Prof. Dr. Dagny Holle-Lee, Head of the West German Headache and Dizziness Center in Essen, Senior Physician at the Department of Neurology, University Medical Center Essen: Migraine is much more than just a severe headache. It is a neurological disorder that often significantly limits those affected in their everyday lives. During an attack, many are unable to work, have difficulty concentrating, or can barely manage their usual tasks. The feeling of no longer being able to perform as usual is part of the experience for many.

According to the International Classification of Headache Disorders, migraine is diagnosed when at least two typical characteristics are present: The pain may be unilateral, throbbing or pulsating, moderate to severe, or intensified by physical activity, such as climbing stairs. This is often accompanied by nausea and/or vomiting, as well as sensitivity to light or noise. If such attacks have occurred at least five times, a diagnosis can be made. However, these criteria were developed for clinical studies. In everyday life, a broader spectrum is often observed. Therefore, a migraine may still be present even if not all criteria are met.

People with migraines already have a certain susceptibility: they are born with a “migraine brain.” Hormonal fluctuations, stress, sleep patterns, lifestyle, or weather changes can trigger attacks throughout life. The typical pain is caused by inflammatory processes in the meninges.

The classic image of migraine – a woman in a darkened room with a cold cloth on her forehead – applies to only some of those affected. Many people go to work despite their migraines and function normally on the outside, even though they are significantly impaired. This should be distinguished from tension headaches, for example. These rarely cause real suffering and do not interfere with everyday life. They only become problematic when they occur almost daily, which is very rare overall. Headaches that noticeably interfere with everyday life are usually caused by migraines.

Ultimately, it is important to know that there is no such thing as a “normal” headache. It is normal to have no headaches. As soon as headaches cause suffering or restrict activities, it is always worth looking for the cause – because the cause, often a migraine, is very treatable in many cases.

Recorded by Stefanie Flunkert