migraine that comes and goes

Overview

A migraine is a type of headache that can cause intense throbbing pain, often on one side of the head. It may come with other symptoms like nausea, vomiting, or sensitivity to light and sound. When migraines come and go, it means they happen sometimes, not every day.

Yes, migraines are very common. About 1 in 7 people worldwide experience migraines.

Migraines can affect people of any age, but they are most common in adults between 30 and 50. They affect more women than men, often linked to hormonal changes.

Symptoms

Common symptoms

• Throbbing or pulsating headache, usually on one side of the head
• Nausea or vomiting
• Sensitivity to light, sound, or smells
• Blurred vision or seeing flashing lights (called aura)
• Feeling very tired or restless

Symptoms in children

• Children may have headaches that are less severe but last for hours
• They might complain of stomach pain instead of head pain
• Pale skin, dizziness, or trouble concentrating

Symptoms in older adults

• Headaches may be less intense but still cause sensitivity to light and sound
• Older adults might have more aura symptoms like tingling or numbness
• Migraines can sometimes be mistaken for other conditions like mini-strokes

Causes

Main causes

• The exact cause is not fully understood, but it involves changes in brain activity and blood flow.
• Triggers like stress, lack of sleep, certain foods, or weather changes can set off an attack.
• Chemical changes in the brain, such as serotonin levels, play a role.

Risk factors

• Family history of migraines
• Being female (due to hormonal fluctuations)
• Age (most common in 30s and 40s)
• Certain medical conditions like depression or anxiety

When to see a doctor

See a doctor urgently if:

• If you have a very severe headache that came on suddenly
• If your headache is accompanied by high fever, stiff neck, or confusion
• If you have weakness, numbness, or speech problems

Book a routine appointment if:

• If your migraines are frequent and affect your daily life
• If over-the-counter pain relief does not help
• If you have new symptoms like aura for the first time

Diagnosis

A doctor will take a detailed history of your headaches and ask about your symptoms, triggers, and family history. They may also perform a physical and neurological exam.

Tests that may be done

• No specific test exists for migraines, but tests like blood work or imaging (CT or MRI) may be done to rule out other causes.

What to expect at your appointment

Your doctor may ask you to keep a headache diary for a few weeks to track your symptoms and triggers. This helps in making an accurate diagnosis and planning treatment.

Treatment

Treatment for migraines that come and go focuses on relieving symptoms during an attack and preventing future attacks. Many approaches can be tried, from lifestyle changes to medical treatments.

Self-care at home

• Rest in a quiet, dark room during an attack
• Apply a cold pack to your forehead or neck
• Drink water to stay hydrated
• Try relaxation techniques like deep breathing
• Avoid known triggers like bright lights or strong smells

Medical treatments

Doctors may recommend medications that can be taken at the start of a migraine to stop it, or preventive treatments taken regularly to reduce how often migraines happen. These can include pain relievers, triptans (medicines that help with migraine), or other prescription options. Always follow your doctor's advice and never exceed the recommended dose.

When is surgery considered?

Surgery is not typically used for migraines. In very rare cases, procedures like nerve blocks or botulinum toxin injections might be considered, but these are not common and should be discussed thoroughly with a specialist.

Living with this condition

Living with migraines that come and go means planning for potential attacks. You might need to pace yourself, avoid known triggers, and have a plan for when a migraine starts. Many people find it helpful to keep a diary to identify patterns.

Lifestyle tips

• Get regular sleep; try to go to bed and wake up at the same time each day
• Manage stress through hobbies, exercise, or meditation
• Stay hydrated and avoid skipping meals
• Limit caffeine and alcohol, as they can be triggers

Diet and exercise

A balanced diet and regular exercise can help reduce migraine frequency in some people. Avoid known trigger foods like aged cheese or processed meats. Gentle exercise like walking or yoga may be helpful, but intense exercise can sometimes trigger migraines in some individuals.

Mental health and emotional wellbeing

Migraines can be frustrating and affect your mood, causing anxiety or depression. It is important to talk about your feelings with a healthcare provider. If you are struggling with thoughts of self-harm or suicide, please reach out to a crisis support line immediately.

Prevention

While you cannot always prevent migraines, you can reduce how often they happen by avoiding triggers and following a healthy lifestyle. Some people benefit from preventive medications prescribed by their doctor.

Complications

If left untreated

• Frequent migraines can lead to chronic migraine (more than 15 headache days a month) if not managed
• They can interfere with work, school, and relationships
• Overuse of pain medications can cause medication-overuse headaches

Long-term outlook

With the right treatment and self-care, most people with migraines that come and go can lead full and active lives. Many find their migraines become less frequent or less severe over time. You are not alone, and help is available.

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