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Brain & nerves

Migraine: Symptoms, Triggers, and Treatments

By The Tessan Editorial Team · July 17, 2026 · 4 min read

Also known as: Migraine headache, Migraine with aura, Migraine without aura, Migraine attack

What is migraine?

Migraine is a chronic neurological disease marked by recurring attacks of intense headache, often one-sided and throbbing. According to the American Migraine Foundation, it affects roughly 39 million Americans. Women are about three times more likely than men to have it. Migraine differs from an ordinary headache in its intensity, its duration (4 to 72 hours when untreated), and its associated symptoms such as nausea and sensitivity to light and sound. The World Health Organization ranks migraine among the leading causes of disability worldwide, and it is the third highest cause of disability-adjusted life years globally, after stroke and neonatal encephalopathy.

Causes and risk factors

Migraine involves neuronal hyperexcitability and activation of the trigeminovascular system. A wave of neuronal and glial depolarization spreading across the cortex is thought to produce the aura and to activate trigeminal nerve fibers, releasing inflammatory mediators such as CGRP (calcitonin gene-related peptide) around the nerve fibers that supply the brain’s vessels. An older theory held that the pain itself was caused by blood vessels dilating, but that explanation is no longer considered viable.

Genetics play a real role: more than half of people with migraine have at least one family member who also has it, and the risk in close relatives is roughly three times higher than in relatives of unaffected people. Several triggers are commonly reported: stress or the letdown after stress, too little or too much sleep, skipped meals or prolonged fasting, certain foods and drinks (chocolate, aged cheese, alcohol), hormonal changes across the menstrual cycle, sensory factors (bright light, loud noise, strong smells), and weather changes.

Symptoms

A migraine attack classically unfolds in phases, though not everyone experiences all of them:

Physical activity worsens the pain, often forcing the person to retreat to a quiet, dark room. Migraine without aura is the most common form.

Diagnosis

Diagnosis is clinical, based on a detailed history of the attacks and their characteristics, a physical exam, and the criteria of the International Classification of Headache Disorders (ICHD-3). A migraine diary (frequency, duration, triggers) helps refine the diagnosis and assess how well treatment is working.

Brain imaging such as MRI is not routine. It is ordered when there are warning signs: a first or worst-ever severe headache, an abnormal neurological exam, atypical features, a change in your usual pattern, new onset after age 50, or systemic signs such as fever.

Available treatments

Management combines acute and preventive treatment:

Taking acute treatment early matters: triptans appear to be more consistently effective when used earlier in the attack, while symptoms are still mild to moderate, and side effects seem less likely when they are taken early.

Prevention and practical tips

Keeping a regular routine (enough sleep on a consistent schedule, staying hydrated, regular meals) reduces how often attacks occur. Managing stress through relaxation, mindfulness, or gentle physical activity is recommended. Keeping a migraine diary helps you identify personal triggers and adjust your lifestyle accordingly.

When should you see a doctor?

See a doctor if attacks are frequent, disabling, or getting worse, or if you are relying on acute medication more and more often, which can itself lead to medication overuse headache. Seek care urgently for a sudden, severe, unusual headache, a headache with fever or a stiff neck, a headache after a head injury, or any headache with new neurological symptoms such as weakness, confusion, or trouble speaking.

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