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Symptoms
By Mayo Clinic staffMigraine headaches often begin in childhood, adolescence or early adulthood. Migraines may progress through four stages — prodrome, aura, attack and postdrome — though you may not experience all the stages.
Prodrome
One or two days before a migraine, you may notice subtle changes that may signify an oncoming migraine, including:
- Constipation
- Depression
- Diarrhea
- Food cravings
- Hyperactivity
- Irritability
- Neck stiffness
Aura
Most people experience migraine headaches without aura. Auras are usually visual but can also be sensory, motor or verbal disturbances. Each of these symptoms typically begins gradually, builds up over several minutes, then commonly lasts for 10 to 30 minutes. Examples of aura include:
- Visual phenomena, such as seeing various shapes, bright spots or flashes of light
- Vision loss
- Pins and needles sensations in an arm or leg
- Speech or language problems
Less commonly, an aura may be associated with aphasia or limb weakness (hemiplegic migraine).
Attack
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. During a migraine, you may experience some of the following symptoms:
- Pain on one side of your head
- Pain that has a pulsating, throbbing quality
- Sensitivity to light, sounds and sometimes smells
- Nausea and vomiting
- Blurred vision
- Diarrhea
- Lightheadedness, sometimes followed by fainting
Postdrome
The final phase — known as postdrome — occurs after a migraine attack, when you may feel drained and washed out, though some people report feeling mildly euphoric.
When to see a doctor
Migraine headaches are often undiagnosed and untreated. If you regularly experience signs and symptoms of migraine attacks, 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
- NINDS Migraine information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/migraine/migraine.htm. Accessed March 28, 2011.
- Cutrer FM, et al. Pathophysiology, clinical manifestations, and diagnosis of migraine in adults. http://www.uptodate.com/home/index.html. Accessed March 28, 2011.
- Boes CJ, et al. Headache and other craniofacial pain. In: Bradley WG, et al. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann Elsevier; 2008. http://www.mdconsult.com/books/page.do?sid=1155758096&eid=4-u1.0-B978-0-7506-7525-3..50111-4&isbn=978-0-7506-7525-3&uniqId=240648610-3. Accessed May 1, 2011.
- Migraine. National Headache Foundation. http://www.headaches.org/education/Headache_Topic_Sheets/Migraine. Accessed March 30, 2011.
- Headache diagnosis and testing. American Headache Society. http://www.americanheadachesociety.org/assets/NAP_for_Web_-_Headache_Diagnosis_&_Testing.pdf. Accessed April 1, 2011.
- Headache: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/headache/headachehope.pdf. Accessed April 1, 2011.
- Migraine. Journal of the American Medical Association. 2009;301:2608.
- Calhoun AH. Estrogen-associated migraine. http://www.uptodate.com/home/index.html. Accessed March 28, 2011.
- Hormones and migraines. National Headache Foundation. http://www.headaches.org/education/Headache_Topic_Sheets/Hormones_and_Migraine. Accessed March 30, 2011.
- Bajwa ZH, et al. Acute treatment of migraine in adults. .http://www.uptodate.com/home/index.html. Accessed March 28, 2011.
- SSRIs, triptans and serotonin syndrome: What is the risk of serotonin syndrome in migraine? American Headache Society. http://www.achenet.org/education/patients/SSRIsTriptansandSerotoninSyndrome.asp?print=y. Accessed April 1, 2011.
- Keeping a headache diary can help your doctor help you. National Headache Foundation. http://www.headaches.org/pdf/How_Keep_Headache_Diary.pdf. Accessed April 1, 2011.
- Gilmore B, et al. Treatment of acute migraine headache. American Family Physician. 2011;83:271.
- Migraine prevention: A guide to the latest methods and treatments. National Headache Foundation. http://www.headaches.org/educational_modules/migraine_module/page_home.htm. Accessed March 31, 2011.
- Fenstermacher N, et al. Pharmacological prevention of migraine. British Medical Journal. 2011;342:540.
- Bajwa ZH, et al. Preventive treatment of migraine in adults. http://www.uptodate.com/home/index.html. Accessed March 28, 2011.
- Cruse RP. Management of migraine headache in children. http://www.uptodate.com/home/index.html. Accessed March 28, 2011.
- Chaibi A, et al. Manual therapies for migraine: A systematic review. Journal of Headache and Pain. 2011; epub Feb. 5.
- Exertional headaches. National Headache Foundation. http://www.headaches.org/education/Headache_Topic_Sheets/Exertional_Headaches. Accessed March 31, 2011.
- FDA approves Botox to treat chronic migraine. U.S. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm229782.htm. Accessed April 14, 2011.
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