Migraine Headache Symptoms Are Not Always Classical One-sided Sickening Headaches

However, if you scratch beneath the surface you find that there are several different types of migraine headache.

Research studies show that the location of headache and type of pain are not always where or what you would expect.

Two large studies of migraine headache symptoms are worth looking at in detail.

Danish Survey of 750 People With Acute Migraine Headache Symptoms

Only 47% had the classic throbbing pain.

42% described the pain as a feeling of pressure in the head. 11% described other types of pain, but the details were not published.

Only 56% had a headache one side of the head only.

44% had pain on both sides of the head.

What does this mean?

This means that only about half to two thirds of people with migraine will experience "typical" migraine headache symptoms of a one-sided, throbbing headache.

In fact over a third of people with migraine will have non-classic symptoms.

Dr Leslie Kelman's Survey of Migraine Headache Symptoms in 1283 people

He made these observations:

1. What Time of Day does Migraine usually Start?

Migraine Headache Symptoms seemed to be more likely to start at these times of the day:

• Morning - 19%
• Afternoon -14%
• Evening - 4%
• During night - 9%
• Anytime - 54%

Most people will feel a build up of migraine pain over about an hour, and Dr Kelman found this too.

2. How Long Does a Migraine Headache Last?

The average length of a migraine headache episode was 24 hours, but 30% endure more than 24 hours of migraine headache symptoms. This is probably on oversetimate of duration as Dr Kelman was selecting his migraine patients from a specialist clinic where we would expect more severe migraine to appear.

3. What does a Migraine Pain Feel Like?

Of the 1283 people, 90% used the term throbbing when describing their head pain during a migraine.

86% used the term "Aching", and 90% also used the term "Pressure". A further 71% reported a Stabbing Pain in the head.

People could report more than one term (Throbbing AND Pressure AND Stabbing), but it certainly illustrates the point that people with migraine can experience more than just a throbbing headache.

4. Which part of the Head gets Sore During a Migraine?
• Pain in or Around the Eye - 67%
• Pain in the Temple - 58%
• Pain across the Forehead - 56%
• Pain in Back of the Head - 39%
• Pain in Neck - 39%
• Pain on Top of Head - 25%
• Diffuse Pain, not in any one place - 17%
5. Headache Nausea, what else?
• About 30-40% of people noticed a watery eye or their nose running.

  This could make people think it might be a "sinus headache". It can also cause confusion with symptoms of a much rarer headache called cluster headache.

  However, Migraine is still the leading cause of episodes of disabling headache - more so than sinus infection or cluster headache.

  If you think you have "sinus headache" it is still more likely that you have migraine - not a blocked sinus.

  Nausea occurred in 90%, and vomiting occurred in 54% of people whose headches were also made worse with physical activity.

  People whose migraine headache symptoms were not worse with activity were less likely to vomit - 31%.

  Stress was reported as a "trigger" for headache in 68%.

  People who report "stress headache" most likely have migraine.

  If "stress headaches" do not resolve by reducing stress, migraine treatments should be considered.

  The other common symptom related to migraine headache was dizziness in 36%.




6. How Severe is Migraine Pain?

Most people will rate their pain an average of 7 out of 10 - which is usually regarded as a severe headache.

7. How quickly can Migraine Return?

About 40% of people with migraine in Dr Kelman's study reported a return of headache within 10 hours of the end of the last one.

8. Are there any other Migraine Symptoms I should know?

Other migraine headache symptoms usually relate to vision, sensation and balance.

These symptoms usually occur as a episodes of Migraine Aura.

If you get episodes of Visual Aura without headache this might be a symptom called Ocular Migraine.

Any of these could be due to migraine:

• Headache Dizziness Symptoms
• Migraine Related Dizziness is a common problem of episodes of otherwise unexplained dizziness. It should be less likely to happen if taking medication to prevent migraine.
• Headache Blurred Vision
• Migraine is easily the leading cause of headache and blurred vision.

  However, if the symptom is progressive - that means it starts as a mild problem and continues to worsen over days or weeks it is not due to migraine.

  Blurred vision due to migraine will build up over a few minutes and then resolve within an hour or two. Like all worrying health symptoms this should be discussed with your own doctor.

• Headache and Vertigo
• Headache and Confusion
• Headache and Weakness (Hemiplegia)
• Cyclical Vomiting
• Cyclical Vomiting Syndrome of Adults is said to be a Migraine Symptom, and migraine prevention drugs like sodium valproate do seem to reduce the nausea
• Rare Migraine Syndrome
• There are many rare migraine syndromes,
where migraine headache or migraine aura is part of the Syndrome. This list is not definitive. Most of these are extremely rare and some may have occured once or twice ever:

• Familial Hemiplegic Migraine (Numerous types)
• CACNA1 associated fatal cerebral oedema
• CADASIL
• MELAS
• Anti-phospholipid Antibody Syndrome
• TREX1 Associated Autosomal dominant retinal vasculopathy with cerebral leukodystrophy
• POLG mutation associated Migraine
• COL4A1 Associated Brain Small Vessel Disease with Axenfeld-Rieger Anomaly
• MTTL1 associated Familial Cyclical Vomiting Syndrome
• Spinocerebellar ataxia type 6 and familial hemiplegic migraine due to CACNA1A missense mutation
• Mitochondrial DNA Depletion Syndrome type 7 (Hepatocerebral type)
• Autosomal recessive mitochondrial ataxic syndrome due to mitochondrial polymerase gamma (POLG) mutations
• Hereditary Haemorrhagic Telangiectasia HHT:(Rendu-Osler-Weber Syndrome)
• Stormorken Syndrome (platelet dysfunction, migraine, ichthyosis, asplenism) (one family ever 1980s)
• Divry-van-Bogaert Syndrome - diffuse corticomeningeal angiomatosis
• Dravet Syndrome (adult type) SCN1A gene)
• Autosomal Dominant Progressive External Ophthalmoplegia Type 3