Brain & Nervous System Migraines Symptoms Migraine Guide Migraine Guide Symptoms Causes Diagnosis Treatment Prevention Coping Symptoms of a Migraine The Symptoms and Stages of a Migraine Attack By Teri Robert linkedin Teri Robert is a writer, patient educator, and patient advocate focused on migraine and headaches. Learn about our editorial process Teri Robert Medically reviewed by Medically reviewed by Nicholas R. Metrus, MD on September 22, 2020 linkedin Nicholas R. Metrus, MD, is a board-certified neurologist and neuro-oncologist. He currently serves at the Glasser Brain Tumor Center in Summit, New Jersey. Learn about our Medical Review Board Nicholas R. Metrus, MD on September 22, 2020 Print Table of Contents View All Frequent Symptoms Rare Symptoms Complications/Sub-Groups When to See a Doctor Next in Migraine Guide Causes and Risk Factors of Migraine While migraines are commonly thought of as just bad headaches, they often involve other symptoms as well. You can experience up to four phases during a migraine episode, each of which can be recognized by its own set of characteristics. Your migraine attacks may not all be exactly the same, but recognizing the range of symptoms that can occur can help tip you off as to if what you're experiencing could be a migraine. If you're already diagnosed, knowing where these symptoms fit into the typical sequence of stages can help you decide when to take your medication. Migraines may result in medication-related complications, and rarely, a migraine can induce a serious health complication. Other conditions, such as transient ischemic attack (TIA) and multiple sclerosis (MS) can produce symptoms similar to those of a migraine, so you may need to seek medical attention if you have any warning signs. Illustration by Cindy Chung, Verywell. Frequent Symptoms Migraine episodes can include several stages: prodome, aura, headache, and postdrome. You may cycle through all of these phases when you have a migraine, or you might experience just one, two, or three of them. The headache phase is the most common, while the aura is the least common. Prodrome The prodrome is characterized by premonitory symptoms of an impending migraine and it can begin hours or days before a migraine episode reaches its peak intensity. Most people with migraine experience prodromal symptoms, and taking migraine medication during this stage may stop the episode from progressing. Typical symptoms during a prodrome are: Food cravingsConstipation or diarrheaMood changes: sadness, irritability, anxietyMuscle stiffness or soreness, especially in the neckFatigueExcessive yawningNauseaFluid retention, bloatingIncreased frequency of urinationDifficulty concentratingVivid dreamsSensitivity to light, sounds, or smellsFeeling cold Aura Approximately one-third of migraineurs experience aura, which usually follows the prodrome and lasts for less than an hour. This stage is characterized by neurological symptoms, and it can be quite terrifying, especially when you experience it for the first time. Symptoms of a migraine aura can include: Visual changes: flashing lights, wavy lines, spots, partial loss of vision, blind spot, blurry visionTingling, numbness, or hypersensitivity of the face or extremitiesVertigo (a sense that the room is spinning)Difficulty finding words and/or speakingConfusionPartial paralysisOlfactory hallucinations (smelling odors that aren't there)Auditory hallucinations (hearing things that are not there)A decrease or loss of hearing An Overview of Migraine With Aura Headache The head pain of a migraine is often described as throbbing, pounding, or pulsating. You may also experience other symptoms along with the head pain. This phase usually lasts from four to 72 hours. Common characteristics of the headache phase may include: Hemicranial (on one side of the head) pain that can shift to the other side or become bilateralPhonophobia (sensitivity to sound)Photophobia (sensitivity to light)Nausea and vomitingDiarrhea or constipationNasal congestion and/or runny noseSadness or anxietyHot flashes and chillsDizzinessDehydration or fluid retention Migraine effects are not limited to the head and often affect the neck, shoulders, arms, or the entire body. The symptoms are often worsened by activities such as walking, riding in a car, or exercising. Postdrome After the most intense phase of a migraine, you may experience a postdrome before your migraine attack is completely over. The symptoms of postdrome include: FatigueMood changes, which can include sadness, anxiety, or elevated moodMuscle achesDizziness or lightheadednessDifficulty concentratingStiff neckScalp tenderness Many people describe postdrome as feeling "like a zombie" or hungover. Postdromal symptoms can be associated with abnormal cerebral blood flow and electroencephalogram (EEG) patterns for up to 24 hours after the end of the headache stage. Even if you do not experience the headache stage, you may still experience a postdrome phase. Concurrent Phases Migraine stages may overlap, sometimes with the aura occurring at the same time as the prodrome, headache, or postdrome. Prodromal symptoms may linger even as the headache peaks, and postdromal symptoms can begin before the headache starts to resolve. Childhood Migraines Children also experience migraines, and the symptoms can differ from those of adults. If you note the following symptoms in your child, migraines may be the cause, especially if your child has a family history of the condition: StomachacheNauseaDizzinessMotion sicknessMoodinessExcessive sleepiness Be sure to