Updated: Jun 1, 2020
Migraine is not just a headache – the headache is only part of it. Migraines are attacks on the entire body. There are four stages to a migraine attack, leading up to the headache and for hours or days after the headache phase is gone. During these stages, strange, frightening and debilitating symptoms can occur significantly impacting the life of a migraineur.
First Stage – Prodrome
40 to 60% of people with migraines experience the prodrome phase, which can begin hours, or even days before the aura or headache stages. Symptoms can range from common symptoms like sensitivity to light, sound or smell, or problems concentrating, a stiff neck, or food cravings. This phase of the attack may involve unusual symptoms, like sneezing, yawning, increased urination, or even low-grade fevers. Mild to severe nausea and or vomiting can occur and continue through the next stages.
Second Stage – Aura
Around 30-35% of people who get migraines experience what is called “aura” that typically starts 30-60 minutes before the headache stage and then goes away once the headache begins. Visual auras are the most common, but other aura symptoms can be felt throughout the body. The visual disturbances can range from sparkly lights, lines across the field of vision, blind spots, jagged/zig-zag lines, and temporary partial or complete blindness. Other aura symptoms can include numbness or muscle weakness on one side of the body or tingling on the hands or face. Additionally, confusion or difficulty speaking can occur, making people think we are having a stroke.
Third Stage – Headache
This stage of the attack is usually what people think of when they think of the “headache” involved with migraines. However, it is nothing like a typical headache. This head pain can be extremely debilitating as it is intense and can last from several hours to three or more days. The pain is usually one-sided, pulsing, throbbing, or very sharp and worsens with physical activity. Symptoms from the prodrome may continue during this stage, including sensitivity to light, sound and smells, and nausea or vomiting.
Fourth Stage – Postdrome
This stage of the attack usually occurs after the headache subsides, lasting a day or two, and can be as debilitating as any of the other stages. It is often called the “hangover” phase, and 80% of migraineurs go through it at some level. Fatigue, body aches, trouble concentrating, dizziness, and sometimes sadness or depression can be part of this stage. Some people describe it as feeling like they have the flu.
After reading this, I hope you understand that migraines are full-body attacks that can last for days. And when someone has frequent migraines, sometimes these symptoms blend together so much that we don’t always know if a symptom is part of the beginning or is signifying the end of a migraine attack. It can be very unsettling and discouraging to feel so disabled, and this can lead to mental struggles, which we will address in part three of this series.