What Are The Four Stages Or Phases Of A Migraine Whats The Timeline
The four stages in chronological order are the prodrome , aura, headache and postdrome. About 30% of people experience symptoms before their headache starts.
The phases are:
It can take about eight to 72 hours to go through the four stages.
What Is An Aura
An aura is a group of sensory, motor and speech symptoms that usually act like warning signals that a migraine headache is about to begin. Commonly misinterpreted as a seizure or stroke, it typically happens before the headache pain, but can sometimes appear during or even after. An aura can last from 10 to 60 minutes. About 15% to 20% of people who experience migraines have auras.
Aura symptoms are reversible, meaning that they can be stopped/healed. An aura produces symptoms that may include:
- Seeing bright flashing dots, sparkles, or lights.
- Blind spots in your vision.
- Numb or tingling skin.
What Happens During A Migraine
Every migraine begins differently. Sometimes people get a warning that a migraine is on its way. A few hours or even days before the actual headache, people might feel funny or “not right. They might crave different foods, or feel thirsty, irritable, tired, or even full of energy. This is called a “premonition.”
Some people get auras. These are neurological symptoms that start just before the headache and last up to an hour. An aura is different in every person, but it often affects vision. For example, a person might:
- have blurred vision
- see spots, colored balls, jagged lines, or bright flashing lights
- smell a certain odor
- feel tingling in a part of their face
Once the headache starts, light, smell, or sound may bother people with migraines or make them feel worse. Sometimes, if they try to continue with their usual routine, they may become nauseated and vomit. Often the pain begins only on one side of the head, but it might eventually affect both sides. Trying to do physical activities can make the pain worse.
Most migraines last from 30 minutes to several hours some can last a couple of days.
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What Are Some Migraine Risk Factors And Triggers
Some things make you more likely to get migraine headaches . Other things may bring on a migraine .
Common migraine risk factors include the following:
- Family history: You are much more likely to have migraines if one or both of your parents had migraines.
- Sex: Women are more likely than men to have migraines.
- Age: Most people have their first migraine during adolescence, but migraines can start at any age, usually before age 40.
Common migraine triggers include the following:
- Food and drink: Certain food and drink may cause migraines. Dehydration and dieting or skipping meals may also trigger migraines.
- Hormone changes: Women may experience migraines related to their menstrual cycles, to menopause, or to using hormonal birth control or hormone replacement therapy.
- Stress: Stress may trigger migraines. Stress includes feeling overwhelmed at home or work, but your body can also be stressed if you exercise too much or dont get enough sleep.
- Senses: Loud sounds, bright lights , or strong smells may trigger migraines.
- Medicines: Certain medicines may trigger migraines. If you think your migraines might be related to your medicine, talk to your doctor. Your doctor may be able to prescribe a different medicine.
- Illness: Infections, such as the cold or the flu, may trigger migraines, especially in children.
Foods that may trigger migraines:
- aged, canned, cured, or processed meat
- aged cheese
- soy sauce
Aura Phase: Strange Feelings Start
About 1 in 3 to 1 in 4 people with migraines get an “aura” that begins before the headache or starts along with it. It may not happen with every headache, though.
An aura can include:
Changes in vision, such as:
- A flickering, jagged arc of light. It may have a complicated shape. It usually appears on the left or right side of your vision. Over a few minutes, it may get bigger.
- A blind spot in your field of vision. This problem — combined with the flickering lights — can make it hard to drive or focus your eyes on small objects.
- You might “see” images from the past or have hallucinations.
These symptoms may continue to get worse over the next several minutes.
Skin sensations. You might feel tingling or “pins and needles” in your body during an aura. It may also cause numbness. These feelings often affect the face and hands, but they can spread out across the body. They may continue to expand over the next several minutes.
Language problems. You may have a hard time communicating with others. Symptoms may include:
- Trouble expressing thoughts when you speak or write
- Trouble understanding spoken or written words
- Trouble concentrating
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Migraine Is Much More Than Just A Headache
There are different types of migraine that involve different symptoms. There are many features or symptoms that are a part of migraine. There are also differences in how severe a symptom might be.
The most common symptoms of a migraine attack include:
- throbbing headache
- sensitivity to light, noise and smell
Causes Of Acute Headaches
- Viral Illnesses. Most acute headaches are part of a viral illness. Flu is a common example. These headaches may relate to the level of fever. Most often, they last a few days.
- Hunger Headaches. About 30% of people get a headache when they are hungry. It goes away within 30 minutes of eating something.