discuss these symptoms with your doctor. They could be signs of another medical condition, but if migraines are the cause, your child can take medication to help prevent and treat episodes. When Children Have Migraines Rare Symptoms Rare symptoms are typically associated with migraine subtypes, and while they may be similar to a migraine aura, the main difference is that these unusual symptoms are usually the most prominent aspect of the migraine episodes. Weakness Weakness, typically in one arm, occurs with hemiplegic migraine. If you have hemiplegic migraines, you may also experience several migraine stages and other aura symptoms. There is a strong hereditary tendency to develop this type of migraine. Stomachaches More common in children than adults, abdominal migraine is characterized by stomachaches that occur without a gastrointestinal cause and may involve nausea and vomiting. Paralysis of Eye Movement Double vision, blurred vision, a droopy eyelid, or an obvious inability to move one eye can be a sign of ophthalmoplegic migraine. Absent Headache Although not very common, you can have a migraine aura without a headache. There are several terms used to describe this experience, including "silent migraine," "sans-migraine," and "migraine equivalent." When There's No Headache, Is It Still a Migraine? Complications/ Sub-Group Indications Migraines do not typically cause complications, although they can. The most common complications are related to medication use. Medication Effects Side effects of overuse can include stomach pain and gastrointestinal bleeding from taking high doses of nonsteroidal anti-inflammatories (NSAIDs). Other medications, including triptans and ergot medications, can cause side effects such as dizziness, tingling, or even vascular complications when taken at higher doses than directed. Keep in mind that all medications—whether over-the-counter or prescription— can cause side effects even at recommended doses. Medication rebound headaches or medication withdrawal headaches can occur when you take migraine medications at high doses or for a prolonged time and then abruptly stop. Be sure to discuss a medication plan with your doctor—and if it isn't working, then discuss another plan instead of taking extra medication to deal with your migraines. Medications That Cause Overuse Headaches Migraine Complications Complications from a migraine itself include some serious concerns that require medical attention: Status migrainosus: If your migraine lasts longer than 72 hours despite treatment, it's termed status migrainosus, a condition that is unlikely to resolve with your regular prescription. You should seek medical attention because you may need treatment with intravenous (IV) medication. Migrainous infarction: An infarction in the brain is a type of stroke caused by lack of blood flow. A migrainous infarction begins with migraine symptoms that can eventually involve stroke symptoms and may produce permanent neurological effects. Seizure: A convulsive episode that may be characterized by involuntary shaking or jerking may occur as a result of a migraine. The physiological reason for this complication is not well understood. Migraine Complications When to See a Doctor/Go to the Hospital Migraines do not normally require emergency medical attention. The treatment is really based on a plan for both prevention and treatment of acute attacks. Nevertheless, when you are not sure if your symptoms are caused by a migraine, or when your migraine pattern changes, you need to seek medical attention. Urgent Medical Care Symptoms such as paralysis, loss of sensation, difficulty communicating, loss of vision, and double vision can all be manifestations of a stroke, MS, meningitis, seizures, and other neurological illnesses. If you experience any of these rare symptoms and they have not been attributed to migraines (or if you're unsure of their connection), then you should get prompt medical attention. Even if you have a diagnosis of migraines, you should have a medical evaluation if your headaches occur with certain features, including: The worst headache of your lifeFeversRecurrent vomiting/can't keep anything downHead traumaFalling/ inability to balance Talk to Your Doctor If your migraine pattern changes in frequency or intensity or if your symptoms change, you should talk to your doctor. You may need a diagnostic evaluation or a change in your treatment plan. What Are the Causes and Risk Factors of Migraine? Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Migraine Foundation. The Timeline of a Migraine Attack. 2018. Dodick DW. A Phase-by-Phase Review of Migraine Pathophysiology. Headache. 2018;58 Suppl 1:4-16. doi:10.1111/head.13300 Cao Z, Lin CT, Chuang CH, et al. Resting-state EEG power and coherence vary between migraine phases. J Headache Pain. 2016;17(1):102. doi:10.1177/0271678X17729783 American Academy of Pediatrics. Migraine Headaches in Children. Updated May 17, 2016. American Migraine Foundation. Sporadic and Familial Hemiplegic Migraine. 2017. Kaniecki R. National Headache Foundation. Case Studies Issue: Status Migrainosus. Migraine. Merck Manual Professional Version. Updated June 2018. Additional Reading Hansen JM, Schankin CJ. Cerebral hemodynamics in the different phases of migraine and cluster headache. J Cereb Blood Flow Metab. 2017;1:271678X17729783. doi:10.1177/0271678X17729783 Irwin S, Barmherzig R, Gelfand A. Recurrent Gastrointestinal Disturbance: Abdominal Migraine and Cyclic Vomiting Syndrome. Curr Neurol Neurosci Rep. 2017;17(3):21. doi:10.1007/s11910-017-0731-4