Migraines like pins and needles may be caused by cluster headache, tension headache, occipital neuralgia and other reasons. 1. Cluster headache: this disease belongs to the primary neurovascular pain, which can be manifested as migraine like pins and needles, the pain starts from one side of the eye and the eye area, and can spread to the same side of the eye socket, forehead and other parts of the body, often in the night suddenly. 2. Tension headache: this disease is usually caused by poor living habits, anxiety and depression, mental overstress, etc., which can lead to excessive contraction of the head muscles or fascia, which may cause migraine like pins and needles, and may be accompanied by panic, dizziness, tinnitus and other symptoms. 3. Occipital neuralgia: the occipital nerve is one of the branches of the occipital nerve, which innervates the sensation of the uppermost part of the neck and the back of the head, etc. When occipital neuralgia strikes, migraine headache like pins and needles may be manifested. Usually manifested as unilateral pain in the uppermost part of the neck, the back of the occipital region, can spread to the top of the head, a few patients may have bilateral headaches. Migraine headache like pins and needles may also be caused by other reasons. If the symptoms continue to be unrelieved, you should seek medical advice as soon as possible, and after diagnosis, treatment will be guided by your doctor.