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Migraine Causes – Triggers and Risk Factors
Migraine is a neurological condition causing severe headaches. Its causes include genetic, hormonal, and environmental factors that trigger attacks in susceptible individuals.
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Migraine is a neurological condition causing severe headaches. Its causes include genetic, hormonal, and environmental factors that trigger attacks in susceptible individuals.
What Are the Causes of Migraine?
Migraine is a complex neurological disorder characterized by recurrent, often one-sided, throbbing headaches. While the exact causes are not yet fully understood, research has shown that a combination of genetic predisposition, neurological processes, and various trigger factors plays a central role in its development.
Genetic Causes
Migraine has a strong hereditary component. Studies show that people with one or both parents affected by migraine have a significantly increased risk of developing the condition themselves. Certain gene variants that influence the brain´s sensitivity to stimuli have been linked to migraine.
Neurological and Biochemical Causes
In the brains of migraine sufferers, specific changes in nerve activity and neurotransmitter balance occur. The most important factors include:
- Serotonin: A drop in serotonin levels can lead to the dilation of blood vessels in the brain, triggering migraine attacks.
- CGRP (Calcitonin Gene-Related Peptide): This neuropeptide is involved in inflammation and pain transmission and is significantly elevated during migraine attacks.
- Cortical Spreading Depression: A slowly advancing wave of electrical activity in the brain, considered the cause of the migraine aura.
Hormonal Causes
Hormonal fluctuations, particularly in estrogen levels, play an important role in migraine development. Women are more frequently affected by migraine than men, pointing to the influence of female sex hormones. Typical hormonal triggers include:
- Menstruation (menstrual migraine)
- Pregnancy
- Menopause
- Use of hormonal contraceptives
Environmental and Lifestyle Trigger Factors
In addition to biological causes, there are numerous so-called trigger factors that can provoke a migraine attack in susceptible individuals:
- Stress and emotional strain: One of the most common migraine triggers.
- Sleep deprivation or irregular sleep: Changes in sleep-wake patterns can promote attacks.
- Certain foods and beverages: Alcohol (especially red wine), caffeine, aged cheese, chocolate, glutamate, and aspartame are suspected triggers.
- Dehydration and skipped meals: Irregular eating and insufficient fluid intake can precipitate attacks.
- Sensory stimuli: Bright lights, loud noises, or strong odors can trigger attacks.
- Weather changes: Fluctuations in air pressure or temperature are frequently cited as triggers by migraine sufferers.
- Physical exertion: Intense physical activity can in some cases trigger migraine.
Medication as a Cause
The overuse of pain-relieving medications can cause a condition known as medication overuse headache, which can intensify or chronify migraine. This particularly affects triptans, analgesics, and NSAIDs when taken on more than 10 to 15 days per month.
Diagnosis and When to See a Doctor
If headaches occur frequently, are very severe, or are accompanied by nausea, vomiting, sensitivity to light or sound, a doctor should be consulted. Diagnosis is typically made through a thorough medical history, a headache diary, and if necessary, imaging procedures to rule out other causes.
References
- Goadsby PJ, Holland PR, Martins-Oliveira M et al. - Pathophysiology of Migraine: A Disorder of Sensory Processing. Physiological Reviews, 2017; 97(2):553-622.
- World Health Organization (WHO): Headache disorders. Available at: https://www.who.int/news-room/fact-sheets/detail/headache-disorders
- Steiner TJ, Stovner LJ - Global epidemiology of migraine and its implications for public health and health policy. Nature Reviews Neurology, 2023; 19:109-117.
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