Migraine: symptoms, triggers, treatment and which doctor to see

What a migraine is, how it differs from an ordinary headache, common triggers, how it is treated and prevented, and when to see a neurologist.

Also known as: Classic migraine; Common migraine; Disorder, migraine; Headache migraine; Headache migrainous; Migraine disorder

What migraine is

Migraine is a long-term neurological condition, not simply a bad headache. People with migraine have repeated attacks of headache, usually moderate to severe, that can last from a few hours to two or three days. Between attacks most people feel completely normal.

The exact mechanism is still being studied. What is clear is that the brain of a person with migraine is more sensitive to change, and an attack involves nerve pathways, chemical messengers and the blood vessels around the brain. The tendency often runs in families.

Doctors describe migraine with aura, where warning symptoms such as flashing lights come before the pain, and migraine without aura, which is more common. When headaches happen on more days than not over several months, it is called chronic migraine, and it usually needs a more structured treatment plan.

Symptoms

An attack can pass through several stages, although not everyone has all of them. Some people notice yawning, food cravings, a stiff neck or a change in mood a day before. During the attack itself, the common symptoms are:

• Throbbing headache, often on one side of the head, though it can be on both sides
• Pain that gets worse with routine activity such as climbing stairs
• Nausea, and sometimes vomiting
• Sensitivity to light, so you want to lie in a dark room
• Sensitivity to sound and sometimes to smells
• Aura in some people — zigzag lines, flashing lights or blind spots, tingling in one hand or the face, or trouble finding words, usually lasting less than an hour before the headache

Afterwards many people feel drained or foggy for a day. Children can have migraine too, and in them the headache may be shorter and stomach pain or vomiting may be more prominent.

Causes, triggers and who is at risk

Migraine is more common in women than in men, and in many women attacks are linked to the menstrual cycle. It usually begins in the teens or twenties. Having a parent with migraine makes it more likely.

Triggers do not cause migraine, but they can tip a sensitive brain into an attack. They differ from person to person. Common ones include:

• Skipping meals or long gaps between meals, including during fasts
• Too little sleep, irregular sleep, or sleeping much longer than usual
• Stress, and also the let-down after a stressful period ends
• Not drinking enough water, especially in hot weather
• Bright sunlight, glare, loud noise or strong smells
• Alcohol, and changes in how much tea or coffee you drink
• Hormonal changes around periods, and some hormonal medicines

Keeping track of attacks for a few weeks is often more useful than cutting out long lists of foods on a hunch.

How it is diagnosed

Migraine is diagnosed from your story and an examination. No blood test confirms it. The doctor will ask how often the headaches come, how long they last, what they feel like, what else happens with them and what you have already tried. A neurological examination checks your vision, strength, reflexes, coordination and sensation, and is usually normal in migraine.

A headache diary is one of the most useful tools. Note the date, how long the headache lasted, how bad it was, any possible trigger and every medicine you took. Bring it to the appointment.

Most people with typical migraine do not need a scan. An MRI or CT scan is advised when something in the history or examination suggests a different cause — for example, a headache that has changed character, an aura that is unusual, or abnormal findings on examination. Your doctor will decide based on these features.

Which doctor to see

A general physician can diagnose and treat most migraine. A neurologist is worth seeing when:

• Attacks are frequent or are making you miss work, college or family life
• Treatment for attacks is not working, or you are taking painkillers on many days
• You are being considered for preventive treatment and the first options have not helped
• Your aura is unusual or includes weakness on one side
• The diagnosis is uncertain, or your headaches have changed

You can find neurologists in Bengaluru or general physicians in Bengaluru on The Doctor Index, each with a registration you can check.

Treatment

Treatment has two parts: stopping an attack once it starts, and, for people with frequent attacks, making them less frequent.

Treating an attack

Simple pain relievers such as paracetamol or anti-inflammatory medicines work for many people, especially if taken early in the attack. Triptans are prescription medicines made for migraine and are often used when simple pain relievers are not enough. An anti-sickness medicine can help with nausea. Your doctor will choose these with your other health conditions in mind, because triptans are not suitable for everyone, including some people with heart disease.

Preventing attacks

Preventive medicines are taken every day, whether or not you have a headache, to reduce how often attacks come. Options include certain blood pressure medicines (such as beta blockers), some antidepressants used at low strength, some anti-seizure medicines and flunarizine. Newer injectable and oral medicines that target a migraine-related protein called CGRP, and botulinum toxin injections for chronic migraine, are used in some cases. Prevention usually takes several weeks to show an effect, so give it time before judging it.

Some of these medicines are unsuitable in pregnancy. If you are pregnant or planning to be, tell your doctor before starting or continuing any of them.

Lifestyle changes

Lifestyle changes support every other treatment: regular meals, a steady sleep routine, enough water, regular exercise and a plan for handling stress. Relaxation training, yoga and cognitive behavioural therapy help some people.

Living with migraine

Migraine tends to come and go over a lifetime, and for many women it eases after menopause. Keep your diary going, review your treatment with the doctor every few months while it is being adjusted, and agree on a clear plan: what to take, how early, and how many days a month is the limit. Let your workplace or college know if attacks affect your attendance, so that reasonable adjustments are possible.

When it is an emergency

Call 112 or 108, or go to the nearest emergency department, for a headache that:

• Comes on suddenly and reaches its worst within seconds to a minute — a thunderclap headache
• Is the worst you have ever had, or feels different from your usual migraine
• Comes with weakness or numbness on one side, a drooping face, slurred speech, confusion or a fit
• Comes with fever, a stiff neck, a rash or vomiting that will not settle
• Follows a head injury
• Comes with sudden loss of vision or double vision

A first-ever aura with weakness can look like a stroke, and it should be treated as one until a doctor has seen you. A new kind of headache starting later in life also needs prompt medical review.

Questions to ask at your appointment

• Is this migraine, or could it be another type of headache?
• Do I need any tests or a scan, and why or why not?
• What should I take for an attack, and on how many days a month at most?
• Should I be on preventive treatment, and how will we know if it is working?
• Are any of my other medicines making the headaches worse?
• What should make me seek urgent help?

Common questions

All neurology conditions →

Sources

• MedlinePlus, US National Library of Medicine — Migraine
• World Health Organization — Migraine and other headache disorders fact sheet
• MedlinePlus, National Library of Medicine — Migraine — Public-domain health-topic summary
• MedlinePlus Genetics — Migraine — Public-domain Genetics summary

Migraine: symptoms, triggers, treatment and which doctor to see is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.

General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-1556.