Migraine in the Athlete

Judy C. Lane, MD, The Head Pain Center, Englewood, Colorado.

Semin Neurol. 2000;20(2) 

In This Article

Abstract and Introduction


Migraine in the athlete may occur secondary to effort, prolonged exertion, or trauma or as a posttraumatic event. The chemistry is probably akin to that of spontaneous migraine. The purpose of this discussion is to outline the differential diagnosis of the athlete presenting with headache. Appropriate treatment can enhance athletic performance and enable the migraineur to participate in athletic endeavors.


Headache associated with exertion was described by Hippocrates, who admonished his students to "be able to recognize those who have headache from gymnastic exercises, or running, or walking, or any seasonal labor."1 In modern times, Stephen King wrote about exertional headache in his book The Running Man. "Lobsterlike, Richard humped backwards on his knees and forearms. His breath came in sharp, doglike gasps. The air was hot, full of the slick taste of oil, uncomfortable to breathe. A headache surfaced within his skull and began to push daggers into the backs of his eyes."2 In the decades of the 1980s and 1990s, an explosion of understanding about the chemical causes of migraine occurred. Given a multitude of new treatment options, this is an exciting time to treat headache sufferers. As migraine primarily afflicts young people, it is not surprising that many people participating in sports have migraine. Almost everybody has a headache on occasion. Many of the headaches that people assume are "normal" actually represent migraine. There is a great deal of controversy about whether it is appropriate to divide headaches into tension type and migraine type. It is thought by many headache specialists, including myself, that tension-type headache is a variation of migraine. Migraine is not an illness but rather an episodic brain disorder. Anyone, given an appropriate trigger, can develop a migraine-type headache. It is the ongoing occurrence of such headache that sets the migraineur apart.


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