A migraine attack is characterized by sudden headaches that often occur on one side of the head. For many sufferers, these headaches and other migraine symptoms, such as nausea and vomiting, are so stressful that their everyday professional and private life suffer greatly. 

At a glance

  • Migraines are different from ordinary headaches. The pain is often on one side of the head only and more severe. 
  • Some people with migraines are more sensitive to sounds and light during an attack. 
  • Some people also perceive flashes of light or unusual shapes in advance of the actual migraine attack. 
  • Without treatment, a migraine attack usually lasts between 4 hours and 3 days. 
  • It is not yet known what exactly causes a migraine to develop. 
  • Headache medication and specific migraine medications should be taken no more than 10 days per month. 

Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.

Migraine: woman holding her head in both hands.

What is a migraine?

A migraine attack manifests itself differently than an ordinary headache. Migraine pain occurs suddenly, it is often very pronounced, and it is usually on one side of the head only. Many migraine patients also report other symptoms such as nausea and vomiting. 

What are the most common types of headache?

The video below outlines the most common types of headache and how they are expressed.

This and other videos can also be found on YouTube

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What are the symptoms of a migraine?

People with migraine usually describe a typical headache with throbbing or pulsating pain that is felt mostly on one side of the head. For many, physical exertion increases this pain significantly, sometimes even simple movements. The headache may be accompanied by other symptoms, such as nausea and vomiting. 

A sudden throbbing headache, usually on one side of the head only, is typical of migraine.

Some people have a migraine that is accompanied by what is known as an aura. In the preliminary stages of the actual migraine attack, these patients see, for example, flashes of light, unusual shapes, or suddenly perceive their surroundings in a blurred or distorted way. Temporary difficulties in speaking, temporary signs of paralysis, and sensations such as tingling can also signal an imminent migraine attack.

This type of aura subsides in about one hour and typically does not have lasting effects. Immediately afterwards, the typical migraine headache sets in. 

Important: Children can also suffer from migraines. For them, the typical migraine headache is not always present. Other symptoms such as nausea, vomiting, and dizziness may be prominent in children. 

What causes migraine?

It is not yet known what exactly causes a migraine. Inflammatory processes in the blood vessels of the brain could be involved in the development of migraines. But medical experts today are currently also discussing the way pain signals are processed in the brain as a possible cause.

In addition, a stressful and hectic daily life can promote the development of migraines, other headaches, and other types of pain. Sometimes migraine attacks occur only during times of rest and relaxation – for example, at the start of the weekend or a vacation. However, these attacks are precipitated by preceding periods of stress at work and in everyday life.

What factors increase the risk of migraine?

The factors that may trigger a migraine attack include irregular sleep patterns and irregular eating habits. Diet and the type and amount of physical activity may also influence the likelihood of another attack.

A migraine diary can help identify individual risk factors. In this way, it may help reduce the frequency of attacks.

How common are migraines?

Migraines affect women significantly more often than men. About 14 percent of women and about 7 percent of men have recurrent migraine attacks. Migraines affect about 4 to 5 percent of children, and occur equally as often in boys and in girls. 

Around 14 percent of women and 7 percent of men experience recurring migraines.

Migraines affect women significantly more often than men. About 14 percent of women and about 7 percent of men have recurrent migraine attacks. Migraines affect about 4 to 5 percent of children, and occur equally as often in girls as in boys.

What is the outlook for people with migraine?

Migraines can change over the course of a person’s life and can also get better on their own. In young women, migraines often first appear with the onset of menstruation. Migraine attacks sometimes disappear completely during pregnancy. For many women, migraine attacks stop entirely after menopause.

Less than 2 percent of migraine patients have chronic migraine. “Chronic” means that migraine symptoms are present more than 15 days per month for at least 3 months.

Can a migraine attack be prevented?

Sleeping habits, eating times, food choices, and other factors can influence the frequency of migraine attacks. However, it varies from person to person which behaviors can promote or reduce migraine attacks. 

To understand the triggers causing the migraines, in other words, the factors that increase the risk of migraine attacks, it is advisable to keep a migraine diary. Either an app or a conventional diary can be used; it is simply important for migraine sufferers to record how long an attack lasts, what they ate and drank before the attack, and what medicines they took. 

Important: Doctors may prescribe certain medications or psychotherapeutic treatment for prevention, especially for patients who have severe and frequent seizures. With psychotherapy, for example, people with migraines can learn techniques that help them to cope more effectively with stress. Some people also try dietary supplements, herbal medicines, or relaxation methods to prevent migraine attacks.

For more information about migraine prevention in children and adolescents, visit gesundheitsinformation.de. 

Information about migraine prevention in adults can also be found at gesundheitsinformation.de. 

How is migraine diagnosed?

A goal-oriented, detailed conversation with a doctor can uncover the essential indications of a migraine. The conversation should include the following important questions:

  • How can the headache be described? 
  • Where exactly does the pain occur and how long has it been present? 
  • Have the symptoms mentioned occurred before? 
  • Are there other symptoms besides the headaches? 
  • Are any medications being taken? If so, which, how often and since when? 

Following the discussion, the doctor will also examine the patient physically. In most cases, these diagnostic steps are enough to determine or rule out a migraine. However, if there is any uncertainty, further examination procedures such as magnetic resonance imaging (MRI) of the head may be considered.

How are migraines treated?

A damp towel, cool packs from the refrigerator, a darkened bedroom: many people with migraines know from their own experience which measures they can use to best alleviate an attack. 

In addition, many people also take medication when experiencing severe pain. These include paracetamol, anti-inflammatory painkillers such as acetylsalicylic acid (ASA), diclofenac or ibuprofen, as well as special migraine medications such as triptans.

In pharmacies, paracetamol, ASA, and ibuprofen are available without a prescription, and to some extent also some active substances belonging to the group of triptans in low doses. 

ASA must only be given to children and adolescents on the advice of a doctor because the active ingredient may cause a rare but life-threatening condition called Reye’s syndrome.

Important: Migraine medications and painkillers taken too frequently can increase headaches. Therefore, it is recommended that these medications are taken no more than 10 days in a given month.

More detailed information, for example, about medication for migraines, can be found at gesundheitsinformation.de.

What effect do migraines have on everyday life?

A migraine attack can have a major impact on the daily life of the person affected. Many people with migraines are unable to do their job during this time, or can only do so to a very limited extent. In general, physical and mental performance is severely limited due to the pain and other symptoms.

The occurrence of migraine attacks can be predictable if they occur mainly at certain times. In women, these are often the days before their monthly menstrual period. However, attacks often occur without any recognizable pattern. This makes it difficult for those affected to plan appointments, dates, or leisure activities for the future. In addition to the fear of another attack with all its limitations, migraine sufferers often worry about how the next migraine attack will affect the family and the job.

Cognitive behavioral therapy can help identify such negative thought patterns and change unfavorable behaviors.

Certain relaxation techniques such as autogenic training can also help people to cope better with the situation. With this technique, one learns to put oneself in a deep state of relaxation.

However, relaxation and increased calmness can also be practiced in other ways, for example, through physical activities such as jogging. What ultimately helps best varies from person to person. 

Visit gesundheitsinformation.de to read about three people who live with migraine attacks and how they cope in daily life.

Where can I find support for migraine?

Doctors can prescribe a health app for people with migraine. 

For more information about these digital health applications (DiGA), see our article Apps on prescription.

Many support options are available in Germany, including self-help groups and information centers. However, many of these groups are organized differently depending on the location. 

A list of contact points is available at gesundheitsinformation.de to help find the right support option.

In cooperation with the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen – IQWiG).

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