It starts without any notice.  The timing is off, the voltage is wrong, the receptor cell is blocked. Something like that.

Some neuron misfires.

The chain reaction that is suppose to happen doesn’t. There is a gap or maybe a double fire on the wrong receptor. Or maybe on the correct receptor.

No one knows.

Just to get an accurate diagnosis hundreds of tests are taken: electroencephalograms, magnetic resonance imaging, computerized axial tomography, blood chemistry, sinus ex-ray, eye exams and then the inevitable psychological exams.

Prescriptions for almotriptan or eletriptan , or any other “triptan” named by a pharmaceutical company are given out like candy. Then there is an attempt for relief through anti-depressants or seizure medications. There is always anti-anxiety medication as a standby. If all else fails, a good old sedative to keep the patient from caring can be useful. Sometimes any one or a combination might work.

It may be neurovascular. Or maybe it is neurolimbic.

No one knows.

But inside the head that little missed synapse becomes one of a thousand things. Maybe a visual distortion. Pretty lightening bolts of clear but wavering bubbles that shoot across one’s line of sight. Maybe an undelineated area of blindness occurs. Or, for the more adventurous there is the numbing of extremities that courses up the body towards the brain. Maybe the direction of the error goes to the nose where strange smells are detected by only the person undergoing the electrical mishap.  The really advanced practitioners can deal with bouts of vertigo.

Then, just when all that mind altering visionary stuff goes away, the brain tries to explode. Internally, of course. No one wants all that brain matter to exit the skull. Except for the person to whom the pain is real. That person feels that the pain is deadly. Panic can issue and a wild cycle of pain, tension, panic, pain begins.

It can make one seek darkness and silence. Or it can do just the opposite and force you to remain moving in an attempt to banish the raging war.

It may stay for a second, a minute, an hour, a day, a week, a month. The lines of synaptic communication may or may not be quickly repaired.

Sometimes, just to be perverse, the pain never comes.

No matter.

There is always an aftermath.

The brain has malfunctioned on an elemental level. It can leave a body craving sleep. It can leave a mind dull and fogged. The brain can require energy for the rest of the body to heal itself. All leaving the person attached to the brain in a state of lethargy. A little like a Raggedy Ann doll. The difference is that as a human, you are awake and aware of the infirmity.

All of it–the synaptic errors, the visual and physical auras, the pain (or lack thereof), the drained energies–all of it, is migraine.

Not A migraine but migraine.

Confused? A non-believer? Convinced that it’s JUST a headache?

Ask someone who has migraine.

It is not just a headache.

I know.

From the error in the synapses to the drained energies, I have just described my last four days.

This is not a plea for sympathy or answers or remedies. This is an attempt to explain a very complicated syndrome that has been reduced to the tag word, “headache”. Excruciating pain may be part of it. But that pain can occur in the head or the belly. The basis of it all is a faulty electric system. The understanding of that system is nil. The cause or causes has never been determined.

The best that medical science can do is treat the symptoms. And that treatment is specific to each individual. It is a course in individual trial and error.

So the next time someone tells you they have a migraine please don’t tell them what you do or what your aunt Lou does or what your next door neighbor does. Just ask them what you can do for them.

And please do it quietly.