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A migraine with aura is not what most sufferers of migraines experience. This is contrary to the beliefs of many among the general public, as most people seem to think the visual symptoms that accompany this type of migraine are pretty much the norm for everyone who has this illness. But not only is this type of manifestation just one kind of migraine variant, but there is even a lot of variation within the aura symptoms themselves. They are not always vision-related symptoms.

It’s true that the effects most generally associated with the migraine with aura are related to vision. People might experience blind spots or see jagged light flashes or have an image split into shards. But for an hour or so prior to the severe headache coming onto the scene, the aura can produce other neurological effects as well, like tingling in the limbs or face, extra sensitivity to light or touch, and even slurring of speech. Since it’s the nerves that are affected, and not the eyes directly, visual symptoms are just one kind of result of the extra nerve sensitivity.

Another type of migraine is sometimes mistaken for one with the aura, which is the ocular or ophthalmic migraine. This has similar visual symptoms to the standard aura, involving blind spots in the vision, as well as zigzagging or brightly flickering light. This type of migraine, though, might occur without a headache at all, as the phenomena originates in the blood vessels of the retina rather than in the occipital cortex, the area of the brain that processes vision (where the aura originates). So there is some debate about whether this is a migraine with aura at all, yet many doctors argue that the otherwise unexplained disturbances in the retinal blood vessels must also surely originate in the occipital cortex.

Even if a person who experiences the migraine with aura and one who has only the visual symptoms are having those symptoms induced by somewhat different means, they are both experiencing a migraine. This means they need the same detective work to find their own migraine triggers, and they both need to try to remove them. And when the migraine comes, in whatever form, they will ultimately depend on the same migraine drugs and treatments. The main difference between them will be whether they’ve got the painful headache. But both lives can be equally disrupted, so the person with only the visual disturbances may not consider themselves to be particularly lucky.

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Migraine treatment is essentially a partnership between the doctors, researchers and the people afflicted with the migraines. While researchers try to find causes and treatments, and doctors try to administer those treatments, the migraine sufferer forms another line of migraine defense. This is because they alone are able to make the connections between certain kinds of food or other triggers and the onset of their headaches. And once they discern those triggers, they can take steps to eliminate them.

But when the headache strikes, steps need to be taken to bring relief, which is where some migraine drugs enter the picture. The non-steroidal anti-inflammatory drugs (NSAIDs), such as acetaminophen or ibuprofen, can help to some degree, though they work only with mild migraines. A group of drugs known as triptans have a better effect as a treatment for migraines, although they too have some limitations and may not work as well with extreme headaches. When heavy duty treatment is needed, doctors may combine medications, such as barbiturates, acetylsalicylic acid (i.e. Aspirin) and caffeine. A Sumatriptan/Naproxen Sodium combination has recently been shown to be very effective.

Migraine treatment is sometimes rather an odd process, perhaps because so many of the symptoms themselves are unusual. No one, for example, would normally expect caffeine to be both a trigger for the headaches and then a potential relief for them. Yet that appears to be the actual case. While caffeine can worsen the widening of blood vessels in the brain that is part of the headache, it can then turn around once the headache is there, and help the stomach absorb medication more quickly. Meanwhile, another odd treatment is botox injections in the scalp. This doesn’t eliminate the causes of the migraine, but prevents tension in the scalp from contributing to the severe headache.

Migraine specialists often tend to think in terms of medical solutions alone, but many people also swear by herbal migraine remedies, such as feverfew or Coenzyme Q10 supplements. The latter has been acknowledged, even by strictly medical practitioners, as something that has been shown to help. The person who is afflicted with a migraine might not particularly care where their migraine treatment comes from, just so long as it does something to ease their condition. Medical or herbal, wherever a cure or effective treatment can be found, it’s all good.

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A great many myths get perpetuated about migraine headaches, very likely by the people who don’t get the headaches themselves. In itself, this is a phenomenon like many others in society, but the difficulty with such myths is that they can have a detrimental effect on the migraine sufferers. Those who suffer these severe headaches are sometimes not just judged harshly simply for having them, but when their doctors also believe these myths (and some do), they might even be treated incorrectly.

Many migraine myths involve people judging the sufferers themselves. So they may think a migraine is “just another headache,” when in fact sufferers are dealing with a genetically-based migraine disease, of which a headache is the most prominent symptom. This is evidenced by the fact that it’s actually possible to have a migraine without a headache at all. Because of this myth, treatments could be prescribed wrongly because a normal headache involves a narrowing of blood vessels in the head, while in a migraine the blood vessels expand. Another myth surrounding migraines is that they are psychological. However, being symptomatic of a genuine neurological disease, they result from actual physiological triggers that affect people’s nerve endings and prompt real physical changes.

