not known, but genetics and environment are factors. 

The top migraine headache triggers include: 

  • Stress
    • A trigger for up to 70% of people with migraine
  • Poor sleep
    • Changes in sleep schedule
    • Irregular sleep schedule
  • Hormones
    • Changes in estrogen levels for women can lead to “menstrual migraines”
  • Caffeine
    • Use of caffeine
    • Withdrawal from caffeine
    • Suddenly stopping medications that contain caffeine
  • Alcohol
  • Weather changes or changes in barometric pressure
  • Certain foods and drinks, such as chocolate, processed foods with monosodium glutamate (MSG), foods with histamine, cheese and other dairy products, artificial sweeteners such as aspartame, cured meats, and foods with a strong smell
  • Dehydration
  • Bright lights (photophobia) 
  • Certain smells
    • Such as perfumes, strong food smells, chemicals, and gasoline
  • Medication overuse 
    • Taking acute migraine prescription medication more than 10 days out of a month can in itself cause more migraine attacks

Other common migraine triggers include: 

What Are Symptoms of Migraines?

Symptoms of migraine are usually described in five phases: 

  • Prodrome: warnings before a migraine
    • Subtle changes in sensations such as an unusual taste or smell
    • Fatigue
    • Muscle tension 
    • Mood changes
  • Aura: visual disturbances that precede the headache phase
    • Geometric patterns or flashing, colorful lights
    • Blind spots (scotomas)
    • Loss of vision on one side (hemianopsia)
  • Headache
    • May last 4-72 hours
    • Usually occurs on one side of the head, but may occur on both sides
    • Throbbing pain 
    • Nausea
    • Vomiting
    • Sensitivity to light (photophobia) 
    • Sensitivity to sound (phonophobia)
  • Headache termination
    • Pain usually goes away with sleep, even if the migraine is not treated
  • Postdrome: other signs can linger after the pain goes away
    • Fatigue
    • Problems concentrating
    • Inability to eat

SLIDESHOW

16 Surprising Headache Triggers and Tips for Pain Relief See Slideshow

What Is the Treatment for Migraines?

Treatment for migraine headaches includes: 

  • Non-medical treatments
    • Ice 
    • Heat
    • Getting adequate hydration
    • Deep breathing
    • Darkened room/covering your eyes
    • Rest
    • Massage
    • Biofeedback
  • Pain relievers
  • Other medications
    • Triptans
    • Trigger point injections
    • OnabotulinumtoxinA (Botox)
  • Anti-nausea medications (antiemetics)
  • Selective serotonin 1F receptor agonist
    • Lasmiditan (Reyvow)
  • Calcitonin-gene related peptide (CGRP) antagonists
    • Rimegepant (Nurtec)
    • Ubrogepant (Ubrelvy)
  • Ergotamine preparations
  • Neuromodulation
    • Transcutaneous supraorbital nerve stimulation 
    • Transcranial magnetic stimulation (TMS) 
    • Remote electrical neuromodulation 
    • Noninvasive vagus nerve stimulation (nVNS) 
  • Peripheral nerve blocks
    • Occipital nerve blocks 
    • Sphenopalatine ganglion blocks

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Reviewed on 8/19/2021
References
https://americanmigrainefoundation.org/

https://www.uptodate.com/contents/migraines-in-adults-beyond-the-basics?search=migraine&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3

https://www.uptodate.com/contents/acute-treatment-of-migraine-in-adults?search=headache%20treatment&source=search_result&selectedTitle=7~150&usage_type=default&display_rank=7

https://www.migraineagain.com/how-to-get-rid-of-a-migraine-fast/