For those who have a headache during a migraine attack, it is often unilateral, moderate to severe in intensity and described as pulsating. 40% have headaches on both sides, or the headache may move from side to side. (Keep in mind that not everyone with migraine gets a headache, for example, migraine aura without a headache.)

Most people with migraines will have increased headaches with physical activity, and be sensitive to light (photophobic), feel unwell and nauseous in connection with an attack. The PIN code(Photophobia+ Indisposed+ Nausea) is a good mnemonic/reminder that often gives an indication that you have migraine.

It is not uncommon for unpleasant symptoms to occur before and after a seizure. Before a seizure(pre-ictal or prodromal phase), irritability, fatigue and increased hunger or sweet cravings are common. Many people also experience pain in the neck or jaw before, during or after a seizure. The neck pain can be both part of the migraine, as well as the opposite way, that neck stiffness, neck pain or other neck dysfunction can trigger a migraine attack. After the attack(post-ictal or postdromal phase), fatigue, poor concentration and a kind of "hang-over" condition are often experienced.

A migraine attack usually lasts from 4 to 72 hours. Those who have an aura will often, but not always, experience a headache around 30 minutes after the aura. If you have a migraine attack that lasts longer than 72 hours, it's called status migraine, and if this is new, you should contact a doctor.

Migraines are divided into several subcategories. First, it's important to determine whether the migraine is with or without aura. Then, according to how often and for how long you have had migraines; whether the migraine is episodic/occasional or chronic. Probable migraine is also a subcategory, which can be important if other diagnoses do not fit with your presentation.

Other varieties of migraine: Menstrual migraine, abdominal migraine, vestibular migraine retinal migraine.

The diagnosis of migraine is mainly based on the symptom description above and the criteria at the end of this article. In addition, you need to see a clinician (doctor, neurologist, physiotherapist, chiropractor or other headache specialist) who can rule out other causes, perform a neurological examination, assess movement in the neck, back, shoulders and jaw, and feel the muscles and tenderness in the neck, jaw, face, skull and shoulders.

You are welcome to start with a digital consultation and/or a physical consultation by booking here.

Migraine is a complex neurovascular disease. This means that both nerves and blood vessels are involved. In addition, during an attack there will be inflammation of nerves and blood vessels. Several systems are thought to affect migraine symptoms, both centrally in the brain and peripherally in the skull, neck and other areas.

• Migraine is a genetic disease. Most people with migraine have a family member with migraine.
• Pre-phase/prodromal: Yawning, fatigue, increased hunger, increased need to urinate and other pre-symptoms, probably due to activation of the hypothalamus.
• Attack phase: The fifth cranial nerve, the trigeminal nerve, and blood vessels form the trigeminovascular system, which leads to the actual pain of a migraine attack.
• Blood vessels in the brain expand, and around the blood vessels there are pain sensors that allow you to perceive pain.
• Nerves from the trigeminal system work together with areas of the brain responsible for vision, coordination, smell and hearing, which explains why you can be light-shy, sound-shy, clumsy and sensitive to smell during a seizure.
• CGRP and PACAB-38 are among the neurotransmitters that trigger migraine attacks. New preventive medicines inhibit precisely these substances, which in turn prevent the headache associated with a migraine attack.

These are the most common risk factors or those who most often get migraines.

• More women than men have migraines
• If you have a family history of migraine, you're more likely to develop it.
• If you have a history of migraines, you may be more prone to attacks if your body is stressed or imbalanced (see below)
• Migraine is the most common headache type (phenotype) after a concussion or whiplash

These are some of the most well-known triggers for migraines:

• Little sleep
• stress
• Neck pain
• Forgot to eat
• Dehydrated
• Bright light
• Strong smells, e.g. perfume
• High degree of physical exertion
• New routines, or lack of routines
• Weather changes
• Certain types of food (heavy diet, blue cheese)
• Caffeine (in case of high intake, or sudden changes)
• Red wine, or alcohol in general
• Hormonal changes
• Too much painkiller headache medication

BUT - these triggers don't always trigger an attack. Migraine is a threshold disease. If your body is in balance, you feel rested and are generally well, you have a high threshold for migraine. If you're tired, fatigued, haven't eaten or are stressed or sad, the threshold for migraines is lower.

• When experiencing an attack, it is painful to move around, especially with an increased heart rate
• Painful to bend your head below chest height
• Bright light
• Loud sounds
• Strong smells

• Due to the triggers and exacerbating factors above, migraine sufferers like to lie in a dark, quiet room and sleep.
• Relaxation techniques can work for many to relieve pain and shorten seizures. Read more about different relaxation techniques here (Link and article coming soon).
• A cold pack or cold wet cloth on the forehead can relieve symptoms.
• Some will find relief in gently massaging the bridge of the nose/eyes/ orbit, temples, back of the neck or jaw muscles.

• Stabile rutiner er avgjørende for å få kontroll over anfall.
  • Søvnhygiene: Legg deg og stå opp til samme tider.
  • Kosthold: Spis faste måltider, og spis mat som gir stabilt blodsukker og som ikke fremmer betennelse 
  • Trening: Bygg deg gradvis opp, med kondisjonstrening, styrke og avspenningsøvelser. Bruk mulighetene når anfallene ikke er som verst.
• Vurder om det er noe som stresser deg, eller som påvirker smerter og kan trigge anfall.
• Vurder om det du selv opplever er en trigger, faktisk alltid er en reell trigger, eller om det varierer. Om det enkelte ganger ikke trigger migrene, er det fornuftig å få forsøke en eksponeringsterapi 
• Les denne artikkelen i sin helhet, som oppsummerer punktene over og en del andre punkter, som kan gi deg større grad av mestring rundt din migrene.