Migraine headache is the commonest primary headache disorder, 18% females and 5% males in the age group of 25 to 55 years suffer from it.

The duration of an attack can be 4 to72 hours though an acute attack can be shorter than 4 hours. The headache is unilateral, moderate to severe intensity, throbbing or pulsating quality, aggravated by a routine physical activity. Not all migraine is accompanied with aura or prodromal symptoms. The common prodromal or premonitory symptoms may be photophobia/ phonophobia, fatigue or physical hyperactivity, elation or irritability, poor concentration, difficulty in finding words, muscle pain, stiffness, food craving, yawning, increased bowel or bladder activity. There may be associated weakness or numbness of face, arms or leg.

Basilar artery migraine is unique, with bilateral neurological presentation of the aura signs. It has specific diagnostic criteria and aura consists of symptoms like decreased level of consciousness, ataxia, visual symptoms, diplopia, hyperacusia, tinnitus, vertigo, dysarthria, which develop over five minutes and can occur in succession. Neurotransmitters like dopamine and serotonin cause these premonitory symptoms, which occur 40 to 60 minutes before actual  onset of headache.Treatment consists of non pharmacological and pharmacological means to reduce disability and improve quality of life. Abortive agents like triptans, potent vasoconstrictors are used for preventing onset of migraine.