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If you've never had a migraine, you might think it's just a really bad headache. But if you've ever had them, or you know someone who does, you know that they're much worse -- and much more complicated -- than that. Hank explains the biology behind this disorder of the central nervous system, and how it can be treated.
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Hank Green: If you've never had a migraine, you might think it's just a really bad headache. But if you have ever had one or you know someone who gets them, you know that they are much worse than that and much more complicated.

A true migraine is a multi-symptom disorder of the central nervous system that affects the brain. But yes, really bad headaches are a major component of it, probably the single most significant and identifiable component. But usually they last longer than a normal headache, anywhere from four hours to several days and it brings along with it a whole array of other symptoms. Most migraine sufferers experience extreme sensitivity to light and sound and sometimes even smells. They also commonly experience nausea, vomiting, even fainting. What little relief they can find is generally only achieved by being in a still, dark, silent room until the symptoms pass.

And believe it or not it gets worse. Migraines also cause problems both before and after the headache. It's different for everyone but the ordeal can start with symptoms as seemingly minor constipation, weird food cravings, neck stiffness or excessive yawning. As the symptoms worsen, people generally enter a phase called aura, in which they may experience things like visual disturbances like seeing shapes or lights blurred or double vision or even loss of vision, pins and needle sensations in the extremities, weakness and sometimes even slurred speech. Now you may notice that these sound a lot like the symptoms of a stroke and in fact migraines have so many things in common with strokes that doctors sometimes have to do tests to determine which disorder they're dealing with.

After the headache is passed most migraine-sufferers experience a period of weakness and fatigue that can last from a few hours to a few days.

Obviously this isn't the sort of thing that anybody wants to experience, so what causes it? Can it be controlled or at least treated? Doctors think that migraines probably are caused by a sharp drop in your brain's level of serotonin, a neurotransmitter that plays a key role in regulating things like sleep and mood. And once that imbalance strikes it causes a whole cascade of effects. But what actually triggers this imbalance is complicated and uncertain.

We do know that one of the most important factors is genetics. If one or both of your parents has experienced a migraine odds are that you will as well. For reasons that we do not understand women are far more likely to have migraines than men and they're even more likely to experience one during times of hormonal changes, for example puberty, menstruation, ovulation, pregnancy, when using hormonal contraceptives or hormone replacements, and during menopause.

Beyond that everyone's triggers are different. For many people it may depend on their stress, their activity level or sleep schedule, all things in which serotonin plays a role. And still others may be triggered by things as seemingly random as bright lights, loud sounds, unusually strong smells or even weather changes.

The treatment of migraines is further evidence that it's not just a headache. It's true that the headache itself can sometimes be treated with pain relievers although they're often less effective. So in addition to pain relief, migraine sufferers may take medications that try to treat the source of the attacks, like by controlling the constriction of blood vessels in the brain, blood pressure, serotonin levels, and inflammations.

So clearly a migraine is more than just a bad headache, remember that when you hang out with people who get them. If they're in a bad way the biggest favor you can give them is just let them be by themselves in a dark room. You can keep watching SciShow but just do it very quietly.

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