- MSG Headache. MSG is a flavor enhancer sometimes added to soups or other foods. In larger amounts, it can cause the sudden onset of a throbbing headache. Flushing of the face also occurs.
- Common Harmless Causes. Hard exercise, bright sunlight, blowing a wind instrument or gum chewing have been reported. So has severe coughing. “Ice cream headaches” are triggered by any icy food or drink. The worse pain is between the eyes .
- Head Injury. Most just cause a scalp injury. This leads to a painful spot on the scalp for a few days. Severe, deeper or entire-head pain needs to be seen.
- Frontal Sinus Infection. Can cause a headache on the forehead just above the eyebrow. Other symptoms are nasal congestion and postnasal drip. Rare before 10 years old. Reason: the frontal sinus is not yet formed. Other sinus infections cause face pain, not headaches.
- Meningitis . A bacterial infection of the membrane that covers the spinal cord and brain. The main symptoms are a stiff neck, headache, confusion and fever. Younger children are lethargic or so irritable that they can’t be consoled. If not treated early, child can suffer brain damage.
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What Is A Migraine
A migraine is not simply a bad headache. A migraine is an intense headache that may be accompanied by other symptoms such as nausea , vomiting , visual problems and an increased sensitivity to light or sound.
Migraines commonly last between four hours and three days. Some people experience migraines several times a week. Others might only experience attacks every few years. If you experience headaches on 15 days or more each month, and eight of these headaches are migraines, this is known as chronic migraine.
Although migraines are not life-threatening and do not shorten peoples life expectancies, they can significantly damage the quality of peoples lives. A World Health Organisation study identified migraine as the sixth highest cause worldwide of years lost due to disability . Repeated migraines can have a negative impact on family life, social life and employment.
There are two main types of migraine: migraine without aura and migraine with aura .
How To Find Relief
There isnt one right way to treat a migraine. If your migraines are infrequent, you may be able to use over-the-counter medications to treat symptoms as they occur.
If your symptoms are chronic or severe, OTC treatments may not be helpful. Your doctor may be able to prescribe stronger medication to treat existing symptoms and help prevent future migraines.
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Common Symptoms Of A Migraine
The main symptom of a migraine is usually an intense headache on 1 side of the head.
The pain is usually a moderate or severe throbbing sensation that gets worse when you move and prevents you carrying out normal activities.
In some cases, the pain can occur on both sides of your head and may affect your face or neck.
Postdromal Phase: After It Stops
Following the most severe phase of the migraine, you may not feel well for up to a day. Symptoms of this post-migraine phase may include:
- Extreme tiredness
- Head pain that flares up when you lean over, move quickly, or get a rush of blood to the head
Your migraines may change over time, including how often they happen and how severe they are. Attacks may not always include all of these stages. Also, you may eventually get the migraine aura without having a headache. Since many of the symptoms found in these stages of migraines can also occur in very serious conditions such as stroke or seizures, seek immediate medical help for any new symptoms, or ones that have never been evaluated by your doctor.
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Learn More About Each Stage Of A Migraine:
One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including constipation, mood changes from depression to euphoria, food cravings, neck stiffness, increased thirst and urination or frequent yawning.
For some people, aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They’re usually visual, but they also can include other disturbances. Each symptom usually begins gradually, builds up over several minutes and lasts 20 minutes to one hour.
Examples of auras 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
- Weakness or numbness in the face, or one side of the body
- Difficulty speaking
- Uncontrollable jerking or other movements
A migraine usually lasts from four to 72 hours if untreated, and the frequency varies by the person. Migraines might occur rarely or strike several times a month.
During a migraine, you might have:
- Pain, usually on one side of your head, but often on both sides
- Pain that throbs or pulses
- Sensitivity to light, sound, and sometimes smell and touch
- Nausea and vomiting
After a migraine attack, you might feel drained, confused and washed out for up to a day. Some people report feeling elated. Sudden head movement might bring on pain again briefly.
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Phases Of A Migraine Attack
Prodrome Phase This first phase of migraine can occur hours to days prior to the attack, says Dr. Spears. It typically involves a change in mood and energy certain cravings or excessive yawning can be a sign of prodrome, he says.
People sometimes confuse these prodrome, or premonitory, symptoms, with migraine triggers. Thats to say, a person who craves chocolate as a prodrome symptom may mistakenly believe that consuming chocolate triggered the migraine attack, according to MigraineAgain.
