4 Phases of a Migraine Attack

Migraines can be broken down into 4 phases:

  1. Prodromal phase
  2. Aura phase
  3. Attack phase
  4. Postdromal phase

1.Prodromal phase (early warning)

The prodrome phase can occur hours or days before the Migraine itself.

About 60% of those with migraines will experience this phase.

During the prodrome phase, a person may experience the following: Anxiety, unexplained energy or feelings of euphoria, irritability, difficulty concentrating, food cravings, sensitivity to smells or noise, fatigue with frequent yawning.

2. Aura Phase (pre-migraine)

The aura phase occurs in classic migraines (now referred to as Migraine with aura), but not in common migraines (now referred to as Migraine without aura).

It typically happens about an hour before to right when the headache strikes. Most aura symptoms last between 15 and 60 minutes, but some Migraineurs observe aura manifestations continuing into the attack.

About 20% of those with migraines experience this phase, but not necessarily with each migraine.

The aura can be characterized by the appearance of flashes, specks, zigzag lines, stars, or shimmering areas. Blind spots or tunnel vision may also occur. Less common auras involve speech disturbances, confusion, tingling or numbness, weakness of the limbs, and confusion.

3. Attack Phase (Also called headache phase)

The Migraine attack phase itself lasts for hours up to several days.

It is characterized by throbbing or pulsing pain ranging from mild to severe, often on one side but sometimes both sides of the head. Most people experience nausea, with or without vomiting. Extreme sensitivity to light and noise is also common. Faintness, numbness, diarrhea, a stiff or tender neck, aversion to food may also occur.

4. Postdromal phase (after headache)

Postdromes generally follow migraines that are long in duration. During the postdrome phase, which occurs after the migraine attack has subsided, a person often feels extreme fatigue, sluggishness, poor concentration, irritability, lowered mood levels, or feelings of well-being.

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