This post is also available in Dutch.
About a month ago I had a migraine attack – which was a strange and new experience to me. From this experience and scientific investigation, I will explain what migraine is and what happens in the brain during an attack.
Migraine, CC BY-NC 2.0, Flickr
Migraine always made me think of my grandpa. He could suddenly get a severe headache and would then out of despair tie a dish towel around his head to isolate himself. As a little girl I thought he looked a bit like a bunny; as if the dish towel were the two big ears hanging by his face. For the rest the whole migraine didn’t mean that much to me. Until a month ago.
Strange cup of coffee
On a Sunday morning I was slowly waking up with a cup of coffee. Suddenly I got a short and intense sharp stab in the left side of my head. Shortly after my right hand and arm started to tingle. This felt just like a numb limb. It was a bit weird so I was making some jokes about it, but suddenly all I could say was some babbling; I wasn’t able to say anything correctly anymore. From that point I didn’t think it was so funny anymore. Fortunately I was able to speak normally again after about half an hour and all that was left was a slight headache and some tingling.
A few days later my GP told me this had been a migraine attack – nothing to worry about, which was all she could tell me. I was however really curious what migraine exactly is and what happens in the brain during an attack. So I started to investigate.
More than just a headache
Migraine is a brain condition with a relatively high prevalence. Estimations say that approximately 2 to 2.5 million adults in the Netherlands have this condition. The most common type of migraine leads to attacks of severe headache that can last for hours or days. On top of that, this can be joined by nausea and oversensitivity for light and sound. About 25% of the people with migraine also experience temporary neurological symptoms such as distortions in their sight, tingling at one side of the body and disruptions in speech. It is very different among people how the migraine is expressed, but the severe headache is most common.
It is not yet entirely clear what exactly happens in the brain during a migraine attack. One theory that is often quoted states that at first there occurs a wave of enhanced brain activation. Afterwards, there is a period of reduced activation which is also called the cortical spreading depression (CDS). This probably leads the brain increasing the sending of headache signals. Also, CDS has been linked to the other neurological symptoms that can occur.
Based on my experience (having had 4 attacks now), experiences of others and scientific knowledge, I would nuance my GP’s expression that migraine is nothing to worry about. It can actually be really obstructive in daily life. You can be switched off for a while, not only because of the headache but also because of the neurological problems you can experience before, during and after an attack. The ideas I had before about migraine have been completely changed, have yours as well?