100 Fun Facts About Migraine

What does the Greek root of the word 'migraine' mean?

Pain in half of the head: the Greek hemikrania, 'half-skull', named the classic one-sided attack. Everyday speech later swallowed the first syllable, which is how hemicrania wore down into migraine.

What was an early English spelling of migraine that also meant low spirits?

Megrim was the usual English form for centuries, and an 1895 dictionary still filed the headache under it. The French spelling migraine has since pushed it out, and megrim is now archaic even for the blues or a passing whim.

Roughly what share of the world's population has migraine in a given year?

14% is about one person in seven, more than a billion people. Yet most are never properly diagnosed: because attacks come and go, the WHO notes, headache is rarely taken as seriously as it should be.

A migraine 'aura' takes its name from the Greek word for what?

Breeze. Doctors first used the word for the current of cold air some patients felt rising towards the head just before a seizure, and it grew to cover any strange sensation that comes shortly before an attack.

What is the name for the warning phase of a migraine, hours or even days before the pain begins?

Prodrome signs include repeated yawning, food cravings and a stiff neck. They are worth learning: people who spot them can treat the attack early, which for some heads off the worst of it.

A typical migraine aura fades within about which length of time?

An hour. Aura symptoms creep in over at least five minutes and fade within 60, and the headache usually arrives before that hour is up.

Migraine with aura was once called 'classic'; what was migraine without aura called?

Common migraine. Only about 30% of people with migraine ever get an aura, so the 'classic' kind is in fact the rarer one; doctors now simply say migraine without aura.

What is the term for the flickering, zigzag visual disturbance of a migraine aura?

Scintillating scotoma. The shimmering zigzag usually starts near the centre of vision and drifts to one side over several minutes, leaving a temporary blind patch in its wake.

After visual disturbances, what is the next most frequent migraine aura symptom?

Pins and needles. The tingling typically starts in one hand, creeps up the arm to the face on the same side, and can leave numbness behind as it passes.

What popular name is given to a migraine aura that comes without a headache?

Silent migraine is the popular name, but doctors say migraine aura without headache, because the vision loss and sensitivity to light and sound can be disabling even with no pain.

Which colour of light did researchers find aggravates a migraine headache least?

Green. White, blue, amber and red light all aggravated the pain more than green did, and for some people a narrow band of green even eased it, a finding that has put green lamps on sale as a migraine aid.

Compared with adults, young migraine patients more often feel the pain where?

On both sides. Adult migraine is classically one-sided, but in the young the pain often takes in both sides of the head, and the one-sided pattern tends to emerge only in late adolescence or early adult life.

What is the name for a migraine attack lasting more than 72 hours despite treatment?

Status migrainosus can bring severe dehydration from vomiting, so a relentless attack sometimes ends with fluids and medicines given through a drip in hospital.

Along with sensitivity to light and sound, which symptom do most people get during a migraine attack?

Nausea. Most people feel sick during an attack and many vomit, which is why anti-sickness medicines are a standard part of migraine treatment alongside painkillers.

What is the postdrome phase commonly nicknamed?

Migraine hangover. The attack isn't over when the pain stops: tiredness, poor concentration and thirst can linger for a day or two afterwards.

Which treatment, injected around the head and neck every 12 weeks, is approved to prevent chronic migraine?

Botox. Approved for migraine in 2010, it is licensed only for the chronic form, meaning headache on 15 or more days a month; people with occasional attacks don't qualify.

Boys and girls get migraine at equal rates until which stage of life?

Puberty. Before it migraine is equally common in both sexes; afterwards the rate climbs much faster in girls, and adult women are about three times as likely as men to have it.

Which of these triggers do women with migraine report most often?

Hormonal variation. Many women with migraine notice attacks around their period, when oestrogen levels fall in the days before it starts.

Which cranial pathway carries the pain signals central to migraine?

Trigeminal nerve. Best known for carrying feeling from the face, it also supplies the pain-sensitive coverings of the brain, which is where migraine pain signals start.

What does CGRP, a molecule central to migraine pain, stand for?

Calcitonin gene-related peptide. Levels of this protein rise during an attack, when it is released around the brain and inflames the pain-sensitive coverings.

Which brain phenomenon is associated with migraine aura?

Cortical spreading depression is a slow wave of abnormal electrical activity that creeps across the brain's surface; alarming as it sounds, the migraine kind is typically harmless and the symptoms it causes are temporary.

Which trigger do people with migraine name more often than any other?

