For those that do not know I have suffered with migraines since 1990. Migraine is a genetic neurological disease that effects 36 million people in this country. It is not just a headache. Migraine happens in 4 phases. Prodrome, Aura, Headache, and Postdrome.
Phase 1: Prodrome:
The prodrome is the first potential phase of a Migraine attack, and it can begin hours or days before other phases. It’s sometimes called “preheadache” or “premonitory phase.” Between 30% and 40% of Migraineurs experience the prodrome, and for those Migraineurs, it can be very helpful because it can serve as a yellow light of sorts, a warning that an attack is coming. Once you know what some of the prodrome symptoms are, you may find that you experience it, but never realized it.
Possible prodrome symptoms include:
- aphasia: difficulty finding words and / or speaking
- constipation or diarrhea
- difficulty concentrating
- excessive yawning
- fatigue
- food cravings
- hyperactivity
- increased frequency of urination
- mood changes — feeling depressed, irritable, etc.
- neck pain
- sleepiness
Phase 2: Aura
Even though it’s experienced by only about 25% of Migraineurs, the Migraine aura may be the most often discussed phases of the Migraine attack. The possible visual symptoms are the best known, but there are many possible symptoms, visual and others. Migraine aura can also serve as a warning and, in some cases, allow Migraineurs to treat the Migraine early enough to stop it before it progresses to the headache phase.
The possible symptoms of Migraine aura include:
- Alice in Wonderland Syndrome: a rare form of Migraine aura in which the distinctive symptom is a type of metamorphosia, a distortion of body image and perspective, which Migraineurs know, while it’s occurring is not real. “Alice in Wonderland” syndrome can occur at any age, but it is more commonly experienced by children.
- allodynia: hypersensitivity to feel and touch to the point that what would be “normal” is painful
- aphasia
- auditory hallucinations: hearing sounds that aren’t actually present
- confusion
- decrease in or loss of hearing
- dizziness
- hemiplegia: one-sided paralysis (occurs in hemiplegic Migraine only)
- olfactory hallucinations: smelling odors that aren’t actually present
- one-sided motor weakness (occurs in hemiplegic Migraine only)
- parasthesia: prickling, stinging, burning, numbness, and / or tingling, usually of the extremities or face
- vertigo: sensation of whirling or spinning, not to be confused with dizziness
- visual:
- wavy lines (sometimes described as “looking like heat rising from pavement”)
- “blank” or tiny blind spots
- blurry vision
- partial loss of sight
- phosphenes: brief flashes of light that streak across the visual field
- scotoma: an area of decreased or lost vision. Some people describe scotoma as being like having tiny blank spots in their vision. Some compare it to tiny snowflakes.
- unilateral (one-sided) (occurs in retinal Migraine only)
This photo is a great example of what it looks like when I look at a book if I am in the Aura stage of a migraine. I sometimes also see little silver things swimming across my eyes and have numbness in my face.
Phase 3: Headache
The symptoms of the headache phase are frequently, but not always, the most debilitating of a Migraine attack. It’s important to note that symptoms are not limited to the head; they may affect other parts of the body as well. The pain of the headache phase can range from mild to severe, which can lead people with mild pain to not recognize that they’re having a Migraine. A Migraine attack can occur without the headache phase. When that occurs, the descriptive terms “acephalgic” or “silent” are applied (i.e. acephalgic Migraine without aura, acephalgic Migraine with aura, acephalgic basilar-type Migraine, etc.).
Symptoms and characteristics of the headache phase may include:
- headache
- frequently unilateral (one-sided). The headache can shift from one side to the other, become bilateral (on both sides), or be bilateral entirely
- often pulsating or throbbing
- worsened by physical activity
- duration of four to 72 hours in adults, one to 72 hours in children
- Because the trigeminal nerve becomes inflamed during a Migraine, and because of its location, pain may occur around eyes, in the sinus area, and the teeth and jaw.
- confusion
- dehydration
- dizziness
- depression, anxiety, panic
- diarrhea or constipation
- fluid retention
- hot flashes and / or chills
- nasal congestion and / or runny nose
- nausea and / or vomiting
- neck pain
- osmophobia (heightened sensitivity to odors)
- phonophobia (heightened sensitivity to sound)
- photophobia (heightened sensitivity to light)
- vertigo
Phase 4: Postdrome
Many people mention feeling “hung-over” after a Migraine. This is often actually part of the Migraine, the postdrome. Most Migraineurs have some symptoms after the headache phase, symptoms that may last hours or even a couple of days.
Postdrome symptoms may include:
- fatigue
- lowered intellect levels
- lowered mood levels, especially depression, or feelings of well-being and euphoria
- poor concentration and comprehension
Migraine symptoms can be unpredictable. Not all Migraineurs experience all four phases of a Migraine attack. A person’s Migraine attacks can vary from one to the next, both in regard to which phases they experience and which symptoms they experience. People who have no issues with depression, anxiety, or panic at other times can experience any of them during a Migraine, as a symptom of the Migraine attack.
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