What Is a Migraine? 31 Facts vs. Fiction

Migraine is a common neurological disorder that affects 12% to 15% of general population. Despite that, it is usually underdiagnosed and inadequately treated due to many misconceptions surrounding the diagnosis and treatment.

Myth: Migraine affects women only. Fact: Migraine affect both women and men, though they are more common in women.
Myth: Migraine starts in the teen years. Fact: Migraine can start at any age, though it’s more common than the teenage period.
Myth: People outgrow migraines. Fact: While some may outgrow their migraines, most patients do not.
Myth: Migraine is just a bad headache. Fact: Migraine is a syndrome with many symptoms (physical and behavioral). Headache is only one of them. Some migraine attacks occur without headaches. Migraine can cause symptoms that can mimic stroke.
Myth: Migraines must have aura (symptoms or sensations, such as flashing lights, which can come before a migraine headache.) Fact: Most migraines are called common migraines and are not preceded by aura.
Myth: A migraine begins when the headache starts. Fact: A “prodromal period” lasts two to three days before the headache starts. Patients may have irritability, sleep problems and other behavioral symptoms before the headache starts.
Myth: Migraine ends when the headache is gone. Fact: A “postdrome period” after the headache is over can last few days and cause excessive fatigue.
Myth: There is always a trigger for migraines. Fact: Many patients cannot identify triggers.
Myth: Migraine triggers are universal. Fact: Every patient has unique migraine triggers -- if they can identify triggers.
Myth: Migraine symptoms are the same in different people. Fact: Migraine symptoms vary from patient to patient and even in the same patient. Migraines are unpredictable and continue to change throughout life.
Myth: Bad headache means migraine. Fact: Migraine can cause bad headache but there are numerous types of headaches other than migraine.
Myth: Mild headache is not migraine. Fact: Migraine causes mild, moderate or severe headaches. The severity has nothing to do with migraine diagnosis.
Myth: Brain scans diagnose migraine. Fact: migraine is a clinical diagnosis based on symptoms. Brain scans are done to rule out migraine mimickers. Brain scans are normal in migraine patients. The disease process is neurochemical and not structural.
Myth: There are no good treatments for migraine. Fact: While there is no cure for migraines, there are numerous treatment options that can help control and reduce migraines.
Myth: Migraine preventative medications should get rid of all migraines. Fact: while this can happen, the goal of treatment is 50% reduction of frequency and severity of migraines.
Myth: “I probably just have a sinus headache.’’ Fact: Ninety percent of self-diagnosed sinus headaches are undiagnosed migraines.
Myth: Lifestyle has no impact on migraines. Fact: Lifestyle has significant impact on migraine and modifications can help.
Myth: Migraines are always hormone related. Fact: Some migraines are influenced by hormonal changes (menstrual period, birth control, hormone replacement, pregnancy and endometriosis), but not all migraines.
Myth: Taking daily over-the-counter medication is a good idea. Fact: Taking abortive medications, which stop a migraine when you feel one coming or once it has begun, more than two to three times a week worsens migraines and causes chronic rebound headaches.
Myth: Caffeine helps with migraine. Fact: In the short term, this is true. However, overuse of caffeine can make migraine headaches worse long-term.
Myth: Migraine preventative medications work very quickly. Fact: While “abortive medications” work quickly, preventative medications require several weeks to months to have full effect.
Myth: No migraine treatment is available if you are pregnant. Fact: While most migraine medications are not safe during pregnancy, there are options like acetaminophen, antinausea medications and nerve stimulation devices like Cefaly and Relivion.
Myth: Anyone can diagnose and treat migraine. Fact: Migraines are usually misdiagnosed so it important to seek treatment for a specialist that is adequately trained to properly treat.
Myth: Opiates (narcotics) are good for migraine headaches. Fact: Opiates can have negative results, including leading to daily headaches.
Myth: All migraine treatments involve taking tablets. Fact: Injectable options and even nerve stimulation devices like Cefaly and Relivion are available.
Myth: Botox injections are not used in migraine headaches. Fact: Botox injections are very effective treatment options for patients who do not respond to first-line treatment.
Myth: Supplements and alternative methods do not help with migraines. Fact: Some supplements like vitamin B2, magnesium, Co-Q 10, butterbur and feverfew do help. Massage therapy, essential oils and acupuncture can help as well. It is best to use such methods as complementary to standard medical treatment rather than as an alternative therapy.
Myth: You must choose one thing to help with migraines. Fact: Migraine management is hard work, and the patient will need to do many things at the same time to control migraines including lifestyle changes, triggers avoidance and sometimes a combination of different medications.
Myth: Piercing and earrings can treat migraines. Fact: We do not have any evidence to support the use of piercing as a migraine treatment. Some of our patients report that piercing temporarily helped reduce their headaches
Myth: Migraines are bothersome but not serious. Fact: Some migraines can last a long time. This is called migrainosus, and it causes significant physical and emotional harm.
Myth: There is no surgical treatment for migraine. Fact: There are surgical treatment options for migraines that do not respond to medical management. The specific type of surgery depends on the nature of the migraines.