Stress. Surveys find 70 to 80% of people with migraine name it, yet for some the attack arrives only once the pressure lifts, at a weekend or on holiday: a 'let-down migraine'.

The '5, 4, 3, 2, 1' rule for diagnosing migraine without aura begins with what?

Five or more attacks, then 4 hours to 3 days of pain, 2 of four pain features and 1 accompanying symptom; with aura the bar is lower, and just two attacks are enough for a diagnosis.

Which body has published the standard diagnostic criteria for migraine since 1988?

International Headache Society. Its checklist diagnoses migraine from symptoms alone, since no blood test or scan can confirm it, and has been revised twice, in 2004 and 2018.

An aura accompanied by motor weakness defines which type of migraine?

Hemiplegic migraine. The weakness hits one side of the body and can last for days, and the familial form is a rarity among migraines: it is passed on by a single faulty gene.

Which type of migraine can cause temporary blindness in one eye?

Retinal migraine. It arises in or behind one eye, so only that eye's sight dims, whereas an ordinary aura starts in the brain and so shows up in both eyes at once.

Abdominal migraine, with bouts of severe stomach pain, is mostly diagnosed in whom?

Children are the usual patients: the attacks bring hours of stomach pain with no headache at all, yet most of them go on to develop migraine headaches later in life.

Which perceptual disorder linked to migraine makes objects seem too large or too small?

Alice in Wonderland syndrome. Psychiatrist John Todd named it in 1955 after the heroine who shrinks and grows; an American neurologist had described it three years earlier, but Todd's label is the one that stuck.

Which ingredient of some migraine painkillers can itself trigger attacks?

Caffeine. It boosts the effect of painkillers such as paracetamol and ibuprofen, but too much can bring on an attack and so can quitting abruptly, so the advice is to cut down gradually.

Which class of drug is first-line for moderate to severe migraine attacks?

Triptans. Unlike everyday painkillers they were developed specifically for migraine, and they work best when taken early in an attack.

The first-line drugs for severe migraine attacks mimic which neurotransmitter at its receptors?

Serotonin. The drugs switch on two of its receptors, 5-HT1B and 5-HT1D, on blood vessels and nerve endings around the brain, which calms the pain signals.

Which word best describes the pain of a typical migraine headache?

Throbbing. Oddly, the throb does not keep time with the heartbeat: when researchers timed both, the pain pulsed more slowly than the patient's pulse.

Studies suggest most self-diagnosed headaches of which kind are really migraine?

Sinus headache. In one study of nearly 3,000 people who blamed their sinuses, about nine in ten met the criteria for migraine, which can itself bring a stuffy nose and facial pressure.

Why are opioids generally avoided for migraine?

They can make attacks more frequent. Regular opioid use can cause medication-overuse headache and push migraine towards the chronic form; even simple painkillers can do it if taken on more than 15 days a month.

After which stage of life do many women find that their migraine attacks ease?

Menopause. Attacks often get worse in the few years leading up to it, then ease for many women once their periods have stopped for good.

The ergot fungus, source of an early migraine drug, grows on which crop?

Rye. Grain contaminated with the fungus can poison people who eat it, yet in 1918 chemists isolated ergotamine from it, and the compound was soon being used to stop migraine attacks.

In 2018 erenumab became the first approved migraine drug of which kind?

A CGRP receptor antagonist. Sold as Aimovig, it is a lab-made antibody that patients inject themselves about once a month, and it was created from the start to prevent migraine.

Which vitamin do neurology guidelines rate as probably effective for preventing migraine?

Riboflavin. Better known as vitamin B2, it is taken for migraine at about 400 mg a day, hundreds of times the amount a normal diet supplies.

Propranolol, widely prescribed to prevent migraine, belongs to which class of heart and blood-pressure drugs?

Beta blockers. The same propranolol that lowers blood pressure and calms the pounding heart of anxiety is taken every day, attack or no attack, to make migraines less frequent.

Which Egyptian medical text of about 1500 BCE describes something like migraine?

Ebers Papyrus. Its remedies sit beside magic spells, and it is named after Georg Ebers, the German Egyptologist and novelist who bought it at Luxor in the 1870s.

Which physician turned 'heterocrania' into 'hemicrania', ancestor of the word migraine?

Aretaeus of Cappadocia had classified headaches into cephalalgia, cephalea and heterocrania.

Which medieval mystic's visions of 'the living light' may describe migraine aura?

Hildegard von Bingen. She said the visions began in early childhood but kept them largely to herself until, in her early forties, one commanded her to write down what she saw and heard.

