Migraines: causes and triggers

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Around a million people in Switzer­land are affected by migraines. While explanations for the causes of migraine are only gradually emer­ging, there is much more clarity among experts on the triggers of migraine attacks.

What is migraine?

The term migraine is used to describe a recurrent headache disorder that manifests itself in attacks lasting from 4 to 72 hours. Women are affected much more than men.

Symptoms

Migraine typically occurs on one side of the head in the form of a pulsating pain of moderate to severe intensity. Physical activity intensifies the pain. Nausea and/or hypersensitivity to light and noise are also experienced. The symptoms of migraine are therefore clearly different to those of other types of headache.

Around a fifth of migraine sufferers experience migraine with aura. This is when the onset of pain is preceded by visual disturbances (e.g. flickering, flashes of light). In rarer cases, sensory (e.g. tingling) or speech disorders also occur.

Hereditary mechanism discovered

What exactly causes a migraine has not yet been conclusively clarified. The assumption that circulatory disorders cause migraine is now generally refuted. Scientists now believe that hereditary factors may be involved, since migraines often run in families. In 2020, neuroscientists at the University of Zurich discovered the mechanism responsible for migraine in families. This takes the form of a genetic malfunction in which certain brain cells responsible for processing pain are unable to dissipate excess sensory stimuli, and generate severe headaches instead.

Numerous trigger factors

While light is only gradually being cast on the causes, more progress has been made in terms of the trigger factors. Although these factors can vary greatly from one person to the next, they do have a constant: a sudden change in a person’s habitual lifestyle.

The most common triggers are:

  • sudden stress
  • certain foods or stimulants (dairy products, seafood, citrus fruits, chocolate, wine, etc.)
  • a change in the daily routine (sleeping/waking up times)
  • extreme emotions (sadness, anxiety)
  • hormonal changes (menstruation)
  • skipping meals (hypoglycaemia)
  • weather changes (seasonal winds)
  • sensory stimuli (loud noises, cigar smoke)
  • over-exertion and exhaustion

Identify triggers

A headache diary can help sufferers identify their personal trigger factors. The more consistently patients record the details of their headache, the more precisely the triggers can be defined and ultimately avoided. Keeping a headache diary – for which apps are now also available – also acts as an important source of information for the attending doctor.

What preventive action can I take?

It isn't possible to make a general statement about effective forms of prophylaxis. Rather, sufferers must find out for themselves which measures they can take to best prevent migraines. Avoiding personal triggers is – as just mentioned – an important step. Other measures could be:

  1. get sufficient sleep
  2. regularly practise endurance sports (e.g. swimming, cycling or walking)
  3. don't just accept the topic of migraine but read up on it.

The German Neurological Society also recommends complementary therapies for those who suffer from more than three migraine attacks a month. They name the most important methods as:

  • Progressive muscle relaxation according to Jacobson (PMR)
  • Cognitive-behavioural pain management training (stress management)
  • Biofeedback therapy

 

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