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Migraine Signs and Symptoms
By Brian P. DunleavyMedically Reviewed by Jason Paul Chua, MD, PhDReviewed: March 18, 2022Medically ReviewedDuring a migraine attack, symptoms may include throbbing pain and sensitivity to light.ShutterstockSigns and symptoms of migraine can vary depending on the type of migraine you have. They can also vary from person to person and from attack to attack. The two major categories of migraine are migraine with aura and migraine without aura, according to Sandhya Kumar, MD, a neurologist and headache specialist at Wake Forest Baptist Health in Winston Salem, North Carolina. Typically, migraine attacks progress through four stages, or phases, which distinguishes them from severe tension or other nonmigraine headaches: prodrome, aura, headache, and postdrome.But not everyone with migraine experiences all four stages: For example, only about 25 to 30 percent of people with migraine experience aura, according to the American Migraine Foundation. In other cases, the headache phase doesn’t occur. According to Dr. Kumar, “In an ocular migraine, a person might not have much of a headache or no headache all, but then they have all these visual auras where they see things like flashing lights or visual phenomena. Some people say it’s like looking through a kaleidoscope.”There can also be migraine symptoms that resemble an urgent health emergency. In hemiplegic migraine, for example, a person experiences weakness on one side of their body in addition to their migraine headache attack, according to Kumar. Sometimes these symptoms can be confused with a stroke or a seizure, according to the American Migraine Foundation. Migraine symptoms can last for hours or days, and they can be serious and debilitating; according to the World Health Organization (WHO), migraine is ranked the sixth most disabling disease, globally. Ask the Headache Specialist Live
Andrew Charles, MD, director of Headache Research and Treatment and professor of neurology at the David Geffen School of Medicine at UCLA, Allison Young, MD, a board-certified psychiatrist specializing in evidence-based lifestyle interventions for the...see more Prodrome The Warning Phase of Migraine
You may notice signs of a migraine attack one or two days before you experience the headache. Most people with migraine will experience this phase, but not always before every attack, according to the American Migraine Foundation. There can be changes in mood and energy level during the prodrome, and often a partner or family member might pick up on the signs even when you don’t, says Roderick Spears, MD, a neurologist at Penn Medicine in Philadelphia. Several signs and symptoms are associated with the prodrome phase. They can include:ConstipationDepressionFood cravingsDifficulty focusingIrritability and changes in moodMuscles stiffness, especially in the neck and shouldersUncontrollable yawningFrequent urination Recognizing these signs and symptoms as part of the prodrome phase and treating them accordingly — whether it’s by taking medication, avoiding migraine trigger, or practicing mindfulness meditation or relaxation techniques — may lessen the severity of the resulting migraine or even prevent it. The Migraine Aura Phase
The aura phase of migraine — in which a person experiences a range of central nervous system symptoms — may occur before or during the headache phase.Auras can take a variety of forms. They can be: Visual Seeing various shapes and geometric patterns, bright spots, or flashes of light, or experiencing vision lossSensory Touching sensations, such as a pins-and-needles feeling in an arm or legMotor Movement-related problems, such as limb weaknessVerbal Speech problemsAuditory Hearing noises or music Auras typically begin gradually and increase in intensity. They can last for several minutes or up to an hour, but for most people they last much less than an hour, says Dr. Spears. For some people, aura is their only migraine symptom, with no headache. Other people always experience a headache after the aura phase, and still others with aura sometimes have a headache and sometimes don’t.People who have migraine with aura and repeated attacks of visual disturbances in only one eye may be diagnosed with retinal migraine. Symptoms of retinal migraine include seeing twinkling lights in the affected eye, having areas of decreased vision or blind spots in that eye, or experiencing temporary blindness in that eye, according to the American Migraine Foundation. The Painful Headache Phase of a Migraine
This phase can last from several hours up to three days. According to Kumar, the following symptoms can occur during the headache stage of a migraine attack:Pain on one or both sides of your head (possibly beginning on one side and then including both sides)Throbbing or pulsating painSensitivity to light, sounds, or smellsNausea and vomitingBlurred visionLight-headedness and fainting “You don’t have to have all the symptoms for it to be a migraine attack,” adds Kumar. When a person has a migraine attack, the symptoms are made worse by routine physical activity, so people typically don’t want to move around, says Spears. “Usually people want to sit or lie down in a dark, quiet room and try to sleep it off,” he says. Allodynia is a common but often misunderstood symptom of migraine. It’s hypersensitivity and pain that results from otherwise nonpainful stimulation — such as taking a hot shower, resting your head on a pillow, gently brushing your hair, and other things that you wouldn’t think twice about outside of a migraine attack.It’s estimated that up to 80 percent of people with migraine experience allodynia to some degree, and in some people, allodynia can linger even after headache pain lets up. Treating migraine attacks early can help to prevent allodynia. Headache Relief
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A variety of medications and home remedies can help ease the pain of a migraine attack.…Learn More The Postdrome or Migraine Hangover Phase