Probably the most unnerving myth connected to migraine headaches, though, is the idea that they are always benign and won’t cause any long-term damage. This has been shown to be untrue. For one thing, in many cases there is a clear link between epilepsy and migraines. For other people, migraines have led to strokes, blindness or aneurysms. In still other cases, migraines have been misdiagnosed as “really” being clinical depression. So rather than receiving the migraine drugs they need, some patients have been given anti-depressants, which don’t help the headaches at all.

Some myths that are attached to migraine headaches, like the one claiming that everyone gets the visual auras when they get the headaches, are pretty harmless. That sort of myth won’t affect whatever treatment the sufferer will get. It’s when the myths actually affect treatments or prescribed drugs that there could be damage. It will be hard for people to get the proper treatments, let alone discover migraine cures, as long as these myths continue to circulate.

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Many people, including some doctors, believe that the only “real” type of migraine is one where people see an aura, as a precursor to the severe headache itself. But it isn’t true at all that every migraine comes with this phenomenon. In fact, those migraine sufferers who do experience the aura are actually in the minority. Some figures suggest that as high as eighty-five percent of those who get migraines experience a migraine without aura rather than one that has one. This type of headache is called a “simple” migraine; if a migraine can ever really be considered simple.

It’s possible that the view of migraines as always having an accompanying visual aura is perpetuated by non-migraine sufferers, not because they’re trying to push migraine myths but perhaps because they’re not sure what else would differentiate this type of headache from the normal run-of-the-mill type. The aura is an exotic feature that might seem to justify these headaches having a classification all their own. But a migraine without the aura is in fact the much more common version. And rather than being redefined as though it’s just one of the other more ordinary types of headaches, this type still has plenty of symptoms identifying it as a genuine migraine.

For example, a common migraine sufferer might experience sensations of nausea or even vomiting, and be sensitive to certain kinds of food, some of which can actually be migraine triggers. Indeed, over-sensitivity to many things is a typical feature of migraines. So while the person may not experience the visual aura, they may still become extremely sensitive to light, sound and temperature. A migraine without aura might also prompt unexpected cravings for salty or sweet foods, cold hands or feet, or even excessive urination.

There is another primary symptom that differentiates these from more ordinary headaches. Migraines tend to be headaches on one side of the head rather than those located more generally. These start on one side, focusing mostly around the temple. They can sometimes spread, perhaps locating themselves around the eyes at the back of the head, but the majority start on one side or the other, not always the same side each time, before they move. This is common to almost all migraines, and the pain can be quite severe. So the sufferers of migraine without aura may actually have cause to be grateful that they don’t have the aura symptom along with everything else they have to deal with.

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All doctors and researchers who deal regularly with migraines are, in the end, looking for migraine cures. They’ve discovered a great deal of information about how migraines work in the first place, not to mention what triggers them. Teaching people how to eliminate these triggers isn’t a cure, exactly, but at least it’s a step in the right direction. However, migraines still afflict people, a great many people in fact, so migraine medications are still another area of research that is going full steam.

The first types of medications generally given for migraines are the non-steroidal anti-inflammatory drugs, or NSAIDS. These are more familiar to people as acetaminophen, aspirin, ibuprofen and naproxen. They are generally over-the-counter drugs, so people whose migraines tend to be mild can self-prescribe, and sometimes nip the headaches in the bud. Occasionally, when combined with caffeine, these can bring not just migraine relief but also relief from the nausea that tends to accompany this condition.

Migraine treatment involves a bit of trial-and-error, moving from the simpler migraine medications for less severe cases to those that pack more of a punch against stronger headaches. Migraine specialists might try triptans if the over-the-counter drugs don’t touch the headache, or they could even resort to opiates. Those, of course, bring the risk of possible addiction, so they are used as little as possible. The doctors need to balance the need for a treatment strong enough to handle the illness, but not so overpowering that it creates worrisome side effects.

Other treatments involve combining different drugs as medication for migraines, so a drug like Fioricet would have butalbital (a barbiturate) with aspirin, paracetamol (acetaminophen) and caffeine. Severe headaches that don’t respond to drug treatments, called refractory migraines, are sometimes treated intravenously with drugs like Decadron, Phergan, Keppra, and so on. Intravenous treatment aims at rebalancing the internal fluids and electrolytes as well as easing the pain.

In many ways, the common migraine is not common at all, and even after years of research its origins and mechanism remain at least partly mysterious. For this reason, treatment can be somewhat hit-and-miss, and it’s not always easy for doctors to tell which migraine medications are going to have an effect on any individual’s headache. But research continues to be done, and many strides have been made. And now at least there are several available choices of treatments to try, with the hope of greater relief.

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