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In 200 BCE, writings from the Hippocratic school of medicine described the visual aura that can precede the headache and a partial relief occurring through vomiting. Worldwide, migraines affect nearly 15% or approximately one billion people. Migraine is a primary headache disorder characterized by recurrent headaches that are moderate to severe.[1] Typically, the headaches affect one half of the head, are pulsating in nature, and last from two to 72 hours.[1] Associated symptoms may include nausea, vomiting, and sensitivity to light, sound, or smell. Migraines are believed to be due to a mixture of environmental and genetic factors Initial recommended treatment is with simple pain medication such as ibuprofen and paracetamol (acetaminophen) for the headache, medication for the nausea, and the avoidance of triggers. Specific medications such as triptans or ergotamines may be used in those for whom simple pain medications are not effective. Caffeine may be added to the above. A number of medications are useful to prevent attacks including metoprolol, valproate, and topiramate. User-contributed text is available under the Creative Commons By-SA License; additional terms may apply.