Migraine is one of the most common neurological diseases, affecting about one in seven people worldwide (WHO) and ranking among the leading causes of disability in adults under 50. It is a brain disorder — not a character flaw and not "just a headache."
What is migraine?
Migraine arises from abnormal excitability of brain networks and release of pain-signalling molecules such as CGRP around the coverings of the brain. Attacks typically last 4–72 hours and often run in families.
Common symptoms
- Throbbing pain, often on one side of the head
- Nausea or vomiting
- Sensitivity to light, sound, and smells
- Worsening with routine movement
- In some patients, an aura: flashing lights or zigzag lines before the pain
Risk factors and common triggers
- Family history and female hormones
- Irregular sleep, skipped meals, dehydration
- Stress — and the "let-down" after stress
- Overuse of painkillers (more than 10 days per month)
How is it diagnosed?
Migraine is a clinical diagnosis: a structured headache history, neurological examination, and a headache diary. Brain imaging is needed only when red-flag features are present.
Treatment options
Acute treatment (triptans, anti-inflammatories, gepants) works best taken early. Preventive treatment is indicated at 4+ attack days per month: daily tablets, CGRP-targeted biologics (Aimovig, Emgality, Vyepti), Botox every 12 weeks for chronic migraine, and ultrasound-guided nerve blocks for rapid control.
Natural ways to help reduce attacks
Regular sleep and meals, steady hydration, aerobic exercise, and stress management measurably reduce attack frequency. Keep a simple diary — the number of headache days is the single most useful fact for your neurologist.
When should you see a neurologist?
If headaches occur on 4 or more days a month, painkillers are needed frequently, attacks disable your work or family life, or the pattern of your headaches changes.
Emergency warning signs: a sudden "worst-ever" thunderclap headache, headache with fever and stiff neck, weakness, speech difficulty, or vision loss — seek emergency care immediately.
Key takeaways
- Migraine is a real neurological disease, and it is treatable.
- Early acute treatment works better than late.
- 4+ headache days a month = time to discuss prevention.
- Painkiller overuse can convert migraine into daily headache.
- CGRP biologics and Botox have transformed chronic migraine care.
References
American Headache Society. (2024). Consensus statement on migraine prevention. https://americanheadachesociety.org International Headache Society. (2018). ICHD-3 classification. https://ichd-3.org NICE. (2021). Headaches in over 12s (CG150). https://www.nice.org.uk