Most migraine sufferers just focus on the pain when one of the killer headaches strikes.
But in reality, there are typically four phases of migraine ““ what some experts refer to as migraine attacks ““ that contribute to the misery, according to the American Headache Society.
1. Prodrome
Think of this as the pre-headache or warning phase of the migraine. About a third of sufferers experience it, and it can occur hours or even days before the pain starts.
Signs and symptoms are diverse, and include:
- Problems concentrating
- Difficulty with reading or speech
- Thirst
- Frequent urination
- Food cravings
- Depressed mood
- Fear of light or sound
- Hyperactivity or sluggishness
- Frequent yawning
- Sleep problems
- Stiff neck
Many patients don’t realize this is their early warning that a headache is coming because the symptoms seem so scattered.
2. Aura
Probably the most talked about phase of migraine, the aura can be terrifying the first time it happens.
Symptoms are most often visual and can include:
- Temporary blindness in one eye or blurred vision
- Flashing lights
- Wavy lines or spots
- Extreme sensitivity to touch
- Speech difficulties such as finding the right words
- Hearing things that aren’t really there
- Loss of hearing
- Dizziness
- Confusion
- Motor weakness
- Hiccups
- Neck pain
- Numbness or tingling on the side where the headache pain occurs.
3. Headache
The most debilitating phase, the actual headache can last as long as 72 hours.
Symptoms include:
- Throbbing pain (mild to severe) that’s often centered on one side of the head or face and is made worse by any physical activity
- Nausea or vomiting
- Extreme sensitivity to light, sound or odors
- Confusion
- Dizziness
- Constipation or diarrhea
- Anxiety or depression
- Nasal congestion or a runny nose
- Fever and chills
- Dehydration or fluid retention
If symptoms last more than 72 hours, get medical attention. The pain most often strikes right around 6 a.m., and many sufferers report being woken up by the pain.
4. Postdrome
Think of this as the hangover phase. It’s likely caused by changes in blood flow to the brain as the body recovers from the migraine.
Symptoms include:
- Fatigue
- Depressed mood
- Difficulty concentrating
- Hyperactivity and feelings of euphoria in some people
It’s important to note that not every migraine sufferer (sometimes called a migraineur) will experience every phase with every headache. Symptoms vary from person to person.
