Migraines affect more than 30 million people, or about 12 percent of the U.S. population. Typically migraines affect women more than men. Yet up to half of people who get migraines are not diagnosed. Continue reading to find out if you are one of the millions who get severe migraines.

The symptoms of severe or acute migraine include pain, which is usually severe and often disabling, as well as intense throbbing. Some people experience nausea, vomiting, or extreme sensitivity to noise or light during attacks. Episodes of severe migraine may last from four hours to three days.

Severe migraine may occur with or without aura. Aura refers to a perceptual disturbance. Examples include experiencing nonexistent smells, lights, or sounds. A migraine is often considered severe when pain, nausea, or other associated symptoms force a person to avoid normal daily activities. Also, a migraine is classified as severe if the person affected has a history of two to five similar episodes. Severe migraine is most common among people 25 to 55 years of age, but even children and teens are susceptible.

A chronic migraine occurs at least 15 days a month, for more than three months. This type of migraine can cause a substantial loss in productivity, and can result in a poor quality of life. It’s important to treat acute migraine in order to prevent the development of chronic migraine.

Virtually everyone gets ordinary tension headaches. Tension headaches typically cause a dull pain, as if a tight band is squeezing the head. Triggers may include:

  • muscle
    tension in the neck and scalp
  • caffeine
  • too
    little sleep
  • dehydration

Tension headaches usually respond to treatment with common over-the-counter pain relievers.

A cluster headache is another, less common, type of headache. Cluster headaches more often affect men. The headaches are characterized by sudden severe pain behind or around the eye, on one side of the head. Pain peaks within 10 minutes, but can last 15 minutes to three hours.

Migraines, which are considered a neurological disorder, are distinct from tension or cluster headaches.

Some people with migraines report warning symptoms. This is known as migraine with aura. Warning symptoms may include blurred vision, seeing “stars,” or other odd sensations like unpleasant smells before the onset of an attack. Affected people may even experience slurred speech or other language difficulties. Temporary loss of vision in one eye has also been reported.

Aura may occur from 10 minutes to one day before onset of a migraine. In some cases, a person may experience an aura without having a migraine. Migraine with aura tends to be less severe and disabling than migraine without an aura.

A number of factors are known to trigger the onset of migraine episodes. More than half of people who experience migraine with aura report having at least one trigger for their migraines. Potential triggers are numerous and may include:

  • fluctuating hormone
    levels (especially among women, and boys going through puberty)
  • stress or anxiety
  • fermented and pickled foods
  • cured meats and aged cheeses
  • fruits such as bananas, avocados, and citrus
  • skipped meals
  • too little or too much sleep
  • bright or strong
  • fluctuations in
    atmospheric pressure due to changing weather
  • drinking alcohol
  • caffeine withdrawal

A migraine results from a complex cascade of abnormal events in the brain, which are not yet fully understood by researchers. However, researchers have been able to determine that the abnormal activity originates in the body’s largest cranial nerve, the trigeminal nerve. Changes within this cranial nerve quickly spread to a network of smaller nerves. These nerves form a web throughout the delicate outer lining of the brain; the dura mater.

Within as little as 10 minutes after a migraine begins, pain-sensing nerves in this network undergo molecular changes. This causes them to become hypersensitive to pressure. This hair-trigger response creates throbbing pain as blood pressure naturally rises and falls with each heartbeat. Also, certain arteries dilate and blood flow is altered causing pain-producing chemicals to be released. Some of these changes may persist even after an attack has passed.

Brain messenger chemicals, dopamine and serotonin, are also believed to play a role in developing a migraine.

Another new theory suggests migraines may be related to “abnormal temperature regulation in certain regions of the brain.” The theory goes on to state, “a migraine attack serves to restore the brain temperature.”

Ultimately, scientists think genetic factors and certain environmental factors (and how those genes and environmental factors interact) affect a person’s susceptibility to developing migraines.

Emerging research suggest there’s a small window of opportunity to stop the progression of molecular changes that result in a migraine. To do this, treatment must begin within 10 to 20 minutes of the appearance of initial symptoms. Another window of opportunity closes within one to two hours of headache onset. After this, the skin of the face and scalp may become hypersensitive to touch. It’s very important to begin appropriate treatment as quickly as possible for best results.

Numerous drugs are available to treat migraine. Over-the-counter drugs, like aspirin, ibuprofen, and acetaminophen are often combined with caffeine to combat mild to moderate migraine episodes.

Doctors may prescribe other drugs, too. Examples include:

  • antidepressants
  • blood
    pressure drugs (beta-blockers)
  • anti-seizure
  • ergot

Triptans, a class of tryptamine-based drugs, have proven quite effective at providing relief from ongoing migraine headache. Some herbal remedies, like feverfew and butterbur, have shown some promise in migraine treatment.

There are two main branches of treatment for migraine. Acute treatments seek to stop a migraine headache or to reduce its severity or duration while it is happening. Preventive treatments seek to keep headaches from starting. They also aim to reduce the frequency and severity of attacks. When a migraine headache is in progress, ending it or reducing pain and other symptoms is of primary importance.