The prodrome phase can occur hours or days before the Migraine itself.
Prodromal symptoms may be rather vague and non-specific, but often the patient can identify those symptoms; euphoria, depression, hyperactivity, lethargy, food cravings, loss of appetite, yawning, sensitivity to light and/or sound ecc.
2. Aura Phase (pre-migraine)
There are two main types of migraines: common (no aura) and classical (has an aura). An aura is usually a visual phenomenon that proceeds the headache. It has been described as flashing lights, blind spots or shapes in the patients field of view. All auras are not visual, it can be associated with motor or sensory problems as well. While the majority of migraineurs experience prodrome with their headache attacks, only 20-25% ever will experience aura.
3. Attack Phase (headache phase)
headache phase 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.
4. Postdromal phase
Postdrome, consists of lingering symptoms that resemble a hangover or flu-like symptoms. Postdromes generally follow migraines that are long in duration. Postdrome symptoms may include: fatigue, poor concentration, irritability, lowered mood levels, or feelings of well-being, queasy stomach, and tender muscles.
Pathophysiology of migraine
Regarding the pathophysiology of migraine traditionally the vascular theory, according to which arterial vessels in the head first constrict reducing blood flow to the brain, then over-compensate and dilate causing a “rush” of blood leading to the throbbing pain associated with most migraines.
This process of constriction and dilation is thought to be controled to some extent in the brain by serotonin.