Why do some people get migraines?

Blame an injury. Blame your lunch. Blame your genes.

There are more than 39 million Americans living with migraines and very little consensus as to their underlying cause.

While there is a large genetic component to migraines, which often run in families, the truth is there are different types of migraines with many different causes and triggers, none of which are easy to pinpoint.

The most prominent sign of a migraine is a moderate to severe headache, though this shouldn’t be confused with a typical tension headache.

“A tension headache is caused by tightness and irritation of the muscles and connective tissue of the head, neck and shoulders. It is the most common type of headache worldwide. It usually results in pressure-like pain and typically requires stress management and exercise for treatment,” says Dr. Kate Essad, a neurologist with Aurora Neurology in Milwaukee, Wis.

Migraines on the other hand are typically characterized by one-sided, throbbing pain that is associated with sensitivity to light and noise. This pain can also worsen with movement and activity.

“Neither headache is dangerous technically, but there are no great medications for tension headaches and there are many medication choices for migraines,” says Dr. Essad.

Other migraine symptoms include nausea, vomiting, fatigue and vision issues, all of which can last for hours or even days.

The routine incidents that can spark a migraine are similarly wide-ranging. Triggers can include:

• Lack of sleep
• Weather changes
• Stress and anxiety
• Head trauma
• Certain medications
• Certain foods and ingredients – This includes aged cheeses, artificial sweeteners, caffeine, chocolate, processed meats, fermented foods, monosodium glutamate (MSG), some fruits and nuts, alcohol and yeast.

For some people, a migraine can even come without warning or without an apparent trigger.

Migraine research

Aurora St. Luke’s Medical Center in Milwaukee joined a clinical trial that aims to determine if a device implanted into the heart can reduce migraine headaches in certain patients.

While a fetus is developing in the womb, there is a hole called a patent foramen ovale (PFO) connecting the top two chambers of the heart. This allows oxygen-rich blood to flow directly from the mother to the fetus, bypassing the fetus’s lungs, which do not yet work. Normally, the PFO closes after birth. But for one out of every four people, the PFO remains open.

“Research has led to the development of a device to permanently close this hole in the heart,” says Dr. Tanvir Bajwa, interventional cardiologist  and Advocate Aurora Research Institute’s principal investigator for the study. “It is currently used to prevent recurrent strokes. However, many cardiologists have anecdotally noticed an unexpected reduction of migraine symptoms after PFO closure.”

No scientific study has ever proved an association between PFO and migraines, which is why researchers are enrolling participants with PFO and a history of migraines into the clinical trial.

When to see a doctor

There is no blood test or scan to detect migraines. The only way to determine if you are experiencing migraines is through a clinical diagnosis with a neurologist.

“People who have migraines that occur four or more time per month, lasting four or more hours each time, and that result in missed work or school or in a decreased quality of life should ask their doctor if seeing a headache specialist is appropriate,” Dr. Essad says.

Are you trying to find a doctor? Look here if you live in Illinois. Look here if you live in Wisconsin. 

Want to know more about our research? Visit aah.org/research.