Although estimates vary, about 28 million American adults - or about 13 percent of the adult U.S. population - suffer from migraines, says Dr. Jason Rosenberg, director of the Johns Hopkins Headache Center at Johns Hopkins Bayview Medical Center. The chronic disorder affects more women than men and can vary from occasional symptoms to frequently occurring, debilitating pain.
How is a migraine defined?
We now think of migraines as a chronic disorder of a hyper-excitable brain, and the symptom of this brain hyper-excitability is intermittent sickness, including headache.
Migraines are hard to describe because they are thought to involve multiple steps; they are probably caused by a genetic sensitivity in which the brain is easily irritated by outside stimulation.
What are some of the symptoms of a migraine?
In addition to pain, symptoms include sensitivity to light, to sound, to smells and, what is probably the most disabling part, sensitivity to activity. By that I mean participating in day-to-day activities actually makes the person feel worse. And nausea is common.
The pain is at least moderate to severe in nature. Some of my patients will say that the pain can be 10 out of 10. It is often throbbing, so the pain pounds with the heartbeat. It also can be one-sided (on one side of the head), on both sides, in the face or neck. Sometimes it is mistaken for neck pain rather than a migraine.
How do you tell the difference between a migraine and a headache that may be caused by a more serious condition or disease?
There are a whole set of features in what we call worrisome headaches and these include: a new headache that you haven't experienced before or an unusual headache for you, a sudden "thunder clap" headache that reaches maximum intensity in five minutes vs. headaches that creep up slower, or the worst headache of your life.
Other things to watch for are new headaches in the elderly or anyone with a history of cancer or HIV, anyone who has headache and fever or stiff neck, or anyone with stroke-like symptoms.
The good news is that the vast majority of headaches are benign, caused by tension or migraine and very few are actually dangerous.
You mentioned that migraines affect more women than men. Why is that?