The final, or postdrome, phase follows the headache in about 80 percent of those with migraine. During postdrome, although the headache pain has subsided, you may feel fatigue, experience body aches, and have trouble concentrating, all of which can be severe enough to be debilitating. Sensitivity to light and strong smells may persist. Drinking a lot of water and getting rest can help you get over this feeling, according to Spears. Some people can experience quite the opposite during the postdrome, according to Spears. “There are people that are elated, almost what you would call euphoric, because they don’t have the pain anymore. They’re so full of energy they can almost be hyperactive,” he says. Migraine Symptoms in Children and Infants
Migraine occurs in about 3 percent of preschool-age children, 4 to 11 percent of elementary school-age children, and in 8 to 15 percent of high school-age children, according to the Cleveland Clinic. Before puberty, migraine is actually more common in boys than girls, says Kumar. As adults, women are 3 times more likely to have migraine than men. “Generally, children with migraine will experience many of the same symptoms as adults with migraine,” says Kumar. These can include headache, light sensitivity, and nausea. “It’s important to remember you don’t need to have all the symptoms of migraine to have it. Children or adolescents may not have all the symptoms of migraine headaches at the time, but they start having some headaches,” she says. Children who experience attacks of abdominal pain associated with loss of appetite, nausea, vomiting, and pallor (or sometimes flushing) — but no headache — may be diagnosed with abdominal migraine, assuming other causes of these symptoms can be ruled out. When very young children and even infants have migraine, it can be challenging to diagnose because they can’t articulate their symptoms and you have to look for signs, says Kumar.Colic, which is excessive and frequent crying of an otherwise healthy and well-fed infant, has been linked with migraine, according to the American Migraine Foundation. Children with migraine are more likely to have had colic when they were babies, and mothers and fathers with migraine are 2.5 and 2 times more likely, respectively, to have a baby with colic, according to the American Migraine Foundation. Rarer Migraine Symptoms
Some types of migraine have symptoms that are outside those experienced by most people with migraine with or without aura, according to the International Headache Society. Gastrointestinal Symptoms
Recurrent gastrointestinal disturbances, such as cyclical vomiting (recurrent bouts of vomiting) and abdominal migraine (characterized by abdominal pain, nausea, vomiting, loss of appetite, and pale skin), are episodic syndromes that can be associated with migraine, according to a paper published in 2018 in BMJ. These can happen before or at the same time as onset of migraine in children who are at risk for a headache condition.Although abdominal migraine is seen mainly in children, most commonly between ages 5 and 9, it can occur in adults as well, according to the American Migraine Foundation. Vertigo
Benign paroxysmal vertigo — in which a person senses motion when there is no motion or has an abnormal sensation during normal motion — is believed to be associated with migraine when it occurs in otherwise healthy children.In adults with migraine, vertigo is associated with migraine with brain-stem aura, a rare subtype of migraine with aura whose symptoms originate in the brain stem or both cerebral hemispheres at the same time, according to the American Migraine Foundation. It can also be a symptom of vestibular migraine, in which vestibular symptoms — which include spontaneous vertigo, positional vertigo, visually induced vertigo, and head-motion-induced vertigo — occur in a person diagnosed with migraine with or without aura, according to StatPearls. Benign Paroxysmal Torticollis
Benign paroxysmal torticollis is a disorder related to migraine that causes the head to tilt or twist to one side; it usually begins in infancy. Other symptoms can include vomiting, pale skin, and trouble controlling body movements, according to a case report published in Developmental Medicine and Child Neurology. Episodes can last 10 minutes or as long as two months, but spells lasting that long are uncommon. Usually, the spells stop by age 2 to 3, and always by age 5. Some experts believe that benign paroxysmal torticollis is a migraine variant. There is often a family history of migraine in children who have this disorder. Status Migrainosus
Status migrainosus is a severe migraine attack that lasts longer than 72 hours, and can be a complication of migraine with or without aura, according to The International Headache Society. The symptoms of status migrainosus are usually more severe than the typical migraine and often require medical intervention to resolve. Additional reporting by Becky Upham. Editorial Sources and Fact-Checking
Migraine Without Aura. American Migraine Foundation. July 25, 2019.Hemiplegic Migraine. American Migraine Foundation. January 12, 2017.Headache Disorders. World Health Organization. April 8, 2016.The Timeline of a Migraine Attack. American Migraine Foundation. January 18, 2018.Understanding Migraine With Aura. American Migraine Foundation. July 6, 21017.Retinal Migraine. American Migraine Foundation. March 10, 2016.Allodynia: When Touch Hurts But Shouldn’t. American Migraine Foundation. September 23, 2016.Migraines in Children and Adolescents. Cleveland Clinic. August 25, 2017.Connection Between Migraine & Colic. American Migraine Foundation. March 15, 2016.Episodic Syndromes That May Be Associated With Migraine. The International Classification of Headache Disorders. 3rd Edition. 2019.Angus-Leppan H, Saatci D, Sutcliffe A, and Guiloff RJ. Abdominal Migraine. BMJ. February 19, 2018.Abdominal Migraine. American Migraine Foundation. September 5, 2016.Migraine With Brainstem Aura (Basilar Type Migraine). American Migraine Foundation.Hilton DB, Shermetaro C. Migraine-Associated Vertigo. StatPearls. June 7, 2020.Giffin NJ, Benton S, Goadsby PJ. Benign Paroxysmal Torticollis of Infancy: Four New Cases and Linkage to CACNA1A Mutation. Developmental Medicine & Child Neurology. February 13, 2007.Status Migrainosus. The International Classification of Headache Disorders. 3rd Edition. 2019.Show LessNEWSLETTERS Sign up for our Chronic Pain Newsletter
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