Migraines

Migraine headaches are a neurological condition with significant vascular involvement.  They occur as a series of phases, usually four, which are the Premonitory Phase, the Aura Phase, the headache itself, and the Postdrome Phase.

The premonitory phase includes symptoms such as light sensitivity, sound sensitivity, fatigue, irritability, depression, muscle stiffness, and can begin as much as 3 days before the actual headache starts.  It is believed that the hypothalamus is involved in causing migraines, it is a part of the brain that is responsible for regulating the autonomic nervous system, which is the part of the nervous system that controls body functions involved in survival which are not under conscious awareness or control.  These include things like blood pressure, hormone regulation, temperature control, thirst and hunger, and respiration.  There seem to be many potential environmental triggers which can bring on a migraine, which vary from person to person, including hormonal changes, weather changes (particularly changes in barometric pressure, so can be triggered by impending rain storms), emotional stress, changes in sleep patterns (although these may also be symptoms of the migraine itself), neck pain, not eating, and things that are common mast cell triggers such as certain smells, foods, alcohol, smoke, exercise, bright lights, and sometimes sex. 

About a third of people who get migraines have an aural phase next.  There are four different kinds of auras associated with migraines- visual, sensory, language, and motor.  Visual auras include things like seeing spots, wavy lines, or a ring around lights.  Sensory aura can include neuralgia, which is tingling and/or numbness.  Language aura refers to problems speaking and finding the right words, and motor aura refers to weakness.  Many of these symptoms such as tingling/numbness and weakness often occur on only one side of the body.  It is believed that the aura phase is caused by something called Cortical Spreading Depression, which means that the neurons on the outside of the cerebrum (the main part of the brain) begin to fire less frequently in a pattern that spreads through the cortex the same way that ripples spread on the surface of water.  People who do not experience aura symptoms may be experiencing this spreading in areas of the brain that they are not consciously aware of. 

The headache phase involves pain (usually, but occasionally not) but also tends to involve additional symptoms such as nausea and vomiting, light and sound sensitivity, balance problems, visual disturbances, sensitivity to certain smells, and a pain symptom called Cutaneous Allodynia which is when even light touch on areas of the skin causes intense pain.  It is currently thought that the Cortical Spreading Depression that occurs earlier in the process activates the Trigeminal Vascular System, which includes activation of the trigeminal nerve.  All sensations on the skin of the face are transferred to the brain via the Trigeminal Nerve.  The Trigeminal Nerve also carries pain signals into the brain from the Dura Mater, which is a thick membrane of connective tissue surrounding the brain and inside the skull.  While the pain signals may be coming from the Dura Mater the pain may be perceived on the face due to referred pain.  Referred pain is when pain signals from different areas of the body activate areas in the brain that are close together and the brain confuses which area is the origin of the signal.
The Postdrome Phase is the final phase in which some of the symptoms, especially the pain, lingers.  This can feel as if your brain is bruised or has been through some sort of accident. 

What Are Migraines?

Menstrual migraines