Aura About 25 to 35 percent of people with migraine have aura, says Spears. The most common aura is a visual change with a kaleidoscope-like phenomenon that can last anywhere from five minutes to an hour but usually much less than an hour, he says. Other aura symptoms may include tingling sensations, numbness, garbled speech, and clumsiness or weakness.
Headache Phase This stage can last 4 to 72 hours, and in most patients, its marked by a headache on one side of the head thats throbbing and pulsating in quality. Typically, the pain is described as moderate to severe, says Spears.
The headache phase is also associated with becoming sensitive to the environment, he adds. Light, sound, and odor sensitivity are common, as are nausea and vomiting, he says.
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How Are Migraines Diagnosed
Despite their dramatic symptoms, migraines are almost never due to an underlying problem that will show up on any testing, even on brain MRIs. Many experts do not recommend brain imaging at all, even in severe cases, as long as the patient’s symptoms are typical for migraines and a thorough neurological examination is normal.
There are extremely rare families that have migraines as a result of a single genetic mutation in one of four known genes that can lead to the condition called familial hemiplegic migraine. There are no genetic tests for the vast majority of patients. Because the condition cannot be diagnosed by scan or blood test, the diagnosis is “clinical” made by an experienced physician.
Acute Drug Treatment To Stop A Migraine Attack
There are several different medication options for treating a migraine attack once its begun. The type of migraine you have as well as the frequency and severity of your attacks is something you should discuss with your doctor when developing a treatment plan.
For people with mild to moderate symptoms, over-the-counter medications are often sufficient to relieve them, according to the American Migraine Foundation. These include:
Your doctor may also prescribe any of a number of drugs for acute treatment of migraine. Generally speaking, acute migraine treatments work better the earlier in the attack you take them, before the pain has gotten severe. Triptans are the most commonly used acute migraine medications, and gepants and ditans are two new classes of migraine drugs that may be helpful if you cant take triptans or are not helped by them.
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What Are The Causes
Doctors are learning more about what brings on these headaches, which often run in families. Some are the result of changes in your brain chemicals. Abnormal brain activity is also involved.
Every person who has migraines has different triggers, but common ones include a lack of sleep, caffeine, and being under stress.
Most people who get chronic migraines are women. This may be because hormone changes are another well-known cause. These shifts happen around your monthly period, as well as during pregnancy and through menopause. Birth control can also play a role.
When To Call A Professional
If you have a history of migraine, you should contact your doctor if you develop headaches that differ from your usual headache or other migraine symptoms. Examples include:
- Headaches that get worse over time
- New onset of migraine in a person over age 40
- Severe headaches that start suddenly
- Headaches that worsen with exercise, sexual intercourse, coughing or sneezing
- Headaches with unusual symptoms such as passing out, loss of vision, or difficulty walking or speaking
- Headaches that start after a head injury
In addition, you may want to see your health care professional if you have headaches that do not get better with over-the-counter medications severe headaches that interrupt work or the enjoyment of daily activities or daily headaches.
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Is Retinal Migraine Dangerous
Most often, a retinal migraine attacks will subside after a short time with no lasting harm, though it can affect your ability to drive safely.
Still, its worth discussing with your doctor and potentially getting an eye examination to look into potential causes and rule out more serious concerns, such as a stroke in the eye.
If its never happened before, losing vision in both eyes at the same time may also be a sign of a more serious problem.
Your head may start to hurt at the same time a retinal migraine affects your vision or up to 1 hour later, or you may not experience a headache at all.
The same is true for the more common migraine with aura.
Retinal migraine is considered relatively rare. Its more common for a different type of migraine to affect vision in both eyes, not just one.
Older research from 2005 puts the frequency at about
The Headache Or Main Attack Stage
This stage involves moderate to severe head pain. The headache is typically throbbing and is made worse by movement. It is usually on one side of the head, especially at the start of an attack. However, you can get pain on both sides, or all over the head.
Nausea and vomiting can happen at this stage, and you may feel sensitive to light, sound, smell and movement. Painkillers work best when taken early in this stage.
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What Else Can I Do To Prevent Migraines
While there are no sure ways to keep from having migraine headaches, here are some things that may help:
Eat regularly and do not skip meals.
- Keep a regular sleep schedule.
- Exercise regularly. Aerobic exercise can help reduce tension as well as keep your weight in check. Obesity can contribute to migraines.
- Keep a migraine journal to help you learn what triggers your migraines and what treatments are most helpful.