Migraine Symptoms

Migraine attacks come in four stages, each with its own set of symptoms. Here is what to expect in each stage.

Sick woman lying in the bed covered with blanke
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Migraine is a type of headache that leads to recurring bouts of throbbing or pulsing pain, often on one side of the head. Other symptoms of migraine include nausea, vomiting, and fatigue. With symptoms changing and lasting for up to several days, it's little wonder the 2019 Global Burden of Disease study found this condition to be one of the most disabling.¹

If you've experienced migraine, you're far from alone. Migraine affects one in seven people worldwide, with women three times as likely to experience it, the American Migraine Foundation (AMF) reports.²

Being able to recognize migraine symptoms is critical in managing the condition. It lets you get proactive about managing attacks and easing the burden of migraine.

What Are the Symptoms of Migraine?

As those with migraine are all too aware, migraines aren't just headaches—they can sideline you from daily life. A migraine attack can last anywhere from a day to a little over a week, though one to two days is usually the case, according to the AMF.³ The attacks come on in four stages, each with a distinct set of symptoms.

There are many types of this headache disorder, which means not everyone experiences migraine the same way. But here's a breakdown of the possible migraine symptoms, by stage, someone can have.

Prodrome

The prodrome phase is the first stage of a migraine attack. During this time, several symptoms can develop. Those with a history of migraine are usually able to see these as signs that a headache is coming. According to MedlinePlus⁴ and the AMF,⁵ in the 24 hours before migraine headaches, you may experience:

  • Food cravings
  • Sudden shifts in mood
  • Yawning
  • Excessive urination
  • Fluid retention
  • Constipation
  • Neck and shoulder stiffness

Aura

About a third of people with migraine experience aura, a time of sensory symptoms like visual disturbances, shortly before the migraine headache, per MedlinePlus.⁶ This aura phase usually serves as a warning that a migraine headache is coming, developing within an hour of the headache's start.

During this phase, you may⁶:

  • See zig-zagged lines or flashes
  • Experience blind spots or double vision
  • Feel numbness or tingling in your hands or mouth
  • Get extremely dizzy
  • Have difficulty speaking

Headache Attack

Headache is the principal symptom of this phase. It can feel like a pulsing and throbbing and can be moderate to severe.⁴ It's also often localized on one side of the head.

But headache isn't the only symptom during this phase. During the headache attack phase, you can also experience:

  • Increased sensitivity to lights, sounds, or certain smells
  • Nausea and vomiting
  • More headache pain when you move, cough, or sneeze

It can take anywhere from four hours to three days for this phase to pass.³

Postdrome

After the headache phase, people can experience a period of recovery from the head pain known as the postdrome phase. This is sometimes called a migraine hangover because it can share symptoms of a typical hangover. During postdrome, the AMF says you may experience⁷:

  • Fatigue
  • Nausea
  • Sensitivity to light
  • Dizziness
  • Body aches
  • Difficulty concentrating

This phase lasts anywhere from hours to several days.⁷

When to See a Health Care Provider

People who have headaches might not realize that what they're experiencing is actually migraine. It's estimated that less than half of people with migraine go to a health care provider for help, according to the AMF.⁸ If you have headaches, you should consider going to a health care provider to discuss a potential migraine diagnosis if you experience the symptoms of migraine and your headaches:

  • Interfere with your daily life
  • Happen frequently
  • Are self-medicating more than two times a week
  • Don't respond to medication

Although they are sometimes disabling, most migraine headaches aren't themselves dangerous or signs of other health issues. Living with migraine means learning ways to manage and prevent attacks. It also means knowing when your symptoms might be due to a cause other than migraine.

The American Headache Society says there are headache red flags that should signal to someone with a history of migraine to call their health care provider or seek emergency help.⁹ That's because these red flags might mean that something other than migraine—such as stroke, blood clot, or change in blood pressure—is causing the headache. According to the AMF, the signs you should get medical help for a headache include¹⁰:

  • A headache that reaches full intensity rapidly, like a thunderclap
  • A headache that comes on suddenly
  • A progressively worsening headache
  • Sudden changes in your headache pattern
  • A headache that feels better based on your positioning (ie, lying down vs. standing up)
  • Speech difficulties
  • Fever
  • Weight loss

Recap

With their characteristic moderate to severe headaches, often impacting one side of the head, migraine headache can be debilitating. Alongside head pain, the attacks may also cause nausea, vomiting, fatigue, and sensitivity to light or sound.

Everyone experiences migraine differently, with some people also having visual disturbances, or auras, prior to onset and others having hangover-like symptoms following the headache.

Since there's no outright cure for migraine, living with the condition means learning the signs that attacks are coming, working to manage and ease symptoms, and incorporating prevention strategies. If headaches and other symptoms are impacting your life, you're best off being proactive about getting help.

Sources:

  1. Steiner TJ, Stovner LJ, Jensen R, Uluduz D, Katsarava Z. Migraine remains second among the world's causes of disability, and first among young women: findings from GBD2019. J Headache Pain. 2020;21(1):137. doi:10.1186/s10194-020-01208-0.
  2. American Migraine Foundation. Facts About Migraine.
  3. American Migraine Foundation. How Long Does a Migraine Attack Last?
  4. Medline Plus. Migraine.
  5. American Migraine Foundation. The Timeline of a Migraine Attack.
  6. Medline Plus. Genetic Conditions - Migraine.
  7. American Migraine Foundation. The Science of Migraine – How to Deal With Postdrome.
  8. American Migraine Foundation. When Should I See a Doctor About Migraines?
  9. American Headache Society. Red Flags in Headache—What if it isn't Migraine?
  10. American Migraine Foundation. Changes in Headache Symptoms: When to be Concerned.
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