The Migraine Continuum (or Spectrum)

Migraine exists on a spectrum, much like autism does, although it is rarely described in those terms. This is an unfortunate oversight. Viewing migraine on a continuum highlights the numerous factors that influence how this illness appears in a person’s life. It also shows all the variables that figure into how migraine can change with an individual’s lifetime.

On one end of the continuum are people who can completely abort a migraine attack within an hour of its onset by taking an over-the-counter painkiller. They aren’t merely calling a bad headache a migraine -- their symptoms meet the clinical definition of migraine -- they’re just incredibly fortunate to have such a quick fix.

At the other end are people who have massively painful, severely disabling migraine attacks every single day and don’t get relief from any medication. These people are literally bedridden for days -- or weeks, or even months -- at a time. They are in the minority, but they do exist.

Most people fall somewhere in between these two extremes. A person may have only one migraine a year, but it is severe, lasts for a week and doesn’t respond to any treatment. Another person may fit the definition of chronic migraine (15 days with headache each month, with at least eight that are migraine), but can stop any migraine in its tracks with a triptan.

Those are just two examples from the middle part of the spectrum. Frequency, intensity and duration are the three primary aspects of migraine targeted in treatment. These, as well as responsiveness to treatment and degree of debility, are among the variables that come into play when thinking of migraine along a continuum.

The vast number of ways migraine can vary from person to person is astonishing. And yet, underneath these differences, we all have the same diagnosis. Although I firmly believe our similarities outweigh our differences, we can only truly understand another person’s experience of migraine if we consider their unique place on the continuum.