Disorders

What is migraine?

Reviewed July 2026 by Teshamae Monteith, MD, FAHS, FAAN

Definition: Migraine is a neurological disorder defined by intense head pain, often only on one side, that may occur alongside other symptoms such as nausea, vomiting, or sensitivity to light, sound, and smells.

Migraine is more than a bad headache—it can be painful and debilitating, making everyday activities difficult or impossible. Understanding more about migraine is an important step to getting the right care.

Common triggers include stress, hormonal shifts, bright or flashing lights, poor sleep, and certain foods and drinks. Migraine affects more than 14% of people worldwide and is three times more common in women than in men. About 2% of people live with chronic migraine, meaning they experience 15 or more headache days—including at least eight migraine days—per month for three months or longer.

What are the symptoms of migraine?

A migraine attack can move through up to five phases, each with its own set of symptoms. Not everyone will experience every phase, but recognizing these signs can help you identify a migraine and respond more quickly.

  • Prodrome (the early warning): Hours or days before the headache begins, you may notice fatigue or frequent yawning, cognitive or mood changes, neck stiffness, food cravings, or increased sensitivity to light. These early signs can be easy to miss, but learning to identify them can help you prepare for what’s ahead.
  • Aura: About 20% of people with migraine may experience a symptom called aura, typically lasting 15-20 minutes. Aura often comes before or at the start of the headache phase, but it can also happen during the headache. The most common type of aura is visual aura (like vision loss or seeing flashing lights or zigzag lines), but other symptoms such as numbness, tingling, weakness, or trouble speaking can also happen.
  • Headache: This main phase of the migraine involves moderate to severe throbbing pain. It’s usually felt on one side of the head, but it sometimes can be on both sides. Other common symptoms include nausea, vomiting, and sensitivity to light and sound. Many people also experience dizziness, brain fog, fatigue, and mood changes. While headache intensity varies, this phase is often debilitating.
  • Postdrome (migraine hangover): Even after the pain fades, you may feel drained, foggy, dizzy, or worn out for one to two days.
  • Interictal phase: Between migraine attacks, some people have on-and-off non-pain symptoms like light sensitivity, brain fog, and fatigue.  

Recognizing these phases can help you identify patterns and help you and your doctor build a more effective treatment plan.

What are the causes and risk factors of migraine?

While experts are still researching what causes migraine, many believe it can be caused by abnormal communication in the parts of the brain that process pain and sensory information. During a migraine attack, the brain releases chemicals that cause pain and other symptoms. Repeated attacks can make the brain more sensitive to pain, which can make migraines worse over time.

Genetics and environmental factors can make some people more likely to have migraines. Hormones can also be part of it—many women notice they get migraine attacks before or during their menstrual periods.

Research continues to uncover more about what drives migraine, giving neurologists new tools to help people manage it.

How is migraine diagnosed?

There is no single test for migraine. Instead, a doctor—often a neurologist—makes the diagnosis based on your medical history and a description of your symptoms.

According to established guidelines, a migraine diagnosis typically requires at least five attacks lasting four to 72 hours, with at least two of these features:

  • Pain on one side of the head
  • Throbbing or pulsating pain
  • Moderate to severe pain intensity
  • Pain that worsens with routine physical activity

Attacks also need to include nausea, vomiting, or sensitivity to both light and sound for diagnosis.

Brain scans or other imaging tests are usually only needed if your symptoms are unusual or if your doctor wants to rule out other conditions. If your headaches are affecting your quality of life, talk to your doctor—an accurate diagnosis is the first step toward effective treatment.

What treatments are available for migraine?

Migraine treatment generally falls into two categories: acute treatments that stop an attack once it starts, and preventive treatments which are taken regularly to reduce how often attacks happen.

Acute treatments: These medications are taken once a migraine begins, while the pain is mild. Over-the-counter pain relievers, triptans, and newer medications called gepants can help relieve migraine pain when taken early in an attack. Opioid-based painkillers are generally not recommended because of the risk of dependence and the potential to make headaches worse over time.

Preventive treatments: If you experience frequent attacks, your doctor may recommend a treatment you take on a regular schedule to prevent attacks from starting. Options include blood pressure medications like propranolol, anti-seizure medications like topiramate, and certain antidepressants such as amitriptyline or venlafaxine. Botulinum toxin type A injections are also approved for chronic migraine.

Newer targeted therapies: One of the most promising advances in migraine care involves medications that block CGRP, one of the brain chemicals involved in migraine pain. These include injectable antibodies (such as erenumab, galcanezumab, fremanezumab, and eptinezumab) and oral gepants (atogepant, rimegepant). These treatments have helped many people who did not respond to other options.

Other therapies: Some lifestyle changes can help prevent migraine attacks. These can include psychological treatments like cognitive behavioral therapy, certain supplements such as magnesium, and exercise.

The right treatment plan depends on how often you have attacks, how severe they are, and your overall health. A neurologist can work with you to find the best approach.

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Frequently asked questions

How can I tell if my headache is a migraine or something else, like a sinus or tension headache?

Many people assume their headaches are caused by sinus problems, but research shows that most self-diagnosed “sinus headaches” are actually migraine. Migraine can cause pressure and pain around the forehead and eyes, and attacks are sometimes triggered by weather changes, which adds to the confusion. A key difference is that migraine pain tends to throb or pulsate, often affects one side of the head, and comes with nausea or sensitivity to light and sound.

Tension-type headaches, on the other hand, usually cause a steady, band-like pressure on both sides. Because migraines can sometimes be felt on both sides of the head, they’re sometimes confused with tension-type headaches.

What are my personal migraine triggers, and how do I identify them?

Migraine triggers vary from person to person, but some of the most common include stress, hormonal changes, poor sleep, bright lights, skipped meals, and certain foods and drinks.

Recent research suggests that some things people think of as “triggers” may actually be early symptoms of an attack that has already begun. For example, craving chocolate before a migraine may be a prodromal symptom, not a trigger.

Keeping a headache diary—tracking when attacks happen, what you ate, how you slept, and how you felt beforehand—can help you and your doctor spot patterns and build a personalized prevention plan.

What is medication overuse headache, and how do I avoid it?

Medication overuse headache (sometimes called “rebound headache”) happens when pain-relief medications are used too frequently, leading to more headaches—not fewer. Taking acute migraine medications more than two to three days per week can increase the risk.

Research shows that nearly 40% of people with migraine have never heard of this condition, which highlights the importance of awareness. If you notice your headaches becoming more frequent despite taking medication, talk to your doctor. A structured plan to reduce acute medication use, often combined with starting a preventive treatment, can help break the cycle.

What's the difference between acute and preventive migraine treatments?

Acute treatments are taken at the start of a migraine attack to stop or shorten it. These include over-the-counter pain relievers, triptans, and gepants. Rimgepant can be used for both acute and preventive use.

Preventive treatments are taken on a regular schedule—daily, monthly, or quarterly—to reduce how often attacks happen and how severe they are. Options include older medications like anti-hypertensive drugs, anti-depressants, and anti-seizure drugs, newer CGRP-targeting therapies, and botulinum toxin type A injections for chronic migraine.

Many people benefit from using both types of treatment together. Your doctor can help you determine the right combination based on how often you experience attacks and how they affect your daily life.