What causes migraine headaches?

A migraine may cause throbbing or pulsing headache, often with nausea and increased sensitivity to light or sound. Some people experience dizziness, vertigo, facial pain or visual and sensory changes before or during an attack. Triggers can include missed meals, dehydration, disrupted sleep, stress, hormonal changes, bright light, strong smells or particular foods. A trigger may lower the threshold for an attack without being its sole cause.

Record when attacks start, their features, sleep, meals, fluids, stress and any menstrual pattern. Keep routines steady where possible, eat regularly, drink enough fluids and rest in a quiet, dim room during an attack. Use headache medicine only as directed, because frequent use can itself make headaches harder to control. A clinician can tailor preventive or acute treatment to your pattern.

Seek urgent help for a sudden severe headache, new weakness, trouble speaking, confusion, fainting, seizure, fever with a stiff neck, or a headache after a significant head injury. Arrange assessment for a new or changing pattern, headaches that steadily worsen, repeated vomiting, or visual symptoms that do not settle. A new headache in pregnancy or with major illness also needs prompt advice.

Ask whether your symptoms fit migraine, what warning signs should change your plan, and whether you need treatment during attacks or prevention. Bring a diary showing frequency, duration, associated nausea, light sensitivity, dizziness or vomiting, plus medicines already tried.