What are the other Names for this Condition? (Also known as/Synonyms)

• Common Migraine
• Migraine Headache without Aura

What is Migraine without Aura? (Definition/Background Information)

• Migraine headache is a chronic neurological disorder and the most common form of headache that is characterized by severe pounding and pain on one side of the head, which can last for several hours. It may be broadly classified into two types:
  • Migraine with Aura
  • Migraine without Aura
• Migraine without Aura is migraine headache that is not preceded by a set of sensory (visual) and neurological disturbances. It is the most common form observed in over 70% of the individuals with migraines. Also referred to as Common Migraine, it may occur many times a week, to sometimes, only once or twice a year
• The ‘aura’ is a temporary phenomenon that is onset about 60 minutes prior to a migraine attack; this is termed migraine with aura. It is important to explain to individuals with migraines this difference, since the aura serves as a warning sign about an impending migraine attack
• The exact cause of Migraine without Aura is not known, but women are more commonly affected than men. Certain trigger factors have been established for the condition that include food, stress, and a lack of sleep
• There are multiple medications, non-traditional techniques, and home remedies available for treating Migraine without Aura. The prognosis of the condition is generally good with appropriate treatment in most individuals

Who gets Migraine without Aura? (Age and Sex Distribution)

• Migraines are common in individuals of all age groups. Anywhere between 70% (to sometimes as high as 90%) of the individuals with migraines may experience Migraine without Aura
• Adolescents and young adults are affected more than older adults; adults over the age of 50 years present fewer cases of migraine
• Migraine without Aura is more common in women than men; while boys report higher incidences than girls (prior to menarche)
• The condition is seen worldwide and no preference for any race or ethnicity is seen

What are the Risk Factors for Migraine without Aura? (Predisposing Factors)

The risk factors associated with Migraine without Aura may include:

• Family history of the condition
• Boys and girls in their teens are more at risk for migraines
• Hormonal changes: Women are likely to be affected by migraine headaches either before or after the onset of menstruation, pregnancy, and menopause, due to hormonal changes that occur in the body

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Migraine without Aura? (Etiology)

The exact cause for Migraine without Aura is not clearly established. Some of the likely causes for migraines include:

• Dilatation of blood vessels in the brain
• Release of certain chemicals
• Presence of an excess amount of dopamine and serotonin; an unusual sensitivity of the blood vessels to dopamine and serotonin is noted

The following factors are known to trigger migraine headache attacks:

• Certain foods such as chocolate, cheese, nuts, alcohol, and monosodium glutamate (MSG, a food enhancer)
• Missing out on meals
• Physical and mental stress
• Use of birth-control pills
• Smoking
• Hormonal changes in women during their menstrual cycle

What are the Signs and Symptoms of Migraine without Aura?

The signs and symptoms of a Migraine without Aura differ from one individual to another. There are three distinct stages in their development, and these are termed:

• Premonitory phase: This is experienced many hours to days before a migraine attack and the symptoms may include:
  • Changes in mood causing irritability, depression, and uncontrollable yawning
  • Changes in sensation such as altered taste and smell
  • Fatigue
  • Individuals may observe sensitivity to sound and light
  • Increased urination frequency
• Headache phase: It is characterized by moderate to severe pain and can last from 4 hours to even 3 days, if left untreated. Additionally, the following may be noted:
  • Pain on one side of the head; throbbing and severe pain
  • The pain gets worse with any physical activity
  • Neck pain and stiffness
  • Nausea and vomiting
  • Increased light and sound sensitivity
  • Dark circles below the eyes
• Postdrome phase: It may be referred to as the “hangover” phase and is characterized by the following symptoms:
  • Eating difficulties
  • Difficulty in concentration
  • Stomach upset
  • Lethargy
  • Mood swings

The frequency of migraine attacks may be as few as 1-2 times per year or as many as several times each week. It is difficult to predict who will experience migraines with or without aura.

How is Migraine without Aura Diagnosed?

The diagnosis of Migraine without Aura may include:

• Complete physical examination and assessment of signs and symptoms
• Thorough analysis of personal and family medical history
• Neurological examination by a qualified healthcare provider, if necessary
• Laboratory tests may be performed to rule out other causes for pain
• Computerized tomography (CT) scan of the head
• Magnetic resonance imaging (MRI) scan of the brain

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Migraine without Aura?

Migraine without Aura may lead to complications that include:

• Some headaches may be severe and last 3-4 days
• Emotional and mental stress
• Poor performance at school or at work
• Recurrence of the condition
• Headaches due to medication overuse
• Side effects of medication

How is Migraine without Aura Treated?

The following medications may be used in the treatment of Migraines without Aura:

• Pain-relieving medicines such as:
  • Ibuprofen and acetaminophen
  • Combination medication of acetaminophen, aspirin, and caffeine
  • Triptans and ergotamines
  • Anti-nausea medications
  • Opiates and other narcotics for severe pain
• Preventive medications such as:
  • Antidepressants
  • Cardiovascular drugs
  • Anti-seizure drugs
  • Botulinum toxin type A (Botox)

Preventive medications are prescribed when:

• There are two or more episodes of migraine headaches in a month
• If the pain-relievers are not effective
• When continued numbness and weakness is noted

Some of the non-traditional therapies that are used in treating Migraine without Aura include:

• Acupuncture
• Biofeedback (relaxation technique)
• Manual therapy involving massage and chiropractic treatments
• Use of vitamin and mineral supplements

Certain home care treatments may include:

• Muscle relaxation exercises including meditation, yoga, listening to music, and gardening
• Getting adequate sleep; while sleeping, resting in a dark quiet room
• Applying ice packs

How can Migraine without Aura be Prevented?

The prevention of Migraine without Aura involves bringing about some lifestyle changes that may include:

• Avoidance of triggers
• Reducing the effects of estrogen (for women)
• Having a stress-free routine with regular sleeping habits
• Regular exercise

What is the Prognosis of Migraine without Aura? (Outcomes/Resolutions)

The long term outlook of individuals with Migraine without Aura varies from one individual to another. It is generally good in a majority of individuals with adequate treatment.

• The migraine pain may subside with proper sleep and rest, even if no treatment is provided, in some individuals
• The acute attack of a migraine headache can be very discomforting, but with appropriate treatment most of the symptoms are manageable

Additional and Relevant Useful Information for Migraine without Aura:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/health-topics/neurological-institute/