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Eiliyah Annam
Nov 93 min read

Inside the Storm: Unpacking the Complex World of Migraines and Their Triggers

Imagine a storm that's brewing right behind your eyes, one that lasts for hours or days, that strikes without mercy inside your head. A slight glimmer of light, a sudden movement, loud sounds, or even a whiff of a strong smell can unleash the storm. This is the exact world of a migraine, where the triggers are unpredictable, where relief often feels like a distant hope to most.



Migraines are at most often characterized as 'bad headaches', but in reality they are not just bad headaches. Migraines are intense, often debilitating neurological events that impact over a billion people worldwide. They can disrupt everyday life, even making simple tasks unbearable to complete.


Most people affiliate headaches and migraines as the same thing, but in reality that is not accurate. Headaches are usually troublesome and usually aren't severe enough to affect whether one can go on with their daily activities. The two most common types of headaches are tension-type and sinus headaches. Tension-type headaches are where the pain affects your head or face, but not directly your brain. Similarly, sinus headaches are where pain is is directed to the face when one has infections in the sinuses. In contrast, migraines affect the brain directly, which is the reason why they are very severe. Affecting the brain directly makes it severe because when migraines occur the 5th cranial nerve that is stimulated sends impulses, such as pain impulses, from the eyes, scalp, forehead, upper eyelids, mouth, and jaw to the brain. Furthermore when triggered, the nerve may release chemicals that lead to painful inflammation in the brain's blood vessels (the cerebral blood vessels) and in the layers of tissue surrounding the brain (the meninges). This inflammation is what makes migraines so severe as it results in intense pain in the brain.


Migraines can take on different forms as well as have different symptoms. The symptoms experienced can even vary from migraine to migraine, which means that one migraine can take on a set of symptoms while the next migraine can appear as a whole other set of symptoms different from the previous migraine. There are different symptoms that can present depending on which of the four stages that migraines can occur as, which are Prodrome, Aura, Headache, and Postdrome.


Prodrome is the pre-migraine stage. In this stage one often feels differences that hints that a migraine is imminent or approaching. The Aura stage are symptoms that occur as a migraine disturbs different areas of the brain. The pain stage of a migraine is the Headache stage. Lastly, the Postdrome stage is when one feels the aftermath of a migraine.


A chronic migraine is different from a regular migraine, as it needs to meet different types of criteria. Chronic migraines can either present as migraines with aura or without aura.


To categorize a migraine without aura, it has to meet the following criteria:

  • Must last between four to 72 hours

  • One of the headache phases that as at least two of the following:

    • Pain on either left or right side of the head.

    • Pain that presents as a pulsating or pounding sensation.

    • Pain that ranges as moderate or severe.

    • Pain that becomes worse with basic activities such as using the stairs or walking

  • One of the headache phases that includes at least one of the following:

    • Vomiting.

    • Nausea.

    • Both photophobia (light sensitivity) and phonophobia (sound sensitivity).


To categorize a migraine with aura, it has to meet the criteria of the following:

  • One or more of the different types of the following aura symptoms:

    • Touch (a numbness or tingling sensation).

    • Visual (flashing lights, haz, zig-zag-like areas that are around the center of your vision or other vision changes).

    • Brainstem (the loss of coordination, issues with balance, tinnitus, or vertigo).

    • Speech/Language (difficulty in speaking or understanding what others say).

    • Motor (hemiplegia, the one-sided weakness or paralysis that affects your body and/or face).

    • Retinal (one-sided blindness that is either partial, total, or shimmering areas).


Example of Migraine with Aura with the visual symptom

A migraines' impact goes far beyond just a painful headache. These complex neurological events disrupt life for over a billion people worldwide, causing intense physical and emotional strain. The unpredictability and variation of symptoms, from throbbing pain to light sensitivity, nausesa, and aura, make migraines an enduring challenge to diagnose and manage.



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