Periods (menstruation), shift work, different sleep patterns, and the menopause. See the separate leaflet called Migraine and Combined Hormonal Contraception for more details. For example, hormone replacement therapy (HRT), some sleeping tablets, and the contraceptive pill. Many people with migraine cope well with stress but have attacks when they relax, leading to so-called weekend migraine. Depression, anxiety, anger, tiredness, stress, etc. Smoking and smoky rooms, glaring light, VDU screens or flickering TV sets, loud noises, strong smells. Dieting too fast, irregular meals, cheese, chocolate, red wines, citrus fruits, foods containing a food additive called tyramine and not drinking enough water (dehydration). However, something may trigger migraine attacks in some people. Most migraine attacks occur for no apparent reason. Most people who have migraine with aura also have episodes of migraine without aura. Sometimes, just the aura occurs and no headache follows (silent migraine).

The headache usually develops within 60 minutes of the end of the aura but it may develop a lot sooner than that - often straight afterwards. The aura usually goes before the headache begins. Each aura usually lasts just a few minutes before going but can last up to 60 minutes. One of the above migraine auras may develop, or several may occur one after each other. Other types of migraine aura include an odd smell, food cravings, a feeling of well-being, and other odd sensations.

If you have an aura before your migraine that includes two different types of nerve problems (such as vertigo, tinnitus or slurred speech) this might be called a brainstem aura. Problems with speech are the third most common type of migraine aura.Numbness usually starts in the hand, travels up the arm and then involves the face, lips and tongue. Numbness and pins and needles are the second most common type of migraine aura.Objects or letters on a page may seem to rotate, shake, or boil.A bright, flashing light, often in a C-shaped pattern, a bit like looking through an old-fashioned kaleidoscope, or zig-zag lines.

It usually affects just one side of your vision and gradually gets bigger over 5-20 minutes. Visual aura is the most common type of migraine aura.The symptoms are the same as those described above, but also include a warning sign, called a migraine aura, which comes on before the headache begins. This is less common than migraine without aura. Sensitivity to light and sound, so that you may just want to lie in a dark room.Typically, it gradually becomes worse and peaks after 2-12 hours, then gradually eases off. It often begins in the morning but may begin at any time of the day or night. The pain is moderate or severe and is often described as throbbing or pulsating. Sometimes it starts on one side and then spreads all over the head. Sometimes it is on both sides of the head. The headache is usually on one side of the head, typically at the front or side.This is the most common type of migraine. Therefore, if you have one or more close relatives who have migraine this is a risk factor for having migraine yourself.

So, there is probably some genetic factor involved. However, there is often a family history of migraine. Migraine is not classed as an inherited condition. It is not a low level of oestrogen that is thought to be the trigger, but the drop in the level of oestrogen from one level to another. The blood level of oestrogen falls just before a period. Oestrogen is one of the chemicals (hormones) that control the menstrual cycle. The cause of, or trigger to, menstrual migraine is thought to be the fall of the level of oestrogen that occurs at this time in the cycle. Recent research has looked at the role of calcitonin gene-related peptide (CGRP) in migraine development, There is hope that this may provide a new route for treating migraine. However, something may trigger a change in activity of some brain chemicals to set off a migraine attack. It is also not clear why people with migraine should develop these changes. The exact changes in brain chemicals are not known. It is now thought that some chemicals in the brain increase in activity and parts of the brain may then send out confusing signals which cause the symptoms. However, this theory is not the whole story and, indeed, may not even be a main factor. The blood vessels in the brain were then thought to open wide (dilate) soon afterwards, which accounted for the migraine headache. A theory that used to be popular was that blood vessels in parts of the brain become narrower (go into spasm) which accounted for the aura.

Migraine with aura treatment