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Symptoms
By Mayo Clinic staffMigraine headaches often begin in childhood, adolescence or early adulthood. Migraines may progress through four stages, including prodrome, aura, headache and postdrome, though you may not experience all the stages.
Prodrome
One or two days before a migraine, you may notice subtle changes that signify an oncoming migraine, including:
- Constipation
- Depression
- Food cravings
- Hyperactivity
- Irritability
- Neck stiffness
- Uncontrollable yawning
Aura
Aura may occur before or during migraine headaches. Auras are nervous system symptoms that are usually visual disturbances, such as flashes of light. Sometimes auras can also be touching sensations (sensory), movement (motor) or speech (verbal) disturbances. Most people experience migraine headaches without aura. Each of these symptoms usually begins gradually, builds up over several minutes, and then commonly lasts for 20 to 60 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 (aphasia)
Less commonly, an aura may be associated with limb weakness (hemiplegic migraine).
Attack
When untreated, a migraine usually 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 often. During a migraine, you may experience the following symptoms:
- Pain on one side or both sides of your head
- Pain that has a pulsating, throbbing quality
- Sensitivity to light, sounds and sometimes smells
- Nausea and vomiting
- Blurred vision
- Lightheadedness, sometimes followed by fainting
Postdrome
The final phase, known as postdrome, occurs after a migraine attack. During this time 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.
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, 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 April 4, 2013.
- Headache: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/headache/detail_headache.htm. Accessed April 4, 2013.
- Cutrer FM, et al. Pathophysiology, clinical manifestations and diagnosis of migraine in adults. http://www.uptodate.com/home. Accessed April 4, 2013.
- Daroff RB, et al. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-1-4377-0434-1..C2009-0-40427-6--TOP&isbn=978-1-4377-0434-1&uniqId=364938937-2. Accessed April 4, 2013.
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- Martin KA, et al. Risks and side effects associated with estrogen-progestin contraceptives. http://www.uptodate.com/home. Accessed April 5, 2013.
- Solomon DH. Nonselective NSAIDs: Overview of adverse effects. http://www.uptodate.com/home. Accessed April 8, 2013.
- Bajwa ZH, et al. Preventive treatment of migraine in adults. http://www.uptodate.com/home. Accessed April 4, 2013.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed April 9, 2013.
- Headaches and complementary health approaches. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/pain/headachefacts.htm?nav=gsa. Accessed April 9, 2013.
- Ramzan M, et al. Headache, migraine and stroke. http://www.uptodate.com/home. Accessed April 9, 2013.
- Cruse RP. Management of migraine headache in children. http://www.uptodate.com/home. Accessed April 10, 2013.
- U.S. News best hospitals 2012-2013. U.S. News & World Report. http://health.usnews.com/best-hospitals/rankings. Accessed April 4, 2013.
- Tintinalli JE, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=40. Accessed April 26, 2013.
- Swanson JW (expert opinion). Mayo Clinic, Rochester, Minn. April 25, 2013.
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