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Symptoms

By Mayo Clinic staff

Migraines usually begin in childhood, adolescence or early adulthood. A typical migraine attack produces some or all of these signs and symptoms:

  • Moderate to severe pain, which may be confined to one side of the head or may affect both sides
  • Head pain with a pulsating or throbbing quality
  • Pain that worsens with physical activity
  • Pain that interferes with your regular activities
  • Nausea with or without vomiting
  • Sensitivity to light and sound

When untreated, a migraine typically lasts from four to 72 hours, but the frequency with which headaches occur varies from person to person. You may have migraines several times a month or much less frequently.

Not all migraines are the same. Most people experience migraines without auras, which were previously called common migraines. Some people have migraines with auras, which were previously called classic migraines. Auras can include changes to your vision, such as seeing flashes of light, and feeling pins and needles in an arm or leg.

Whether or not you have auras, you may have one or more sensations of premonition (prodrome) several hours or a day or so before your headache actually strikes, including:

  • Feelings of elation or intense energy
  • Cravings for sweets
  • Thirst
  • Drowsiness
  • Irritability or depression

When to see a doctor
Migraines are often undiagnosed and untreated. If you experience signs and symptoms of migraine, keep a record of your attacks and how you treated them. Then make an appointment with your doctor to discuss your headaches and decide on a treatment plan.

Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.

See your doctor immediately or go to the emergency room if you have any of the following signs and symptoms, which may indicate other, more serious medical problems:

  • An abrupt, severe headache like a thunderclap
  • Headache with fever, stiff neck, rash, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
  • Headache after a head injury, especially if the headache gets worse
  • A chronic headache that is worse after coughing, exertion, straining or a sudden movement
  • New headache pain if you're older than 50
Causes Definition
References
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  2. Wilson JF. In the clinic: Migraine. Annals of Internal Medicine. 2007;147:ITC11-1.
  3. Allais LK, et al. Acupuncture for migraine prophylaxis (review). Hoboken, N.J.: John Wiley & Sons; 2009.
  4. Headache and facial pain. In: Aminoff MJ, et al. Clinical Neurology. 6th ed. New York, N.Y.: McGraw-Hill Companies; 2005. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=66. Accessed April 3, 2009.
  5. Goadsby PJ, et al. Headache. In: Fauci, AS, et al. Harrison's Online. 17th ed. New York, N.Y.: McGraw-Hill Companies; 2008. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed April 3, 2009.
  6. Bajwa ZH, et al. Pathophysiology, clinical manifestations, and diagnosis of migraine in adults. http://www.uptodate.com/home/index.html. Accessed March 17, 2009.
  7. Bajwa ZH, et al. Acute treatment of migraine in adults. http://www.uptodate.com/home/index.html. Accessed March 17, 2009.
  8. Bajwa ZH, et al. Preventative treatment of migraine in adults. http://www.uptodate.com/home/index.html. Accessed March 17, 2009.
  9. Trigger avoidance information. American Headache Society. http://www.achenet.org/tools/TriggerAvoidanceInformation.asp. Accessed March 31, 2009.
  10. Migraine. National Headache Foundation. http://www.headaches.org/education/Headache_Topic_Sheets/Migraine. Accessed March 31, 2009.
  11. Hormones and migraines. National Headache Foundation. Accessed March 31, 2009.
  12. Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed March 31, 2009.
  13. Cruse RP. Pathophysiology, clinical features, and diagnosis of migraine in children. http://www.uptodate.com/home/index.html. Accessed March 17, 2009.
  14. Cruse RP. Classification of migraine in children. http://www.uptodate.com/home/index.html. Accessed March 17, 2009.
  15. Cruse RP. Management of migraine headache in children. http://www.uptodate.com/home/index.html. Accessed March 17, 2009.
  16. Martin VT, et al. Eletriptan treatment of migraine in patients switching from barbiturate-containing analgesics: Results from a multiple-attack study. Cephalagia. 2005;25:726.
  17. Taylor M, et al. Botulinum toxin type-A (BOTOX) in the treatment of occipital neuralgia: A pilot study. Headache. 2008;48:1476.
  18. Lawler SP. A randomized, controlled trial of massage therapy as a treatment for migraine. Annals of Behavioral Medicine. 2006;32:50.
  19. FDA public health advisory. U.S. Federal Food and Drug Administration. http://www.fda.gov/cder/drug/advisory/SSRI_SS200607.htm. Accessed March 31, 2009.
  20. Bigal ME. Excessive acute migraine medication use and migraine progression. Neurology. Neurology. 2008;71:1821.
  21. Bigal ME, et al. Advil. Wyeth Consumer Healthcare. http://www.advil.com/products/advil/tablet_label.asp. Accessed April 2, 2009.
  22. Maxalt (prescribing information). Whitehouse Station, N.J.: Merck & Co.; 2008. Accessed April 2, 2009.
  23. Treximet (sumatriptan and naproxen sodium) tablets approved by FDA for acute treatment of migraine. GlaxoSmithKline. http://www.gsk.com/media/pressreleases/2008/2008_us_pressrelease_10034.htm. Accessed April 2, 2009.
  24. Neurontin (prescribing information). New York, N.Y.: Pfizer; 2007. http://www.pfizer.com/products/rx/rx_product_neurontin.jsp. Accessed April 2, 2009.
  25. Acupuncture: An introduction. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/acupuncture/introduction.htm. Accessed April 2, 2009.
  26. Natural product effectiveness checker. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed April 2, 2009.
  27. Feverfew. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed April 2, 2009.
  28. Butterbur. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed April 2, 2009.
  29. Rios J, et al. Evidenced-based use of botanicals, minerals, and vitamins in the prophylactic treatment of migraines. Journal of the American Academy of Nurse Practitioners. 2004;16:251.
  30. The dangers of aspirin & NSAIDS. The American College of Gastroenterology. http://www.gi.org/patients/women/asprin.asp. Accessed April 3, 2009.
  31. Fernandez-de-las Penas C, et al. Chronic tension-type headache: What is new? Current Opinion in Neurology. 2009;22:e1. Accessed April 20, 2009.
  32. Swanson JW (expert opinion). Mayo Clinic, Rochester, Minn. April 20, 2009.
  33. Saarto T, et al. Antidepressants for neuropathic pain. Cochrane Database of Systematic Reviews. 2007:CD005454.
  34. Ninan M, et al. Dynamic optimization of chronic migraine treatment: Current and future options. Neurology. 2009;72(suppl):14.
  35. Olesen J, et al. New appendix criteria open for a broader concept of chronic migraine. Cephalagia. 2006;26:742.

DS00120

June 6, 2009

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