Migraines are believed to be due to a mixture of environmental and genetic factors.[3] About two-thirds of cases run in families.[6] Changing hormone levels may also play a role, as migraines affect slightly more boys than girls before puberty and two to three times more women than men.[10][11] The risk of migraines usually decreases during pregnancy.[10] The underlying mechanisms are not fully known.[12] It is, however, believed to involve the nerves and blood vessels of the brain.[6]
Initial recommended treatment is with simple pain medication such as ibuprofen and paracetamol (acetaminophen) for the headache, medication for the nausea, and the avoidance of triggers.[5] Specific medications such as triptans or ergotamines may be used in those for whom simple pain medications are not effective.[6] Caffeine may be added to the above.[13] A number of medications are useful to prevent attacks including metoprolol, valproate, and topiramate.[4]
Globally, approximately 15% of people are affected by migraines.[7] It most often starts at puberty and is worst during middle age.[1] In some women they become less common following menopause.[12] An early description consistent with migraines is contained in the Ebers papyrus, written around 1500 BCE in ancient Egypt.[14] The word “migraine” is from the Greek ἡμικρανία (hemikrania), “pain on one side of the head”,[15] from ἡμι- (hemi-), “half”, and κρανίον (kranion), “skull”.[16]
