What is a Migraine?

Migraines aren’t just “bad headaches.” If you’ve ever had one—or know someone who has—you’ll know how much more complicated and challenging they can be. In recent years, medical research published in leading journals has given us a clearer understanding of what migraines are, why they happen, and how they can be better managed.

What Exactly is a Migraine?

A migraine is a type of brain disorder that causes recurring attacks of headache, often with other symptoms. The pain is typically one-sided, throbbing, and can be severe enough to disrupt daily life. Migraines are not just headaches—they can also cause:

• Sensitivity to light, sound, or smells

• Nausea and vomiting

• Vision changes (such as flashing lights or blind spots)

• Dizziness or vertigo

• Brain fog (difficulty concentrating, feeling mentally “cloudy”)

• Visual blurring or even double vision

Some people experience warning signs before the headache starts, known as an “aura”—these might be visual changes, tingling sensations, or difficulty speaking.

Types of Migraine

Migraines come in several types, including:

• Migraine without aura (“common migraine”): Headache attacks without preceding neurological symptoms.

• Migraine with aura: Headache that’s preceded by visual or sensory changes, such as flashing lights, zigzag lines, or numbness.

• Chronic migraine: Headache on 15 or more days per month, with at least 8 of these meeting migraine criteria.

• Vestibular migraine: Episodes where dizziness and balance problems are the main features, sometimes without much headache.

• Hemiplegic migraine, brainstem migraine: Rare types that can mimic stroke-like symptoms or cause double vision, unsteadiness, and weakness.

What Causes Migraines?

Medical science still doesn’t have all the answers, but we know migraines involve complex changes in the brain. Migraines are believed to result from temporary changes in the way nerves, blood vessels, and brain chemicals interact. Genetics play a big role—if migraines run in your family, you’re more likely to get them¹.

Common Triggers

Certain triggers can set off a migraine, including:

• Stress or anxiety

• Changes in sleep patterns

• Hormonal changes (e.g., periods or menopause)

• Certain foods (like chocolate, cheese, or red wine)

• Bright lights or loud sounds

• Skipping meals

• Weather changes

Not everyone’s triggers are the same, and sometimes migraines happen for no obvious reason.

Treatment of Migraine

Migraine treatment usually falls into two categories:

• Acute treatments (for when a migraine strikes) include simple painkillers, specific migraine medications, and anti-nausea tablets.

• Preventive treatments are considered if you have frequent or severe attacks and may include medications, injections, and lifestyle changes. Preventive therapy is generally started when migraines are frequent (usually 4 or more attacks per month), prolonged, disabling, or not controlled by acute medicines²⁴.

For a detailed guide to the latest migraine treatments, please see our separate blog post on migraine management.

Other Symptoms: What We Know from Recent Research

Beyond headache pain, migraines can sometimes cause dizziness, vertigo, brain fog, visual blurring, and double vision. These symptoms are now well-recognised in medical literature⁶⁷⁸. “Brain fog,” or cognitive difficulty during or after migraine, is also being studied and is a common complaint among patients.

When to See a Doctor

Migraines are common—affecting about 1 in 5 women and 1 in 15 men—but they’re not “just part of life.” If headaches are interfering with your work, family, or quality of life, see your doctor or a headache specialist. There are effective treatments, and new options are emerging every year.

Takeaway

Migraines are more than headaches—they are a brain condition with complex causes and a huge impact on daily life. Thanks to ongoing research, our understanding and management of migraine is better than ever. If you suffer from migraines, you’re not alone—and there’s real help available.

References

1. Charles A. The pathophysiology of migraine: Implications for clinical management. NEJM 2024.

2. Goadsby PJ, et al. Recent advances in the pharmacological management of migraine. Lancet 2023.

3. Dodick DW, et al. CGRP monoclonal antibodies for the preventive treatment of migraine. NEJM 2023.

4. British Association for the Study of Headache, BMJ Best Practice: Migraine (2023).

5. American Headache Society: The American Migraine Prevalence and Prevention Study.

6. Noseda R, Burstein R. Migraine pathophysiology: Anatomy of the trigeminovascular pathway and associated symptoms. Headache 2021.

7. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (ICHD-3).

8. Waliszewska-Prosół M, et al. Cognitive impairment and “brain fog” in migraine patients. Cephalalgia 2022.