Migraines

Migraines Overview

By: Melina Allahverdian, OTD, OTR/L, LRC

Signs and Symptoms

• Headache including discomfort/pain
• Sensory sensitivity (light, sound, smell)
• Nausea/vomiting
• Dizziness
• Cognitive fog or difficulty with focus, concentration, or thought processing; numbness; tingling; visual disturbance; fatigue; neck pain [4]

Pathology and Onset

• Change in brain activity impacting change in brain chemical balance and activity [4]
• Common triggers include: inconsistent eating or fluid routines; specific dietary triggers; disrupted sleep; hormonal triggers; environmental triggers such as light or sound exposure, barometric pressure change, or altitude change; stress and stress letdown; overexertion; physical trigger exposure 

Stages and Types

4 stages include [4]:

• Prodrome: the pre-migraine stage, common to feel subtle differences or onset of symptoms (can be a few hours or days in duration)
• Aura: can include visual disturbance (up to 1 hour in duration)
• Headache: pain and attack stage (can be up to 72 hours in duration)
• Postdrome: comedown and recovery often known as the “hangover” stage (up to 48 hours in duration) 

Types include [3]:

• Migraine with aura- symptoms include aura
• Migraine without aura- symptoms do not include aura
• Silent migraine- pain is not associated 
• Hemiplegic migraine- unilateral weakness 
• Retinal migraine- temporary loss of vision in one eye 
• Chronic migraine- more than 15 headache days per month 
• Abdominal migraine- pain located at the stomach; most common in children
• Vestibular migraine- includes vertigo 

Important Terminology

• Aura – visual disturbance or change in sensation including seeing dots, sparks, zigzags or scintillating scotomas, unilateral tingling or numbness, disruption in speech or language
• Vertigo – sensation that the environment around you is spinning, may result in feeling imbalance or dizziness
• Photophobia – light sensitivity
• Osmophobia – smell sensitivity
• Phonophobia – sound sensitivity (also can be known as hyperacusis)

Helpful Resources

Websites: 

• https://americanmigrainefoundation.org/
• https://americanheadachesociety.org/ 
• https://www.milesformigraine.org/ 
• https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201 
• https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches 
• https://www.nhs.uk/conditions/migraine/ 

Books: Heal Your Headache by Buchholz and Calhoun; The Way Out by Gordon

Apps: Migraine Buddy; Curable; Visible 

Movie: Out of My Head 

References 

1. American Headache Society. (2026). https://americanheadachesociety.org/
   American Migraine Foundation. (2023). https://americanmigrainefoundation.org/

2. American Migraine Foundation. (2023, January 19). What Type of Headache Do You Have? American Migraine Foundation. https://americanmigrainefoundation.org/resource-library/what-type-of-headache-do-you-have/

3. American Migraine Foundation. (2018, January 18). The Timeline of A Migraine Attack. American Migraine Foundation. https://americanmigrainefoundation.org/resource-library/timeline-migraine-attack/

4. Buchholz, D.W. and Calhoun, A. (2003), Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain. Headache: The Journal of Head and Face Pain, 43: 824-824. https://doi.org/10.1046/j.1526-4610.2003.03153.x