What is Migraine?
Causes, Symptoms, and Treatment Options

Migraine is a complex neurological condition that significantly disrupts daily life. From throbbing pain to light sensitivity and nausea, migraines affect millions worldwide and remain a leading cause of disability.

Over the years, migraine treatment has evolved from painkillers and lifestyle adjustments to advanced medications, therapies, neuromodulation devices, and Botox injections.

This progress means patients today have more effective, personalised choices than ever before.

This guide explains what is migraine, the types of migraine, migraine causes, symptoms of migraine, and evidence-based migraine treatment options, including Botox for migraine, CGRP therapies, lifestyle strategies, and 5 tips for instant migraine relief.

What Is Migraine?

Migraine is a complex neurological condition causing repeated episodic moderate to severe headaches, accompanied by nausea, light sensitivity, and fatigue.

Unlike tension-type headaches, migraine pain is typically throbbing or pulsating, often on one side, and may last 4–72 hours.

Many people also experience nausea, vomiting, and heightened sensitivity to light, sound, and smell.

Core features of a migraine headache:

Pulsating, moderate to severe pain (often unilateral)
Worsening with routine activity
Nausea and/or vomiting
Photophobia and phonophobia
In some, an aura (visual or sensory disturbances) precedes the pain

What Is the Difference Between a Headache and a Migraine?

Not all headaches are migraines. This quick table shows key distinctions:

Aspect	Headache	Migraine
Pain quality	Dull, pressing	Throbbing/pulsating
Intensity	Mild to moderate	Moderate to severe, disabling
Laterality	Both sides	Often one-sided (can switch)
Duration	< 4 hours	4–72 hours
Associated symptoms	Minimal	Nausea, vomiting, light/sound sensitivity, aura
Triggers	Stress, dehydration, tension	Hormonal shifts, sensory stimuli, foods, and sleep disruption

Types of Migraine

Migraine without aura (common migraine): Headache with typical migraine features, but no preceding aura.
Migraine with aura (classic migraine): Reversible visual, sensory, or speech symptoms occur before or with the headache.
Chronic migraine: Headache on ≥15 days/month for ≥3 months, with migraine features on ≥8 days.
Vestibular migraine: Prominent dizziness/vertigo with/without headache.
Hemiplegic migraine: Transient weakness on one side (stroke-like; requires urgent assessment).
Silent (acephalgic) migraine: Aura and migraine symptoms occur without significant head pain.
Other subtypes include menstrual migraine, retinal (ocular) migraine, status migrainosus (>72 hours), and paediatric variants like abdominal migraine.

What Is the Cause of Migraine?

There is no single cause. Migraines likely arise from genetics, brain network excitability, and neurotransmitter changes that activate the trigeminovascular system.

Mechanisms implicated:

Trigeminal nerve activation → release of inflammatory neuropeptides around meningeal vessels
Cortical spreading depression → linked to aura and central sensitisation
Serotonin and CGRP dysregulation → altered pain signalling and vasculature responses

Common triggers (vary by person to person): hormonal fluctuations, stress, sleep changes, certain foods (aged cheeses, processed meats, alcohol), bright/flickering lights, strong odours, dehydration, weather or altitude shifts, skipped meals, and overexertion.

Safety: When to Seek Urgent Care

“Thunderclap” sudden, severe headache
Headache with fever, stiff neck, confusion, seizures, double vision, weakness, or numbness
New headache after head injury or with exertion/cough
New headache pattern after age 50
Visual loss in one eye, jaw claudication, or the worst headache of your life

Phases of a Migraine Attack

Prodrome (hours–days before): fatigue, mood change, food cravings, neck stiffness, frequent urination.
Aura (in a subset): flashing lights, zigzags; tingling, numbness, or speech disturbance; usually ≤60 minutes.
Attack (headache phase): throbbing pain (often unilateral), worsened by activity; nausea/vomiting; sensitivity to light/sound/smell.

What Are the Symptoms of a Migraine Headache?

Domain	Symptoms of Migraine
Pain	Unilateral, throbbing/pulsating, moderate–severe; worse with movement
Sensory	Photophobia, phonophobia, osmophobia
Gastrointestinal	Nausea, vomiting
Neurological	Aura (visual/sensory/speech), dizziness, difficulty concentrating
Systemic	Fatigue, neck stiffness, chills or sweats in some

What Is the Reason for a Migraine Headache?

