Migraine
Migraine attacks can include headache together with nausea, light or sound sensitivity and, in some people, neurological symptoms known as aura.
Clinician-Reviewed Resources
Migraine & Headache Resource Centre
Practical information to help you understand migraine, recognise patterns, track symptoms and prepare for a more productive clinical consultation.
Migraine is more than simply a bad headache. Symptoms, triggers and frequency vary considerably from one person to another, which is why understanding your individual pattern matters.
Understanding migraine
What is migraine?
Migraine is a neurological condition that can cause recurrent attacks involving headache and a range of other symptoms.
The headache is often moderate to severe and may be throbbing or pulsating. It can affect one side of the head, although this is not always the case.
Nausea and sensitivity to light or sound are common. Movement or normal physical activity can make symptoms feel worse for some people.
Migraine is individual.
Not everyone experiences the same symptoms, and your pattern can
also change over time.
Not every headache is migraine
“Headache” describes a symptom. Migraine is one of a number of conditions that can cause headache.
Tension-type headache
Often described as pressure or tightness rather than pulsating pain. The pattern and associated symptoms can differ from migraine.
Other headaches
Headaches can have many causes. A new, unusual, rapidly changing or severe headache pattern deserves appropriate medical assessment.
Common migraine symptoms
Head pain
Pain may be throbbing or pulsating and can range from moderate to severe. It does not have to occur on only one side.
Light sensitivity
Bright light can become uncomfortable during an attack and some people prefer to rest in a darker environment.
Sound sensitivity
Ordinary sounds can feel unusually intense or uncomfortable.
Nausea
Migraine may cause nausea and, in some people, vomiting.
Difficulty concentrating
Some people describe difficulty thinking clearly before, during or after an attack.
Fatigue
Tiredness may occur during an attack or continue during the recovery period afterwards.
Migraine with aura
What is migraine aura?
Some people with migraine experience temporary neurological symptoms known as aura. Aura does not occur in every person with migraine and does not accompany every attack.
Visual symptoms
These may include flashing lights, zig-zag patterns, blind spots or other temporary changes in vision.
Sensory symptoms
Some people experience temporary tingling, pins and needles or altered sensation.
Speech or language
Temporary difficulty finding or producing words can occur in some forms of aura.
New neurological symptoms need appropriate assessment.
Do not assume that a first episode of visual, sensory or speech
disturbance is simply migraine.
Episodic and chronic migraine
One of the most useful things to establish is how many days each month you experience headache and how many have migraine features.
Episodic migraine
This broadly describes migraine occurring on fewer than 15 headache days per month.
Chronic migraine
Chronic migraine is defined by a high frequency of headache: 15 or more headache days per month for more than three months, with migraine features on at least eight days per month.
This is one reason a headache diary can be so
valuable. Memory alone can make it surprisingly difficult to
estimate the true number of headache days over several months.
Commonly reported migraine triggers
Triggers vary considerably. Something associated with an attack for one person may have no effect on another.
Sleep changes
Too little sleep, disrupted sleep or substantial changes to your normal sleep schedule may be associated with attacks.
Stress changes
Both periods of stress and the “let-down” period after stress can coincide with migraine.
Meals & hydration
Missed meals, long gaps between eating and dehydration are commonly reported associations.
Hormonal changes
Some people notice a relationship with menstruation or other periods of hormonal change.
Sensory factors
Bright or flickering light, strong smells and loud environments may be relevant for some people.
Travel & routine
Jet lag, disrupted routines and changes in sleep or meals during travel can sometimes coincide with attacks.
Try not to become overly restrictive.
The aim of tracking is to identify meaningful patterns, not to
create an ever-growing list of things you feel you must avoid.
Practical tool
Keep a migraine diary
A simple diary can help establish frequency, identify patterns and make a consultation considerably more useful.
Date: When did the attack occur?
Duration: How long did it last?
Severity: Mild, moderate or severe?
Symptoms: Nausea, light/sound sensitivity, aura?
Medication: What did you take and when?
Possible triggers: Sleep, meals, stress, hormones?
Impact: Did it affect work, sleep or normal activity?
Headache-free days: Record these too.
A notes app or calendar is also perfectly adequate if you record the same information consistently.
Helpful foundations
Lifestyle changes do not eliminate migraine for everyone, but greater consistency can make patterns easier to understand and may help some people manage their condition.
Regular sleep
Aim for a reasonably consistent sleep and waking pattern where possible.
Regular meals
Avoid unnecessarily long gaps between meals if this appears to be associated with your attacks.
