Migraine: Understanding and Managing Attacks
Far more than a simple headache.
Dr. Laurent Vidal
Neurologist
In simple terms
Migraines affect about 12% of adults. Identifying triggers and using the right treatment shortens crises.
What you need to remember
- Common triggers — Hormonal fluctuations (menstrual migraine)
- Acute treatment — Triptans remain the most effective specific class for moderate to severe attacks when taken early.
- Prevention — Beta-blockers, topiramate, amitriptyline and the newer anti-CGRP monoclonal antibodies (erenumab, fremanezumab) significantly reduce attack frequency in chronic migraine.
A migraine is a recurring neurovascular disorder characterized by moderate to severe pulsating pain, usually unilateral, lasting 4 to 72 hours. Nausea, vomiting, and sensitivity to light or sound often accompany the pain.
Common triggers
- Hormonal fluctuations (menstrual migraine)
- Sleep deprivation or oversleep
- Skipped meals, dehydration
- Stress and post-stress relaxation
- Specific foods: aged cheese, processed meats, alcohol
- Bright lights or strong smells
Acute treatment
Triptans remain the most effective specific class for moderate to severe attacks when taken early. NSAIDs or paracetamol can suffice for milder crises. Avoid analgesic overuse: more than 10 days per month causes medication-overuse headache.
Prevention
Beta-blockers, topiramate, amitriptyline and the newer anti-CGRP monoclonal antibodies (erenumab, fremanezumab) significantly reduce attack frequency in chronic migraine.
A headache diary for 4 weeks identifies most triggers and dramatically improves treatment.
The words explained
Medical terms used above, in everyday language.
- Chronic
- A problem that lasts a long time, usually more than three months, and often comes back.
- Acute
- Something that starts suddenly and lasts a short time.
- Hormone
- A chemical messenger made by your body that tells organs what to do.
- Prevention
- Steps taken before a problem starts, to make it less likely.
- Antibody
- A protein your body makes to recognise and neutralise a specific germ.
When should you see a doctor?
- Your symptoms last more than a few weeks or keep coming back.
- They get worse quickly, or stop you doing everyday things.
- You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
- You already take medication and want to change anything about it.
This article explains general health information. It does not replace advice from your own doctor.
Frequently asked questions
- What is Migraine: Understanding and Managing Attacks?
- Migraines affect about 12% of adults. Identifying triggers and using the right treatment shortens crises.
- What are the main symptoms or signs of Migraine: Understanding and Managing Attacks?
- Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
- When should you see a doctor for Migraine: Understanding and Managing Attacks?
- See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.
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