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Where Do Migraines Come From?

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The short answer is easy: migraine headaches come from the brain. Migraine is an inherited tendency to have a hypersensitive brain, one that reacts adversely to certain internal and external stimuli by unleashing an onslaught of pain and accompanying symptoms from the brainstem's "headache generator."

The brainstem is a complicated structure, where many important life-sustaining functions are crowded into some very expensive real estate. Sandwiched between the rest of the brain and the spinal cord, it houses centers for balance, breathing, consciousness and sleep, as well as controls for movement and sensation of the face, ears, mouth, tongue and neck. In addition, passing through the region is all of the neuronal traffic running to and from the brain and the rest of the body. 

Specific brainstem circuits for facial pain are known to "light up" on functional brain scans during migraines, and the nearby emesis (nausea and vomiting) center becomes reflexively activated. Gateway systems in the brainstem and thalamus that control the sensitivity of other circuitry are thought to become active, in effect cranking up the volume of other incoming sensations, rendering unpleasant or even downright painful what would normally be innocuous levels of light, sound, odors and movement. In short, the generator is thought to unleash simultaneous cascades of neuronal activity leading to the pain as well as the multiple other accompanying (and unpleasant) symptoms of migraine. 

Exactly how these events unfold remains unclear. The leading theory has the headache generator itself causing the main symptoms of migraine after reaching some sort of internal threshold. But there are other factors that influence migraines.  

  • Ethnic background plays a role. For example, Caucasians tend to suffer migraines more than other ethnicities, while Asians probably get migraines the least.
  • There are socio-economic issues too. People in the lower fourth of the socio-economic ladder suffer migraines more often, and no one knows exactly why.
  • Major life-changing events such as the loss of a job, divorce, personal injury or the death of a loved one can provoke migraines, sometimes even leading them to occur on a daily basis.
  • Altitude can also play a role. If you are a migraineur and live in Denver, then you would tend to have more trouble with migraine headaches than if you lived at sea level. 

Posted in Hypertension and Stroke on November 29, 2011

Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer

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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.


Posted by: PHILLYGEEZER | November 29, 2011 9:32 PM

I have suffered from migraines since I was 18. I had no idea what I had the fist time I got one. It affected my speech, balance, vision and made me deathly ill for two solid days. I am now 60 over the years the symptoms have lightened up to the point where I can work through them. My vision is still affected but for only about 20 minutes and most of the time I have no headache afterwards. I have three sisters, two of which get migraines, one of which still gerts violently ill from them and takes medication to prevent them. I hope one day researchers wiil find a definate cause and a cure so no one has to suffer with them.

Posted by: dvinson | December 4, 2011 3:42 AM

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