Medical Encyclopaedia › Migraine (short definition)
In brief: Migraine is a neurological disease with recurring, usually throbbing headache attacks, often on one side, accompanied by nausea and sensitivity to light and noise. About one in seven people is affected, women much more often than men.
How does migraine develop?
Migraine is based on an innate hyperexcitability of the brain. During an attack, the trigeminal system is activated, releasing the messenger substance CGRP among others; this causes an inflammatory reaction in the meningeal vessels and the typical pain. The predisposition is often hereditary.
Typical symptoms
An untreated attack lasts 4 to 72 hours. The pain is moderate to severe, gets worse with physical activity and is often accompanied by nausea, vomiting and sensitivity to light and noise. In about a quarter of those affected, an aura comes first, for example flickering, zigzag lines or tingling, which usually lasts less than an hour.
Common triggers
Attacks can be favoured by irregular sleep, stress and especially the relaxation afterwards, skipped meals, lack of fluids, hormonal fluctuations around menstruation or alcohol. Triggers vary from person to person; a headache diary helps to identify them.
Acute treatment
For mild to moderate attacks, painkillers such as ibuprofen, acetylsalicylic acid, paracetamol or their combination with caffeine help, if necessary together with a medicine against nausea. For more severe attacks, triptans are effective; they should be taken as early as possible in the headache phase. Acute medicines should be taken on no more than ten days a month, otherwise medication-overuse headache threatens.
Prevention
For frequent or very distressing attacks, preventive treatment may be considered, for example with beta-blockers, topiramate, flunarizine or amitriptyline. Newer options are antibodies against CGRP or its receptor and, in certain cases, botulinum toxin for chronic migraine. Regular endurance sport, relaxation techniques and a regular daily rhythm are supportive.
When to see a doctor?
New or changed headaches, headaches after the age of 50 and frequent attacks should be assessed by a doctor. A sudden, extremely severe headache, paralysis, speech disturbances, fever with neck stiffness or a first-time aura lasting longer than an hour are an emergency (call 112 in Europe).
Related terms in the encyclopaedia
Headache, Aura, Triptans, Medication-overuse headache, Tension-type headache, Cluster headache, Botulinum toxin, Neurology
Further reading on Medizin Aktuell
Sources
- Deutsche Gesellschaft für Neurologie (DGN) und Deutsche Migräne- und Kopfschmerzgesellschaft (DMKG): Leitlinie „Therapie der Migräneattacke und Prophylaxe der Migräne“, AWMF-Register 030-057
- Headache Classification Committee der International Headache Society: Internationale Kopfschmerzklassifikation ICHD-3
- IQWiG: gesundheitsinformation.de – Gesundheitsinformationen des Instituts für Qualität und Wirtschaftlichkeit im Gesundheitswesen
Note: This article is for general information and does not replace advice, diagnosis or treatment from a doctor or pharmacist. Last updated: October 2026.