Hydration
Maintain normal hydration throughout the day rather than waiting until you feel significantly thirsty.
Caffeine consistency
Large changes in caffeine intake can matter for some people. Tracking intake may help identify a relationship.
Activity
Regular activity can form part of general wellbeing, adjusted to what you can comfortably tolerate.
Stress management
Pacing, breaks and relaxation strategies may be useful where stress appears to influence your migraine pattern.
An important consideration
Medication-overuse headache
People living with frequent headaches can understandably find themselves using acute pain or migraine medicines increasingly often.
In some circumstances, frequent use of acute headache medicines can itself contribute to an increasingly persistent headache pattern. This is known as medication-overuse headache.
The relevant frequency varies according to the medicine being used, so this is something to discuss with a doctor or other appropriately qualified clinician rather than stopping prescribed medication without advice.
Your migraine diary should record every day on which you
take acute headache medication, not simply the days on
which the headache is particularly severe.
What should you bring to a migraine consultation?
01
Your diary
Bring several weeks of headache or migraine records if possible. Paper, phone notes or a calendar are all acceptable.
02
Medication history
List current medicines, medicines you use during attacks and previous migraine treatments you have tried.
03
Your priorities
Consider what matters most: fewer headache days, reduced severity, less disruption to work or improved day-to-day function.
Clinical assessment
What happens at a migraine consultation?
A consultation begins with understanding your headache history, frequency, associated symptoms and how headaches affect your daily life.
History & assessment
- Headache and migraine frequency
- Symptoms and pattern
- Aura where relevant
- Medication use
- Previous treatments
- Relevant medical and family history
- Red-flag screening
Planning next steps
Following assessment, the clinician can discuss appropriate management options, whether further investigation or referral may be appropriate, and how your progress should be monitored.
Prescription-only treatments, where clinically relevant, are discussed privately following assessment and are not advertised on this resource page.
Urgent medical attention
When should a headache be treated as urgent?
Most recurrent headaches are not medical emergencies. However, some headache presentations require urgent assessment.
Call 999 or attend A&E if appropriate for symptoms such as:
- A sudden, extremely severe headache that reaches maximum intensity very rapidly
- Headache accompanied by new weakness, paralysis, marked confusion, collapse or other significant neurological symptoms
- A severe headache following a significant head injury
- Headache with fever, marked neck stiffness or a concerning rash
- A severe headache with loss of consciousness or seizure
A significant or unexplained change in your usual headache pattern should also be medically assessed, even where it does not appear to require emergency care.
Do not use this page to self-diagnose an emergency.
If you are seriously unwell or concerned about acute neurological
symptoms, seek urgent medical help.
Migraine & Headache FAQs
Is migraine just a severe headache?
No. Migraine is a neurological condition. Head pain is common, but attacks may also involve nausea, light or sound sensitivity, aura and other symptoms.
Do migraines always affect one side of the head?
No. One-sided pain is common in migraine but is not required. Pain can occur on both sides or vary between attacks.
Can migraine occur without aura?
Yes. Many people with migraine never experience aura. Migraine without aura is common.
Can aura occur without a headache?
Aura can sometimes occur without a subsequent headache. However, new neurological symptoms should be appropriately assessed rather than automatically attributed to migraine.
How many headache days should I record?
Record every headache day, not simply severe migraine attacks. Also record medication use and, where practical, headache-free days. This provides a much clearer picture of frequency.
Should I avoid every possible migraine trigger?
Usually the more useful approach is to look for repeatable patterns rather than trying to avoid a long list of possible triggers. Migraine triggers vary considerably between people.
Can frequent painkiller use make headaches worse?
Frequent use of some acute headache medicines can contribute to medication-overuse headache. If you are regularly taking medication for headaches, discuss the pattern with your doctor or appropriately qualified clinician.
Can Santi liaise with my GP or neurologist?
Where appropriate and with your consent, relevant clinical information can be shared to help coordinate your care.
Does this page advertise prescription-only migraine treatment?
No. This is an educational resource. Prescription-only options are discussed privately following an appropriate clinical assessment where relevant.
Santi London · South Kensington
Need help understanding your migraine pattern?
Bring your headache diary, medication history and questions to a clinical consultation. The aim is to understand your pattern, identify appropriate next steps and determine whether any further assessment or referral is needed.
Santi London · 33 Thurloe Street · South Kensington · London SW7 2LQ
This page provides general educational information and is not a substitute for individual medical assessment. It does not advertise prescription-only medicines. Any prescription treatment is subject to appropriate clinical assessment and suitability.