Understanding the Four Stages of a Migraine Episode

If you don’t get migraines, there is a high chance you know someone who does. According to The Migraine Trust, migraine is the third most common disease in the world. In fact, about one in seven people suffer through migraines. Furthermore, migraine is ranked globally as the seventh most disabling disease.

Migraines, perhaps unlike other conditions or types of pain, often have distinct stages that occur during an attack. Although each person experiences migraines in a unique way, they’ll probably recognize these patterns in their attacks.

Do you suffer through migraine attacks that interfere with your ability to complete everyday tasks? If so, come see board-certified headache specialist Bernadette Nazario-Lopez, MD, PharmD at the Migraine and Headache Center of Florida in Altamonte Springs. In this blog, our pain experts discuss migraine basics and the stages of a migraine.

Migraine basics

Migraines are headaches that cause severe throbbing or pulsing pain, often with one side of the head more impacted than the other. Migraine attacks typically last for a few hours, but some people may experience an attack for days.

Doctors don’t know the exact cause of migraines, but changes in serotonin levels do seem to play a factor. Additionally, migraines are often hereditary and impact women more than men, likely due to fluctuations in hormones associated with menstruation and menopause.

Prodrome

The prodrome, or premonitory phase, occurs one to three days before the headache itself and typically lasts from 1-24 hours. During this phase, you may notice subtle physical and mental changes that point to a coming migraine. Examples include tiredness, mood changes (usually energetic to depressed), excessive yawning, mental fogginess, food cravings, irritability, thirst, increased urination, increased sensitivity to light, and stiffness in the neck.

Aura

Auras are neurological symptoms that occur about 10 to 30 minutes before the main headache. People experiencing aura may see flashing lights, zigzagging lines, and blind spots. Other aura symptoms include:

• Numbness or tingling in the face or limbs
• Impairments or disturbances in taste, smell, or touch
• Weakness in the face or limbs
• Partial vision loss
• Changes in speech

About 30% of patients with migraine experience aura and it may not occur with every migraine.

Main stage

Also known as the headache stage, the main stage of a migraine is the actual severe head pain. Pain occurs on one side of the head but can move over the course of the migraine, which can last anywhere from 4-72 hours. The actual head pain can be throbbing, stabbing, burning, and/or drilling. Other symptoms felt during this stage include:

• Nausea
• Vomiting
• Giddiness
• Insomnia
• Nasal Congestion
• Anxiety
• Depressed Mood
• Neck pain and stiffness

Sensitivity to light, sound, smell, and even touch are also common during the main stage.

Postdrome

This stage occurs after the pain; many people will feel drained and almost hungover for hours to days after their migraine headache. During this phase, there may be decreased concentration and lack of comprehension. At times, some of the symptoms during this stage may be a reverse of those felt during prodrome – tiredness turns to energy and appetite swings in the opposite direction.

To learn more about migraines and how we may be able to treat your pain, book an appointment online or over the phone with Migraine and Headache Center of Florida today. 

*Individual recommendations may vary.