Which 17th-century physician introduced the vascular theory of migraine?

Thomas Willis. The English doctor, who also coined the word 'neurology', launched a vascular view of migraine that Harold Wolff's 20th-century theory would closely echo.

Which everyday action typically makes migraine pain worse, a sign doctors use to tell it from other headaches?

Climbing stairs. Routine movement sharpens the pain mid-attack, which is part of how doctors define migraine, yet trials find that regular aerobic exercise can reduce the number of attacks.

Which doctor's first book was called Migraine?

Oliver Sacks. By his own account he wrote most of it in nine days in 1967; it came out in 1970, three years before Awakenings.

Which Canadian physician covered migraine in his 1892 Principles and Practice of Medicine?

William Osler. His textbook dominated English-speaking medicine, and its migraine chapter recommended remedies that included ergot, bromides and cannabis.

Migraine with aura is associated with an increased risk of what?

Ischaemic stroke. The extra risk is clearest for attacks with aura, but headache worriers can relax on one point: a study of nearly 40,000 women found no link between migraine and brain tumours.

Which mineral supplement do neurology guidelines rate as probably effective for preventing migraine?

Magnesium. Low magnesium has itself been linked to migraine, and the daily supplement is cheap and generally safe: its commonest side effect is diarrhoea.

Which headache disorder is even more common worldwide than migraine?

Tension-type headache. It affects nearly two billion people, yet because its pain is milder, migraine causes several times more disability worldwide.

Women who get migraine with aura are usually advised to avoid which form of contraception?

The combined pill. Its oestrogen is the concern, so those who get aura are steered to oestrogen-free methods such as the progestogen-only pill.

Which Stone Age surgery is often said, on little evidence, to have treated migraine?

Trepanation. Skulls with drilled or scraped holes survive from the Neolithic, many with regrown bone showing the patient lived, but there is little evidence the aim was to cure headaches.

Migraine ranked second among global causes of disability in 2019; which complaint ranked first?

Low back pain. The Global Burden of Disease ranking counts years lived with disability, a measure of suffering rather than deaths, and among young women migraine came first.

What everyday remedy can end a migraine attack?

Sleep. Doctors build it into the rulebook: if someone falls asleep mid-attack and wakes without the pain, the attack is timed as ending at the moment they woke.

In Europe, where does most of the economic cost of migraine come from?

Lost working time. A Europe-wide study found about 93% of migraine's cost came from sick days and reduced output at work, with medicines, scans and hospital care making up the rest.

Which migraine look-alike typically strikes people over 50, with a tender scalp and jaw pain when chewing?

Temporal arteritis. Inflamed arteries at the side of the head cause it, and doctors treat it as an emergency because, without prompt steroids, it can cause sudden permanent loss of sight.

Which corticosteroid is sometimes added to treatment when a migraine attack drags on past 72 hours?

Dexamethasone. Trials show a single dose mainly lowers the chance of the headache bouncing back over the next three days, so it is kept for stubborn attacks rather than routine ones.

Scans show which brain region changing its activity the day before a migraine attack?

Hypothalamus. Because it governs hunger, tiredness and daily rhythms, its early stirring may explain why yawning and food cravings can warn of an attack hours before any pain.

During which of these do many women find their migraine attacks ease or stop?

Pregnancy. Many women with migraine have fewer attacks while pregnant, with the relief usually arriving in the second and third trimesters rather than the first.

Topiramate, often prescribed to prevent migraine, was first licensed as a treatment for which condition?

Epilepsy. First approved for seizures in the 1990s, it comes with a strict rule: anyone who could become pregnant must use contraception, because it can harm a developing baby.

Which type of migraine is marked by attacks of vertigo and unsteadiness?

Vestibular migraine. Named for the inner ear's balance system, it often strikes people with a history of motion sickness, sometimes going back to childhood.

Which everyday reflex, repeated uncontrollably, can be an early warning sign that a migraine attack is on the way?

Yawning again and again can begin long before the pain, alongside mood swings, food cravings and extra trips to the toilet. Such signals can show up a day or more ahead of the headache itself.

Which sweet food, long blamed for triggering migraine, may simply be craved once an attack is already brewing?

Chocolate cravings can be an early symptom rather than a cause: the attack is already under way when the urge strikes. The snack then takes the blame for a headache that was coming anyway.

Which running back was named MVP of Super Bowl XXXII despite missing most of a quarter with a migraine?

