Updated 22 February 2016

Causes of migraines

No one knows exactly what causes migraine attacks, but both environmental factors and genetics seem to be involved.

Researchers still do not know exactly what causes migraine attacks, but both environmental factors and genetics seem to be involved. Although scientists have yet to determine the exact cause of migraine, environmental factors and genetics seem to be involved.

The brain chemical serotonin may also play a role. Serotonin assists in regulating pain in the nervous system and levels of this neurotransmitter drop during migraine episodes.
Most migraine pain originates in the arteries of the scalp or from the jaw and neck muscles. When the muscles become tense, the arteries can become painful.

Although migraine has an arterial component to the pain, it can often be prevented by treating the tension in the jaw and neck muscles. When the muscles relax, the arterial pain often subsides as well. The opposite is also often true – arterial pain can cause the muscles to react by becoming more tense, and this can result in muscle pain. When the arteries are treated, the muscle pain often subsides.

The arteries involved in migraine are usually the superficial temporal arteries (on the temple) or the occipital arteries (at the back of the head). However, in many patients other smaller arteries are also involved.

A number of potential triggers for migraines have been identified. (Triggers don’t, however, always cause migraines.) Some of these are:

- Alcohol 

- Allergic reactions

- Foods like chocolate, fermented foods, dairy products, citrus fruit, avocado, bananas 

- Foods that contain MSG, nitrates or tyramine

- Hormonal fluctuations associated with menopause, birth control and menstrual cycles

- Irregular or insufficient sleep 

- Irregular eating patterns

-  Loud noise, bright light and strong smells

- Smoking 

- Stress 

Read more: 

Symptoms of a migraine  

Treating migraines  

What is a migraine?

Reviewed by Dr Elliot Shevel, BDS, Dip MFOS, MB, BCh, Maxillo-facial and Oral Surgeon and Medical Director, The Headache Clinic, Johannesburg and Cape Town, February 2015.


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Dr Elliot Shevel is a South African migraine surgery pioneer and the founder and medical director of The Headache Clinic in Johannesburg, Durban and Cape Town, South Africa. The Headache Clinic is a multidisciplinary practice dedicated to the diagnosis and treatment of Primary Headaches and Migraines. Dr Shevel is also the main author of all scientific publications generated by his team. He recently won a high level science debate in which he was able to prove that the current migraine diagnosis and classification is not based on data. Tertiary Education - Dr Shevel holds both Dental and Medical degrees, and practises as a specialist Maxillo-facial and Oral Surgeon. Follow the Headache Clinic on Twitter@HeadacheClinic.

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