migraine with fever

Overview

Migraine with fever is when a person has a migraine headache and a body temperature higher than normal (a fever). Migraine itself usually does not cause fever. When both happen together, it often means another illness — like a cold, flu, or infection — is triggering the migraine. It is important to see a healthcare provider to find the cause and get the right treatment.

Migraine with fever is not very common. Most migraines happen without fever. When fever occurs, it is usually because the person also has an infection, such as a viral illness.

Anyone who gets migraines can have one with a fever if they also get an infection. Children and older adults may be more likely to have fever with headache because their bodies respond differently to illness.

Symptoms

Common symptoms

• Throbbing or pulsing headache, often on one side of the head
• Nausea or vomiting
• Sensitivity to light, sound, or smells
• Body temperature above 38°C (100.4°F)
• Feeling tired or weak

Symptoms in children

• High fever with headache
• Irritability or crying more than usual
• Not wanting to eat or drink
• Vomiting
• Appearing confused or drowsy

Symptoms in older adults

• Headache that may be less severe but with confusion or dizziness
• Fever that can be lower than in younger adults
• Increased risk of dehydration
• Changes in behaviour or thinking

Causes

Main causes

• Infections such as the flu, common cold, sinusitis, or COVID-19
• Migraine triggered by the fever itself or the immune response
• Serious infections like meningitis or encephalitis (inflammation of the brain or its lining)

Risk factors

• Having a history of migraines
• Being exposed to someone with a contagious infection
• Having a weakened immune system (due to illness or medicines)
• Young children and older adults are at higher risk for fever-related complications

When to see a doctor

See a doctor urgently if:

• Any of the emergency symptoms listed above — call emergency services immediately
• Fever with a stiff neck, confusion, or rash
• A headache that comes on very suddenly like a 'thunderclap'

Book a routine appointment if:

• If you have migraines and a fever that lasts more than 2 days without emergency signs
• To discuss a plan for managing migraines that happen with illness
• If your fever and headache keep coming back

Diagnosis

A healthcare provider will ask about your symptoms, do a physical exam, and check your temperature, heart rate, and neck flexibility. They may press on your face and sinuses to check for infection. They will also ask about your migraine history.

Tests that may be done

• Blood tests (to check for signs of infection or inflammation)
• Urine test (to detect a urinary tract infection)
• Lumbar puncture (spinal tap) if meningitis is suspected
• CT scan or MRI of the head (if the headache is severe or unusual)

What to expect at your appointment

The doctor will explain what they think is causing the fever and headache. They may recommend rest, fever reducers, and migraine treatments. If a serious infection is found, you may need treatment in hospital. Most people recover well with the right care.

Treatment

Treatment focuses on two things: lowering the fever and managing the migraine. The underlying cause (such as an infection) also needs to be treated. Always follow your healthcare provider's advice.

Self-care at home

• Rest in a quiet, dark room
• Drink plenty of fluids (water, clear soups) to stay hydrated
• Apply a cool, damp cloth to your forehead or neck
• Take acetaminophen (paracetamol) or ibuprofen as directed by your pharmacist or doctor for fever and pain
• Avoid strong odours, bright lights, and loud noises

Medical treatments

Your doctor may recommend fever-reducing medicines and migraine-specific treatments. These can include medicines that calm the blood vessels in the brain or block pain signals. If an infection is found, you may need antibiotics or antiviral medicines. In severe cases, you might require hospital care for fluids and monitoring.

When is surgery considered?

Surgery is not needed for migraine with fever. Surgery may be required for some causes of infection (like a brain abscess), but that is very rare.

Living with this condition

When you have a migraine with fever, take it easy. Focus on getting better by resting and staying hydrated. Keep track of your symptoms, and note how often you have migraines with fever. This can help you and your doctor find patterns and triggers.

Lifestyle tips

• Keep a headache diary to record what you eat, your sleep, and any illnesses
• Try to get enough sleep and avoid skipping meals
• Manage stress with relaxation techniques like deep breathing or gentle yoga

Diet and exercise

During a migraine with fever, it's best to eat light, bland foods like crackers, rice, or apple sauce. Avoid heavy, spicy, or very sweet foods that might upset your stomach. Once you feel better, return to a balanced diet. Gentle exercise, such as walking, can help prevent future migraines, but avoid vigorous activity when you are unwell.

Mental health and emotional wellbeing

Having frequent migraines, especially with fever, can be frustrating and worrying. It may cause anxiety about when the next episode will happen. Talk to your healthcare provider about these feelings. If you feel very down or anxious, consider speaking with a mental health professional. Remember, you are not alone, and help is available.

Prevention

You may not be able to prevent every migraine with fever, especially if it is caused by an infection. But you can reduce your risk by avoiding common triggers: stay up to date with vaccines (like flu and COVID-19), wash your hands often, and avoid close contact with sick people. For migraines in general, identify and avoid your personal triggers.

Vaccines

Getting recommended vaccines — such as the flu shot and COVID-19 vaccine — can help prevent infections that might trigger migraines with fever. Talk to your healthcare provider about which vaccines are right for you.

Screening programmes

There is no routine screening for migraine with fever. If you have recurring episodes, your doctor may suggest keeping a headache diary and having regular check-ups to monitor your health.

Complications

If left untreated

• Prolonged or worsening headache
• Dehydration from vomiting or not drinking enough
• Seizures, especially in young children with high fever
• Serious infections spreading to the brain or spinal cord (meningitis, encephalitis) if left untreated

Long-term outlook

Most cases of migraine with fever get better with rest, home care, and treatment of the underlying infection. The outlook is excellent for common viral illnesses. If the cause is more serious, prompt medical treatment usually leads to a good recovery. By working with your healthcare provider, you can manage symptoms and reduce future episodes.

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