Before the pain starts, you may actually know that a migraine is ongoing. Do you feel irritable, tired, slightly nauseated?

Do you feel neck pain, does light or smells bother you? It seems like a migraine attack starts even before the pain appears. Patients have described this phase, known as prodrome. But is it really useful to call it a prodrome (preliminary phase) if the attack is indeed started? This is somewhat philosophical. But can this help us to understand the cause of migraines? We know now that during this early phase, the hypothalamus is active. The hypothalamus is a tiny zone with huge responsabilities. It interacts with the pituitary gland to regulate the hormones in your body and this leads to light-dark cycles, sleep, appetite, sexual drive, menstrual cycle etc. The hypothalamus may be more important in migraine than we thought before. It may be sensitive to certain triggers and initiate the migraine cascade.

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