Terrell Davis had his vision impaired by the attack, took medication before half-time, and came back to rush for 157 yards and three touchdowns against the Packers.

Which hallucinogenic drug was first made by a Swiss chemist from ergotamine, an early medicine for migraine attacks?

LSD is built from lysergic acid, which chemists obtain by breaking down ergotamine. About 25 kg of the migraine drug's tartrate salt can yield 5 to 6 kg of the hallucinogen.

Which American painkiller brand became, in 1998, the first migraine medicine cleared for sale without a prescription?

Excedrin Migraine won clearance early in 1998, yet its active ingredients were identical to the Extra Strength tablets already on shelves. Only the label was new.

A 'thunderclap' headache that peaks within a minute, unlike a migraine, most urgently suggests which emergency?

Bleeding around the brain, a subarachnoid haemorrhage, lies behind 10 to 25 percent of headaches that hit full force within seconds. That is why a thunderclap is treated as an emergency until scans say otherwise.

The shimmering zigzags of a migraine aura arise not in the eyes but in which part of the brain?

The occipital lobe at the back of the head processes sight, which is why the shimmer typically shows up in both eyes at once rather than in one.

People who get migraine with aura are more likely than others to have a small unsealed opening in which organ?

The heart of about one adult in four keeps a flap-like gap between its upper chambers, a patent foramen ovale. A large trial confirmed the gap is more frequent in migraine patients, but closing it did not end their headaches.

What nickname do doctors give the near-daily headaches caused by taking migraine painkillers too often?

Rebound headache, formally medication overuse headache, can follow simple painkillers taken on 15 or more days a month. The cure is to pause the tablets, which often makes things worse before they improve.

Which figure from the Gospels is tormented by a terrible migraine in Bulgakov's The Master and Margarita?

Pontius Pilate suffers so badly in the novel's Jerusalem chapters that he has suicidal thoughts and loves only his dog, Banga, the one being he is attached to.

Fever and a stiff neck alongside a severe headache point away from migraine and toward which dangerous infection?

Meningitis is suspected whenever fever accompanies a severe headache, one of the 'red flag' combinations that tell doctors to look beyond migraine and investigate urgently.

Migraine is diagnosed chiefly from what, rather than from brain scans or laboratory findings?

The pattern of symptoms is what counts: how long attacks last, where the pain sits and what comes with it. Scans are kept for 'red flag' cases, and routine imaging is judged unnecessary once the criteria are met.

Which ancient Greek physician's school noted a visual aura before headache, and relief once the stomach was emptied?

Hippocrates and his followers noted both details more than two thousand years ago, long before the condition had the name we use for it.

Greek and Roman physicians moved away from supernatural explanations and blamed migraine on an imbalance of what?

The four humours were the body's fluids, and a headache meant they had fallen out of balance. Earlier Babylonian texts had put such pain down to supernatural forces and treated it with religious rites.

Which Chicago Bulls star was hobbled by a severe migraine in Game Seven of the 1990 Eastern Conference Finals?

Scottie Pippen made only one of his ten field goal attempts as the Bulls lost 93–74. A year later he and Chicago were NBA champions.

Which ear piercing, through the innermost fold of cartilage, is claimed without good evidence to relieve migraine?

Daith piercings are claimed to act on the vagus nerve, but researchers who reviewed the evidence concluded that it does not support them as a treatment for migraine or tension headaches.

Amitriptyline, widely prescribed to prevent migraine attacks, was approved in 1961 as which kind of drug?

An antidepressant of the tricyclic class, amitriptyline is also used for nerve pain and fibromyalgia. In trials on young patients, though, it prevented migraine no better than placebo.

Poisoning by ergot, the fungus behind early migraine drugs, was known in the Middle Ages as which saint's 'fire'?

St Anthony gave his name to the burning gangrene because monks of his order devoted themselves to nursing its victims. Centuries later, purified ergot compounds became headache medicines.

Which term describes the aversion to smells and odours that many people feel during a migraine attack?

Osmophobia affected as many as a quarter of migraine sufferers in one study. Foul odours are the usual culprits, but the sensitivity can extend to every scent.

What do doctors call migraine medicine taken regularly to stop attacks starting, as opposed to 'abortive' treatment?

Prophylactic treatment is usually considered for people who have four or more migraines a month. Abortive drugs, by contrast, are taken once an attack has begun, and work best early.

Which herbal migraine preventive carries warnings because its natural alkaloids can damage the liver?

