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The Relationship Between Migraine and Fever

Migraine is a complex neurological disease that can cause intense head pain and other debilitating symptoms. Fever is defined as having a temperature above 100.4F (38C). While migraine attacks are not usually associated with fever, in some cases, migraines may occur along with a fever.

Typical Migraine Symptoms

Common migraine symptoms include:

• Moderate to severe headache pain, often described as throbbing or pulsing
• Increased sensitivity to light, sound and odors
• Nausea and vomiting
• Dizziness or vertigo
• Vision changes like blurriness or seeing auras

Migraine pain is often localized to one side of the head. Attacks can last anywhere from 4 to 72 hours in adults. Migraines sometimes involve "premonitory" symptoms in the hours before head pain starts like fatigue, mood changes, food cravings, and neck stiffness.

Fever Is Not a Typical Migraine Symptom

While migraine causes significant discomfort and disability, an increase in body temperature or fever is not considered part of the diagnostic criteria for migraine. During a typical migraine attack, the person's temperature usually remains in the normal range.

Possible Links Between Migraine and Fever

Even though fever is uncommon, some people do experience fevers during or following their migraine episodes. Here are some potential explanations:

Associated Viral Illness

Viruses are a common trigger of migraine attacks. The same viral infection that triggered the migraine could also independently cause a fever. Colds, sinus infections, and the flu are examples.

Stimulation of the Immune System

Research indicates migraines may arise due to neurogenic inflammation and activation of the trigeminal nerve system. This nerve stimulation could theoratically also spark a slight fever in some people by revving up the immune system.

Side Effect of Medications

Certain migraine medications like triptans or ergotamine can sometimes cause low-grade fevers, along with chills as a side effect. Discontinuing the medication typically resolves this fever response.

Associated Conditions

Some chronic illnesses that increase migraine risk like lupus or rheumatoid arthritis can also increase susceptibility to fevers. The fever may stem from the associated condition rather than the migraine itself.

Key Considerations for Migraine With Fever

While fever and migraine only overlap in certain cases, pay attention to these factors if you experience a fever with your migraine attack:

Level of Fever

Migraine-related fevers are more likely to be low grade, around 100F. Very high fevers over 102F are unlikely to be caused by a migraine itself. Seek medical advice for fevers over 102F which could signal an infection.

Onset and Duration

Take note of when the fever develops and how long it lasts. Fevers that start shortly before or during the migraine attack and resolve as the attack subsides are more likely migraine-related. Fevers lasting days suggest another illness may be triggering both symptoms.

Accompanying Symptoms

Assess for any other worrisome symptoms alongside the fever like a severe headache, neck stiffness, rash, trouble breathing, or confused mental state. These warrant urgent medical evaluation to rule out serious conditions like meningitis, encephalitis or sepsis.

Prior History

Consider your personal health history. If you have never spiked a fever with previous migraines, new onset fever with headache deserves medical investigation to identify the cause.

Serious Causes of Fever and Headache

While most fevers related to migraine are low grade and temporary, a high fever with headache can signal a medical emergency. Seek immediate medical care if you have:

Fever Over 102F

High fevers above 102 require evaluation to rule out dangerous infections like meningitis, encephalitis and sepsis, which need rapid treatment.

Stiff Neck

Neck stiffness or difficulty bending the neck coupled with headache and fever could indicate meningitis, an infection of the brain and spinal cord membranes.

Mental Status Changes

Fevers paired with confusion, delirium or loss of alertness can signify brain infections, inflammation, or seizures requiring hospitalization.

Focal Weakness

Experiencing localized weakness or numbness on one side of the face or body with fever is an emergency red flag for stroke.

Respiratory Distress

Trouble breathing along with high fever and body aches may indicate a life-threatening case of sepsis from severe infection.

Diagnosing the Cause of Fever With Migraine

To determine the source of your fever if you experience one with a migraine attack, your doctor may order:

Complete Blood Count

This checks for signs of infection like elevated white blood cells and bands. Platelet levels help rule out bleeding risks.

Blood Cultures

Positive blood cultures would confirm a bacterial or viral infection causing the fever.

CT or MRI

Brain imaging scans for abnormalities like tumors, cysts or fluid buildup that could spark fevers.

Lumbar Puncture

Spinal tap to analyze cerebrospinal fluid and check for infections like meningitis and encephalitis.

Temporal Artery Biopsy

This test diagnoses temporal arteritis, an inflammatory condition that can cause fever and headache, especially in older adults.

Treating the Cause of Fever With Migraine

Treatment focuses on resolving the underlying reason for the fever, which may include:

Antibiotics

If a bacterial infection is the cause, antibiotics would be prescribed to clear the infection and fever.

Antiviral Medications

Antiviral agents like acyclovir can fight certain viral infections associated with fever and headache.

Immunosuppressants

For conditions like lupus and temporal arteritis causing fever, immunosuppressants reduce inflammation and fevers.

Hydration

Fluids and electrolytes are crucial for replacing losses from fever sweats and vomiting.

Medication Adjustments

Switching or discontinuing any fever-producing medications and transitioning to alternatives without that side effect.

Managing Fever Symptoms With Migraine

In addition to treating the underlying cause, you can help manage fever discomfort with migraine using:

OTC Pain Relievers

Medications like acetamin

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.