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Migraines are a particular type of headache that affects roughly 12% of adults in the U.S.  It is more common in women than men.  The cause of migraines is not clearly understood but appears to be the result of a complex process of nerve dysfunction in and outside of the brain.


4 Phases of Migraine Cascade

Migraines are a disorder of recurrent attacks that occur as a cascade of events over the course of hours to days.  A typical migraine attack progresses through four phases.

Migraine Cascade

Prodrome:  Symptoms that occur 24 - 48 hours before the headache and may include things like yawning, depression, cravings, neck stiffness.  The symptoms vary widely and not everyone with migraines will have a prodrome.


Aura:  Approximately 25% of migraine sufferers develop neurological symptoms that can include visual changes, numbness, burning sensation, weakness, jerking, or difficulty speaking.  Auras can occur just before or with the headache.  Auras can also occur without ever developing a headache.


Headache:  Migraine headaches are usually one-sided and throb.  Light, sound, and/or smells typically make the pain worse.   The headache intensity usually increases over several hours and is accompanied by nausea and sometimes vomiting.


Postdrome:  Once the headache subsides, patients might have a period where they feel drained while others feel euphoric.

Migraine Triggers

Most migraine patients have identified conditions that "trigger" their migraines.  

Most Common Migraine Triggers
Emotional Stress
Hormone Changes in Women
Not Eating
Weather Changes
Sleep Disturbances


Treatments for Migraines

Migraines can be difficult to treat.  There are are two main categories of treatment.  Preventative and acute (abortive).

Preventative Treatments for Migraines

The purpose of these treatments is to reduce headache frequency, severity, and duration.  There are several classes of medications and treatments used to prevent migraines.  Some of these are:

  • Certain blood pressure medications

  • Certain antidepressants

  • Certain antiseizure medications

  • Calcitonin gene-related peptide (CGRP) antagonists

  • Botulinum toxin (Botox) injections

  • Transcutaneous supraorbital nerve stimulation

  • Transcranial magnetic stimulation

Acute Treatments for Migraines

The purpose of these treatments is to treat the symptoms of an existing migraine.  There are several classes of medications used to treat the symptoms of migraines:

  • NSAIDs and acetaminophen

  • Calcitonin gene-related peptide (CGRP) antagonists

  • Certain serotonin agonists

  • Dihydroergotamine (DHE)

  • Migraine cocktails

  • Ketamine


How Migraines are Diagnosed

The process for diagnosis of migraines is complicated and depends on many factors.  A short summary of migraine diagnosis criteria are:

Migraine with aura (complicated migraine)

You must have a headache, plus:

  • Visual symptoms (seeing spots, sparkles, or lines) or vision loss.

  • Sensory symptoms (feeling pins and needles, for example).

Migraine without aura (common migraine)

You must have a headache and:

  • The attacks included pain on one side of your head.

  • You’ve had at least five attacks in a month, each lasting between four and 72 hours.

Plus, you’ve experienced at least one of the following:

  • Nausea and/or vomiting.

  • Lights bother you.

  • Sounds bother you.

Keep in mind that only a medical professional can diagnose migraines.  If you are having headaches, please contact your primary care provider or a neaurologist for evaluation.

Get Started with Ketamine

Call or text our patient coordinator to see if ketamine is right for treating your migraines.

Call or Text Now 480.341.5174

When to Seek Emergency Help

Although migraines can be debilitating, they are typically not dangerous.  However, there are certain headache "reg flags" that are concerning for emergency conditions.  

Red Flags for Possibly Dangerous Headaches
New or "worst" headache
New headaches after age of 50
New neurological (stroke-like) symptoms
Headache with fever
Headache with a stiff neck
Headache with confusion

This is not an all-inclusive list of concerning symptoms.  If you have any of the above symptoms, get directly to your nearest emergency department.  If you have other symptoms that are concerning to you, please be evaluated.

The information on this website is NOT comprehensive and should NOT be used as a substitute for the medical advice, diagnosis, or treatment by a health care provider.  This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient.  All patients must be examined and diagnosed individually to determine appropriate diagnosis and treatment for each individual patient.

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