The reason for a migraine headache is multi-factorial. Causal factors include:

Genetically determined brain hyper-excitability plus neurotransmitter shifts
Blood vessel changes contribute to pain, but are not the sole driver

Migraine vs Other Primary Headaches

Feature	Migraine	Tension-Type Headache	Cluster Headache
Pain	Throbbing, moderate–severe	Pressing/tight, mild–moderate	Excruciating, sharp/burning
Side	Often one side	Both sides	Strictly unilateral (periorbital)
Duration	4- 72 hours	30 min–7 days	15–180 min, multiple/day (clusters)
Activity worsens?	Yes	No	Restless/agitated
Associated	Nausea, photophobia/phonophobia ± aura	Minimal	Tearing, red eye, nasal congestion
Sex predominance	Women > men	None	Men > women

What Is the Treatment for Migraine headaches?

Acute (Abortive) Treatments

These are medicines you take at the beginning of a migraine to stop it from getting worse.

Everyday pain relievers/NSAIDs such as paracetamol, ibuprofen, can help with mild to moderate attacks. (It’s important not to overuse them, which may lead to rebound headaches.)
Triptans like sumatriptan, rizatriptan, and zolmitriptan are designed explicitly for migraine and can be very effective for moderate to severe pain.
Newer options such as gepants and lasmiditan are alternatives for those who cannot tolerate triptans.
Anti-nausea medicines like metoclopramide or prochlorperazine may be added if sickness is a big part of your migraine.
Dihydroergotamine (DHE) is sometimes used in selected cases when other treatments don’t work.

Preventive (Prophylactic) Treatments

If you have migraines often (four or more days a month), or they severely disrupt your daily life, preventive medication may help reduce how frequently and how intensely they strike.

Beta-blockers such as propranolol are often prescribed
Anticonvulsants like topiramate and valproate can be prescribed
Antidepressants, including amitriptyline, may also reduce migraine frequency
CGRP monoclonal antibodies are newer treatments targeting the migraine pathway directly.
Botox (onabotulinumtoxinA) injections are given every 12 weeks and are especially effective for chronic migraine.

Lifestyle & Non-Drug Approaches

- Regular sleep, meals, hydration, and exercise; limit caffeine and alcohol.
- Stress reduction techniques like meditation and breathing exercises
- Supplements like magnesium, riboflavin (B2), CoQ10; selected herbal options with safety oversight.
- Neuromodulation devices such as external trigeminal nerve stimulation and non-invasive vagus nerve stimulation.

5 Tips for Instant Migraine Relief

Withdraw to a dark, quiet room to reduce sensory overload.
Cold or warm compress on the head/neck to modulate pain.
Hydrate promptly; dehydration worsens migraine pain.
Caffeine early (modest dose) may potentiate analgesics; avoid overuse.
Controlled breathing or brief mindfulness to lower stress-driven escalation.

Who Is More Likely to Experience Migraine?

Genetics: Genetics plays a strong role in migraine, and it often runs in families, with children more likely to experience it if one or both parents are affected.
Women and hormonal influences: About three times more common in women; attacks often cluster around menses, pregnancy, or perimenopause.
Children and adolescents: These may present atypically (e.g., motion sickness, abdominal pain); look for light/noise avoidance and a need for dark rest.
Comorbidities: Depression, anxiety, sleep disorders, epilepsy, and bipolar disorder raise risk and burden.

How Is Migraine Diagnosed?

Diagnosis is usually clinical, based on pattern recognition and exclusion of secondary causes.

What clinicians assess:

Headache features (unilateral, throbbing, activity-worsened, 4–72h) and associated symptoms
Frequency and disability (e.g., MIDAS score)
Aura characteristics and timeline
Family history and trigger patterns

When tests help:

MRI/CT scan (if neurological deficits, abrupt “thunderclap” onset, new pattern after age 50, or head trauma is suspected).
EEG, when seizures are suspected;
Blood tests to exclude metabolic or inflammatory causes.

