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This Is What's Happening In Your Brain When You Have A Migraine

Dan 5 Jun 2019

Everyone gets a headache from time to time. But migraines are on another level entirely. About 15 percent of people worldwide live with these recurring, nasty headaches.

They say that knowledge is power. So if you're part of that 15 percent — heck, even if you're not — it can be helpful to know what's going on in the brain when a migraine strikes.

Some migraines are days in the making.

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About 60 percent of people who experience migraines will go through what's known as the prodrome phase.

This phase begins hours or even a couple of days before the pain really starts. The prodromal phase is characterized by all sorts of things, from food cravings to muscle stiffness to a weird mood.

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They might let you know in advance

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Auras are more than just a hippy-dippy notion about someone's personality. In this context, auras are a real thing — a kind of visual disturbance that can include flickers and zig-zags. Some people who get migraines, but not all, may experience an aura before the main phase of the migraine strikes.

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Here comes the pain.

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Auras typically aren't painful. But the migraine itself can be severely painful, sometimes to the point where a person is unable to function normally. The pain is made worse by physical activity and can extend from the head down into the neck.

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The pain phase is no joke.

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Unlike most headaches, migraines can seriously interfere with quality of life. The constellation of symptoms, from nausea to an inability to focus, can cause sufferers to miss work as they seek out a dark and quiet room.

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There's a hangover.

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After the most painful phase comes the postdromal phase, which is more or less a migraine hangover. Like a hangover, this takes the form of aches and pains and foggy thinking.

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Migraines vary in big ways.

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The postdromal phase isn't always hangover-esque. One study states, "Some people feel unusually refreshed or euphoric after an attack, whereas others note depression and malaise." Some migraine sufferers might experience one effect, then the other.

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They might be triggered.

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Like much of what goes on in the brain, this isn't thoroughly understood. But it's been suggested that triggers like feeling tired, eating something, or even the weather can influence whether someone experiences a migraine.

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It's electric.

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This diagram shows something known as cortical spreading depression (CSD), which is a wave of electrical activity in the brain. Depending on which areas of the brains are effected, CSD can influence certain aura symptoms.

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Why does it hurt so much?

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All sorts of ideas have been tossed around, but ultimately, the exact processes that cause pain in a migraine are not known. There's no shortage of theories, though, including a connection to the central nervous system, or even blood vessels in the head and neck.

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5, 4, 3, 2, 1...

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Doctors diagnosing migraine symptoms use the "5, 4, 3, 2, 1" criteria: if a patient has had five or more attacks, or attacks lasting four hours to three days in duration, or two specific symptoms, or one or more of nausea or light sensitivity, they likely experience migraines.

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Can they happen in your gut?

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This is somewhat controversial, but some doctors suggest that a certain type of abdominal pain may in fact be a type of migraine, or even something that happens before a migraine sets in.

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There's still lots we don't know.

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The brain is tough to truly understand, and migraines have only been medically classified for just over three decades. Their classification was most recently updated in 2004.

But as the body of research grows, so too does medical understanding. If you experience bad headaches, don't suffer alone — talk to your doctor about what you can do!

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