The presidential run of Rep. Michelle Bachmann (R-Minn.) hit an unexpected obstacle Tuesday when The Daily Caller reported that, according to sources close to her campaign, she suffered from debilitating migraine headaches brought on by stress on an almost weekly basis. Bachmann, whose migraine condition had not previously been disclosed, was said to have been hospitalized for it on several occasions because the pain and other symptoms left her "incapacitated," in the words of one adviser. Further reporting by Politico confirmed and expanded upon details of Bachmann's migraine medical history. Although some polls had identified Bachmann as a frontrunner in the race for the G.O.P. nomination, commentators have now begun to speculate about her medical fitness to be president of the U.S., and to wonder whether voters would abandon her candidacy on the basis of this new information.

Widespread misunderstanding of migraines and their treatment may cloud the issue, unfortunately. More than 300 million people around the world are afflicted with migraines, but the severity of their symptoms varies considerably: the excruciating head pain and sensitivity to light and sound that commonly characterize migraines can last anywhere from a few hours to several days. Stress is a common trigger for the attacks, but almost anything—allergies, alcohol, hunger, or the weather—can be. Migraine costs the U.S. economy an estimated $17 billion annually in lost work, medical expenses and disability pay.

As neurologist David W. Dodick of the Mayo Clinic in Arizona and physiologist J. Jay Gargus of the University of California, Irvine, noted in their 2008 Scientific American article "Why Migraines Strike," abnormalities of blood flow were often blamed for migraines in the past, but physicians now know that migraines are actually a neurological problem. A spreading wave of intense neural activity in portions of the brain’s cortex seems to trigger the auras, or visual illusions, that frequently precede migraine pain. It also somehow seems to activate pain signals within the trigeminal nerve system that serves the membranes around the brain.

Because of this neural involvement, most current drug treatments for migraine were originally developed to help with problems such as epilepsy and depression. Newer, more specific therapies are under development, including handheld devices that could be placed near the skull to emit magnetic signals that might be able to suppress the abnormal "brainstorm" setting off migraines. The burdens of pain and unsatisfactory treatments still fall heavily upon migraine sufferers, but their future prospects are improving.

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