What Is A Migraine?  Simply put, Migraines are caused by a misfiring of the nervous system. There is an overwhelming build-up of nerve cell activity in the brain stem at the base of the brain and the effect of this spreads in a cascade to produce the migraine headache that lasts for several hours to a day or more before it gradually recedes. The misfiring can spread to other parts of the brain to produce visual distortions, pins and needles in the face and strange tastes before the headache starts. Some sufferers may recognise that they are building up to an attack days before it starts. Different sufferers have many different patterns of symptoms and this has produced a plethora of competing theories, and treatments, and has lead to a degree of competition between some doctors who believe that they have the better explanation/treatment. The reality is that they are all right, or at least partially so!  Trigger Zones  It has been recognised for years that Migraine sufferers have trigger zones, the most common ones being at the back of the head, over the eyes, and over the temples. These correlate to the distribution of the Occipital Nerve and the Ophthalmic Branch of the Trigeminal Nerve. Interestingly both these nerves have their roots in the same part of the brain, where migraines start, and they carry not just ordinary sensory fibres of touch and pain etc but also fibres of the sympathetic nervous system, a more primitive system that controls many body functions such as breathing and blood pressure. The intimate linking of the two apparently separate nerves covering different areas is illustrated in some people who are aware of sensations above their eye when the back of their neck is pressed. As it happens, both these points are also acupuncture points. Occipital Nerve blocks have been used at the back of the head for many years, with varying success, and dentists have talked about the TemporoMandibular Jaw joint being a cause of migraines, and treated jaw misalignments, again with varying success.  Seeing Inside The Brain  More recently a special brain scan called a Functional MRI Scan has enabled doctors to visualise the brain activity as a migraine is actually happening and you can see the build-up of nerve cell activity as the migraine occurs. More specifically, for those who have a well define trigger zone over one eye you can see that the ophthalmic branch of the Trigeminal Nerve is thickened as it comes out from behind your eye over the bone and up on to your forehead. This is the place that sufferers press to relieve the headache in a migraine attack, though in reality pressing there works in part by distracting you from the migraine because it is so unpleasant to do, even when you're not having an attack!!  