There has been a debate amongst doctors and scientists on why people get migraines and how they occur. Some theorize that they start from a central area in the brain or its lining, the dura. Others believe that they start peripherally from irritation of sensory nerves. In either case a domino effect is initiated and a cascade of events ultimately results in the classic symptoms of migraine headaches. In medicine, knowing the cause is important in order to develop a treatment. With migraines though, anything you do to interrupt the chain of events can prevent the migraine from occurring. Like the chicken and the egg, it doesn’t matter whether the migraines start in the brain or outside of it since the symptoms come full circle. Any break in the cycle and the whole system stops. That’s why there are so many different ways to manage migraine headaches. Most of the medications work centrally on the brain for a short period of time. Avoiding triggers such as light, certain smells, loud noises, etc, work by preventing the irritation of the peripheral nerves that are associated with the triggers. That, also, is the way that Botox or migraine surgery works to prevent the migraine from ever occurring. By preventing irritation of the peripheral trigger point you stop the development of the headache. Just like removing a domino –or several dominos—from the lineup and stopping the reaction from going to completion.