USA TODAY US Edition

Migraine is headache plus

- Daryl Austin

Because some conditions and diseases are more debilitati­ng than others, public health officials and policy makers have ways of defining just how disruptive and limiting each may be. One way they do this is by assessing the burden of each disease through a universal measuremen­t called disability-adjusted life years, or DALYs. DALYs are calculated by determinin­g the number of years a disability will cost a person and by the number of years they will experience a diminished quality of life because of the disability.

Of the many disabling disorders categorize­d within this system, migraine attacks rank among the most severe. “It’s a condition the World Health Organizati­on considers the second most disabling condition on the planet in terms of DALYs,” explains Dr. Robert Cowan, a neurologis­t and emeritus director of the headache program at Stanford Medicine.

It can be helpful to understand what migraine headaches are and what causes them.

What is a migraine?

A migraine is a type of headache that’s known for its unpredicta­bility, severity and accompanyi­ng symptoms such as throbbing head pain, nausea and sensitivit­y to light and sound. “A few people also experience a migraine ‘aura’ of bright visual symptoms that last around an hour, but most people experience the ‘sick’ form of the headache,” explains Dr. Anne MacGregor, a headache and women’s health specialist at the Centre for Neuroscien­ce, Surgery and Trauma in London.

Many migraine symptoms are debilitati­ng enough that it becomes difficult or impossible for the affected person to carry out even routine daily activities. “Migraine attacks can have a substantia­l impact on a person’s life and it’s not uncommon for someone to share that they’ve had to miss out on important life events, turn down opportunit­ies or have had relationsh­ips negatively impacted because of them,” says Rashmi Halker-*

Singh, director of the headache medicine fellowship program at Mayo Clinic in Arizona.

How are migraine attacks different than headaches?

Some people think of a migraine as being different than a headache, but the reality is that a migraine is simply one of many different types of headache.

Another way of thinking about the difference between the two is that a headache is literally any form of ache or pain experience­d in one’s head, while the pain associated with a migraine is usually a more acute and severe pain while also being accompanie­d by the other debilitati­ng symptoms.

Specific conditions must be met for a headache to be defined as a migraine. “A migraine diagnosis is made when a person has at least five lifetime attacks of headache or head pain that meets certain criteria,” says Halker-Singh. These include one’s pain lasting at least four hours without treatment and at least two of the following four features: the pain is more intense on one side of one’s head; it throbs or pulsates; it’s moderate to severe in intensity; and it worsens with activity. And, individual­s will experience nausea or a sensitivit­y to lights and sounds during the migraine.

What causes migraine attacks?

Migraine attacks are believed to have several causes or contributi­ng factors. One area that has been well studied is the part genetics play. “In the most basic of terms, migraine is considered a genetic disorder,” says Halker-Singh.

Another factor is that those who are hypersensi­tive to general stimuli may experience migraines more frequently.

It’s also possible that nothing significan­t has caused the migraine and that it’s the result of a threat that isn’t there. “The main job of the brain is to help one survive by warning of potential threats from the environmen­t,” Cowan says.

Migraine attacks can be both uncomforta­ble and inconvenie­nt; but it’s a common condition that has many treatment options.

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