Botox Injections for Migraine

For people living with chronic migraine (15 or more headache days in a month), Botox injections can be an effective treatment option.
FDA and NICE approved for chronic migraine prevention.
Injections are placed in specific muscles across the forehead, temples, and neck.
Treatment is given every 12 weeks and takes only a few minutes.
Helps reduce the frequency, severity, and duration of migraine attacks.Shown to improve quality of life by reducing reliance on frequent pain medication.

Living Well With Migraine: Practical Strategies

To pinpoint triggers, keep a migraine diary (sleep, stress, meals, weather, cycle, foods, activity).
Align routines, consistent sleep/wake times, and meal times; maintain hydration.
Create a migraine-friendly environment (adjustable lighting, screen filters, noise control).
Plan a stratified acute plan with your clinician to act early and avoid medication overuse.

Why Choose Dr Mohamed El Toukhy for Migraine Treatment?

Choosing the right specialist can transform outcomes. Dr Toukhy, senior consultant in Pain Medicine, focuses on early diagnosis, precise evaluation, and minimally invasive, non-surgical treatments that help patients avoid major surgery and get back to life.

How Dr Mohamed El Toukhy helps patients with migraine pain and chronic headaches:

Root-cause approach with individual-specific treatment plans
Botox injections for migraine as part of evidence-based chronic migraine care
Advanced interventional options where appropriate (e.g., radiofrequency ablation, epidurals, facet joint injections, spinal cord stimulation, intrathecal pain pump in selected chronic pain contexts)
Experience across complex pain conditions, including chronic pain, joint pain, failed back surgery, and migraine treatment.

Taking Control of Migraine: Your Next Step with Dr El Toukhy

Migraine is much more than a severe headache. It is a complex neurological condition that causes disabling headaches, nausea, and sensitivity to light and sound.

Although there is no permanent cure, modern treatments, neuromodulation devices, and Botox injections for migraine have transformed the way this condition is managed.

With the proper guidance, it is possible to decrease both the frequency and severity.

Dr Mohamed El Toukhy, Consultant in Pain Medicine, specialises in advanced, minimally invasive pain management strategies tailored to each patient’s needs.

His expertise in migraine care, including Botox therapy, offers hope to those struggling with chronic attacks and helps restore a better quality of life.

If migraine pain affects your daily routine, don’t wait any longer.

Book your consultation and step towards lasting relief.

FAQs on Migraine

What is migraine and what are its symptoms?

A neurological disorder with recurrent throbbing headaches plus symptoms of nausea, vomiting, and sound and light sensitivity. Some experience aura with visual or sensory changes.

What is the cause of migraine?

It is multifactorial, involving genetic predisposition, brain hyperexcitability, and neurotransmitter changes that activate trigeminal pain pathways. Triggers (hormonal shifts, stress, sleep disruption, certain foods) can precipitate attacks.

What is the difference between a headache and migraine?

Headaches are often milder and non-disabling. Migraines are moderate to severe, pulsating, and accompanied by sensory and gastrointestinal symptoms, usually requiring targeted treatment.

What is the treatment for migraine?

Early acute therapy should be started as prescribed. Preventive medications like beta-blockers and anticonvulsant drugs reduce frequency; Botox is effective for chronic migraine.

What is migraine medicine, and which is best?

The best choice depends on your health profile and attack pattern. Options include NSAIDs and triptans for acute therapy; beta-blockers, anticonvulsants, antidepressants, and Botox for prevention in chronic migraine.

What is the symptom of migraine headache?

Laterality, pulsating quality, severity, nausea/vomiting, light/sound sensitivity, aura type/duration, and functional impact (e.g., MIDAS score).

What is the reason for migraine headache worsening with movement?

Central and peripheral sensitisation during attacks amplifies pain signalling so that routine activities can aggravate symptoms.

Is Botox a good option for migraine pain?

Yes, for chronic migraine, Botox injections every 12 weeks across specific muscle groups can reduce monthly headache days and intensity.

What is the treatment for migraine during pregnancy?

Non-drug strategies and selected medicines (only when the physician prescribes) with established safety profiles may be considered.

What are 5 tips for instant migraine relief?

Dark, quiet room, cold/warm compress, hydrate, modest early caffeine, controlled breathing/mindfulness.