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Migraine Headaches HOL-emblem1-web.GIF (3556 bytes)

A migraine is characterized by flashes of light that appear across the field of vision, problems with speech, numbness or dizziness. Migraine pains are typically intense and, at their worst; are debilitating, with weakness, nausea, sweating and vomiting. The senses are heightened and the slightest noise, light or movement unbearable.

Usually, the pain is localized or especially intense on one side of the head or over one eye. The person may also suffer from irritability. He or she usually wants to be left alone and out of any direct light.

About one in five migraine sufferers will experience an "aura" minutes before the onset of a headache. Women report seeing flashes of light and zigzag patterns and sometimes experiencing speech impairment, confusion and numbness in their faces and limbs.

From beginning to end, migraine attacks may last for hours to days. In addition to the symptoms described, patients with migraine (with or without aura) may experience a prodrome, or symptoms which occur up to 48 hours before the actual migraine attack begins. Some patients, for example, may have food cravings, changes in mood, irritability, drowsiness, difficulty concentrating, nausea, diarrhea or excessive yawning.

See Also: Phases Of Migraine

Two Categories of Migraine

The two most important categories are
bulletMigraine without aura (common migraine) and
bulletMigraine with aura (classic migraine).

An aura is a forewarning, usually consisting of visual disturbances or neurologic symptoms and occurring within the hour before the onset of the headache. About 60 percent of all types of migraine attacks consist of migraine without aura.

Migraine Without Aura (Common Migraine)

The most prominent symptom of migraine without aura is headache. It is associated with a slowly increasing pain, eventually developing into a throbbing headache. The headache may be severe and is often described as throbbing in quality. About 60 to 70 percent of the time, the headache pain is unilateral (occurring on one side of the head). Symptoms which commonly accompany the headache include photophobia (severe sensitivity to light), phonophobia (sensitivity to noise), nausea, and occasionally vomiting. These features distinguish migraine from tension-type headache, which is often described as a "band-like" sensation around the head without other associated symptoms.


A diagnosis of migraine without aura is made if the patient fulfills the specific criteria detailed below.

The patient must have a history of five previous similar episodes, with pain lasting between 4 and 72 hours.

Additionally, they must meet two of the following four characteristic symptoms:

  1. Unilateral head pain;
  2. Pain must be throbbing or pulsing;
  3. An experience of moderate to severe pain which inhibits or restricts the ability to function;
  4. Pain is made worse by routine physical activity.

Furthermore, they must have one of the following two symptoms present:

  1. Nausea and/or vomiting;
  2. Adverse reactions to light or sound.

Migraine With Aura (Classical Migraine)

Classical migraines are far less common. It is associated with experiencing some degree of blindness or visual impairment that slowly occupies a larger field of vision. The blinded area is often surrounded by a sparkling edge. Up to one-half of the field of vision can be blinded or reduced. The blindness usually lasts about twenty minutes and is followed by a severe one-sided headache with nausea, vomiting, and sensitivity to light. The "aura," occur within one hour of the onset of the headache phase. Some patients experience symptoms of the aura without subsequent development of headache.

Visual disturbances associated with migraine aura are variable, and may include flashing or "scintillating" lights, jagged or "zigzag" patterns, geometric shapes, colored or white spots (scotomas), mirage-like distortion of objects, and many others. Typically, these phenomena "march" or build-up across the field of vision. Such patterns are frequently present in both eyes, but their occurrence in one eye only (retinal migraine) is also common. Migraine aura may also occur in the form of neurologic symptoms such as numbness, tingling, or weakness on one side of the body, vertigo (sensations of the room spinning), double vision, or difficulty speaking. Such migraine attacks are often referred to as "complicated migraine" if the neurologic symptoms persist for more than 24 hours.

The aura is followed by an intense crescendo of a headache, frequently behind one eye or on one side of the head. The pain may be pounding, throbbing, viselike, or stabbing; frequently it feels like the head is going to explode from pressure. Other symptoms that can accompany the headache of a migraine, include
bulletSensitivity to light


Migraine with aura employs the same diagnostic criteria as common migraine with the following exceptions.

Patients only need a history of two prior migraine attacks and must fulfill three of the following four criteria:

  1. One or more aura symptoms;
  2. Aura symptoms that develop over more than 4 minutes;
  3. Aura lasts less than 60 seconds;
  4. Headache follows within 60 minutes of the aura ending.

Related Topic: Phases Of Migraine

Next Topic:Call Your Doctor If

                Treatment of Migraine

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