Migraine attacks are often described as a series of phases, each presenting its own set of symptoms and challenges. Understanding these stages can help migraine sufferers better manage their condition and prepare for the onset of an attack. While not everyone experiences all stages, and some may have overlapping or more severe symptoms, the typical migraine attack progresses through four distinct stages:
Prodrome (Pre-Migraine Stage)
The prodrome phase occurs 24 to 48 hours before the actual migraine attack and serves as a warning sign. During this stage, individuals may experience subtle symptoms that indicate a migraine is coming. Common symptoms include:
- Fatigue or irritability
- Food cravings or loss of appetite
- Sensitivity to light or sound
- Neck stiffness
- Yawning
- Mood changes (e.g., depression or euphoria)
Not everyone experiences the prodrome phase, but recognising these early signs can help individuals take steps to prevent or manage the attack. For example, some might begin treatment during the prodrome phase to reduce the severity of the migraine.
Aura (Not Present for All Migraines)
The aura stage typically occurs just before or during the early onset of a migraine. It can last anywhere from 5 minutes to an hour, and not all migraine sufferers experience it. Aura symptoms are neurological and are often visual in nature, although they can also involve other senses. Common aura symptoms include:
- Visual disturbances (e.g., flashing lights, zigzag patterns, blind spots)
- Numbness or tingling sensations in the face or extremities
- Difficulty speaking or understanding language
- Dizziness or light headedness
Aura is more common in individuals who experience "classic" migraines. However, many people suffer from migraines without an aura (referred to as "common" migraines).
Headache (Pain Phase)
The headache phase is the hallmark of a migraine and typically lasts anywhere from 4 hours to 72 hours, although it can vary in intensity and duration. Migraines often begin on one side of the head but can spread across both sides. The pain is usually described as intense, throbbing, or pulsating and may worsen with physical activity or movement. Other symptoms that often accompany this phase include:
- Nausea and vomiting
- Sensitivity to light (photophobia) and sound (phonophobia)
- Blurred vision
- Dizziness
- Increased pain with physical activity
During this phase, sufferers may need to retreat to a dark, quiet room and rest to reduce symptoms.
Postdrome (Migraine Hangover)
Once the headache subsides, the postdrome phase occurs. This phase can last up to 24 hours and is often referred to as a “migraine hangover.” Though the pain may be gone, migraine sufferers often still experience lingering symptoms, including:
- Fatigue and weakness
- Difficulty concentrating or thinking clearly (often referred to as "brain fog")
- Mood disturbances (e.g., feeling drained, irritated, or depressed)
- Mild sensitivity to light or sound
The postdrome phase is often a time of recovery, and individuals may need to rest and rehydrate as they regain their energy.
Managing Each Stage of a Migraine
Understanding the four stages of a migraine is crucial in managing the condition. Early intervention during the prodrome phase, such as resting or taking prescribed medications, can potentially reduce the severity of the headache phase. During the headache, finding relief through rest, hydration, and medication is essential. And finally, giving the body time to recover in the postdrome phase will help speed up the return to normal activities.
This blog is not written by a medical professional and should not be considered to be medical advice nor should replace medical advice from a trained professional. Please seek advice from a medical professional should you be suffering from migraines or any other medical conditions.