Migraine

There are five distinct stages to a migraine, although not everyone goes through all the stages:

1. ‘Prodromal’ (pre-headache) stage. Some people experience changes in mood, energy levels, behaviour and appetite, and sometimes aches and pains several hours or days before an attack.

2. Aura. Some people experience a sensation, or aura, just before their migraine starts. Symptoms of aura include flashes of light or blind spots, difficulty focusing, and seeing things as if you are looking through a broken mirror. This stage normally lasts around 15 minutes to an hour.

3. Headache stage. This is usually a pulsating or throbbing pain on one side of the head. You usually have nausea or vomiting, and extreme sensitivity to bright light and loud sounds, with a strong desire to lie down in a darkened room. This stage lasts for four to 72 hours.

4. Resolution stage. Most attacks gradually fade away. Some people find the headache stops suddenly after they have been sick. Sleep often relieves the symptoms.

5. ‘Postdromal’ or recovery phase. There may be a stage of exhaustion and weakness afterwards.

Other symptoms commonly associated with a migraine are:

• nausea – you may feel queasy and sick; this may be followed by vomiting
• increased sensitivity – you may have photophobia (sensitivity to light), phonophobia (sensitivity to sound) and/or osmophobia (sensitivity to smells), which is why many people with a migraine want to rest in a quiet, dark room

Other symptoms can also occur during a migraine. These include:

• poor concentration
• sweating
• feeling very hot or very cold
• abdominal pain (which can sometimes cause diarrhoea)
• a frequent need to urinate

Not everyone experiences these symptoms when they have a migraine, and they do not usually all occur at once.

The symptoms accompanying migraine can last anywhere between four hours and three days. They will usually disappear when the headache goes.

You may feel very tired for up to seven days after a migraine attack.

About one third of people with migraines have warning symptoms, known as aura, before the migraine. These include:

• visual problems – you may see flashing lights, zigzag patterns or blind spots
• stiffness or a tingling sensation like pins and needles in your neck, shoulders or limbs
• problems with co-ordination – you may feel disoriented or off balance
• difficulty speaking
• loss of consciousness – this only happens in very rare cases

Aura symptoms typically start between 15 minutes and one hour before the headache begins. Some people may experience aura with only a mild headache.