Butterbur extracts cut the number of attacks in trials, but the plant's pyrrolizidine alkaloids are toxic unless carefully removed. In 2015 the American Academy of Neurology withdrew its endorsement on safety grounds.

Which outermost membrane around the brain is rich in the pain-sensing nerve endings involved in a migraine attack?

Dura mater takes its name from the Latin for 'tough mother'. The brain itself has no pain receptors, so the ache of an attack has to come from the tissues wrapped around it.

Which American writer described living with chronic migraine in her essay 'In Bed', collected in The White Album?

Joan Didion dated the essay 1968 and placed it in her 1979 collection, whose title piece borrows the popular name of a Beatles album from that same year.

Which compound, found in aged cheeses and cured meats, has long been suspected of setting off migraine attacks?

Tyramine came under suspicion when a British pharmacist noticed that his wife, who was on MAOI medication, had severe headaches after eating cheese. Doctors still speak of the 'cheese reaction'.

Which term describes the trouble finding or understanding words that can strike during a migraine aura?

Aphasia is a less frequent form of aura than the visual and tingling kinds. Like them it is fully reversible, with speech returning once the aura passes.

What is the term for normally painless touch on the skin or scalp becoming painful during a migraine attack?

Allodynia is pain from a stimulus that does not normally hurt, in the way sunburn can make wearing clothes or running warm water over the skin unbearable.

In the POUND checklist that doctors use to spot migraine, which word does the letter D stand for?

Disabling intensity is one of five features the mnemonic checks. When four or five are present in a patient seen in primary care, the chance that the headache is migraine is about 92 percent.

Which American duo, led by singer Tyler Joseph, included a song called Migraine on their 2013 album Vessel?

Twenty One Pilots first released the track on the Three Songs EP in 2012, months before Vessel came out on the Fueled by Ramen label.

Once blamed on swollen blood vessels, migraine is now classed by doctors as which type of disorder?

Neurological is the modern label: attacks are traced to nerve cells and chemical signals in the brain. The vascular theory that dominated the 20th century put the pain down to widening arteries.

Which factor is estimated to account for roughly a third to a half of the risk of developing migraine?

Inherited genes matter, yet rarely a single one: many variants each nudge the risk up slightly. Twin studies put the genetic share at 0.36 to 0.48.

The tingling of a sensory migraine aura typically starts in one hand, then spreads up the arm to which area?

The mouth and nose on the same side come next, as the sensation creeps slowly from its starting point. Numbness tends to follow once the tingling has passed.

The MIDAS questionnaire, used to gauge how badly migraine affects a patient, counts what over the previous three months?

Days lost to headache are tallied across work, school, housework and leisure, including days when productivity fell by half or more. Five answers are added up to give the score.

Physician Hubert Airy, who drew one of the first pictures of a migraine aura in 1870, had a father in which post?

Astronomer Royal Sir George Airy was his father. Hubert became a physician and a pioneer in the study of migraine, and has two portraits in the National Portrait Gallery.

At which Swiss pharmaceutical company did Arthur Stoll isolate ergotamine, an early migraine drug, in 1918?

Sandoz marketed the compound as Gynergen from 1921, and doctors first used it against migraine in 1925.

Eptinezumab, an antibody drug used to prevent migraine, is given every three months by which route?

An intravenous drip sets it apart: its sister antibody drugs are injected under the skin, often by patients themselves.

Migraine with brainstem aura, which brings slurred speech and double vision, was formerly named after which artery?

Basilar migraine was the old label, dropped because the artery at the base of the brain is unlikely to be involved. The newer name points to the brainstem itself.

A fall in the level of what, just before a period, is linked to the onset of menstrual migraine?

Estrogen levels fall in the days leading up to a period, and that withdrawal is the suspected trigger. These attacks usually last longer than others and respond less well to short-term treatment.

Which rare 'migraine', marked by a drooping eyelid and misaligned eyes, has been reclassified as a nerve disorder?

Ophthalmoplegic migraine is now called recurrent painful ophthalmoplegic neuropathy, since the fault lies in the nerves that move the eye. Each attack weakens them on the same side as the headache, then reverses.

Abdominal migraine is defined in the headache classification and in which gut-disorder criteria named after a city?

Rome IV criteria describe sudden bouts of intense belly pain that keep recurring and disrupt normal activities. The average attack has been reported to last 17 hours.

What do doctors call migraine that strikes on fewer than 15 days a month, the counterpart of the chronic form?

Episodic migraine is not a fixed category: each year about three in every hundred people who have it cross the line into the chronic form.