Migraine Headaches
A migraine is much more than a bad headache. This neurological disease can cause debilitating throbbing pain that can leave you in bed for days! Movement, light, sound and other triggers may cause symptoms like pain, tiredness, nausea, visual disturbances, numbness and tingling, irritability, difficulty speaking, temporary loss of vision and many more.
What’s a migraine? What does a migraine feel like?
A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells. It may last at least four hours or even days. About 12% of Americans have this genetic disorder. Research shows that it’s the sixth most disabling disease in the world.
What are the types of migraines?
There are several types of migraines, and the same type may go by different names:
Migraine with aura (complicated migraine): Around 15% to 20% of people with migraine headaches experience an aura.
Migraine without aura (common migraine): This type of migraine headache strikes without the warning an aura may give you. The symptoms are the same, but that phase doesn’t happen.
Migraine without head pain: “Silent migraine” or “acephalgic migraine,” as this type is also known as, includes the aura symptom but not the headache that typically follows.
Hemiplegic migraine: You'll have temporary paralysis (hemiplegia) or neurological or sensory changes on one side of your body. The onset of the headache may be associated with temporary numbness, extreme weakness on one side of your body, a tingling sensation, a loss of sensation and dizziness or vision changes. Sometimes it includes head pain and sometimes it doesn’t.
Retinal migraine (ocular migraine): You may notice temporary, partial or complete loss of vision in one of your eyes, along with a dull ache behind the eye that may spread to the rest of your head. That vision loss may last a minute, or as long as months. You should always report a retinal migraine to a healthcare provider because it could be a sign of a more serious issue.
Chronic migraine: A chronic migraine is when a migraine occurs at least 15 days per month. The symptoms may change frequently, and so may the severity of the pain. Those who get chronic migraines might be using headache pain medications more than 10 to 15 days a month and that, unfortunately, can lead to headaches that happen even more frequently.
Migraine with brainstem aura. With this migraine, you'll have vertigo, slurred speech, double vision or loss of balance, which occur before the headache. The headache pain may affect the back of your head. These symptoms usually occur suddenly and can be associated with the inability to speak properly, ringing in the ears and vomiting.
Status migrainosus. This is a rare and severe type of migraine that can last longer than 72 hours. The headache pain and nausea can be extremely bad. Certain medications, or medication withdrawal, can cause you to have this type of migraine.
What are the four stages or phases of a migraine?
The four stages in chronological order are the prodrome (pre-monitory), aura, headache and postdrome. About 30% of people experience symptoms before their headache starts.
The phases are:
Prodrome: The first stage lasts a few hours, or it can last days. You may or may not experience it as it may not happen every time. Some know it as the “preheadache” or “premonitory” phase.
Aura: The aura phase can last as long as 60 minutes or as little as five. Most people don’t experience an aura, and some have both the aura and the headache at the same time.
Headache: About four hours to 72 hours is how long the headache lasts. The word “ache” doesn’t do the pain justice because sometimes it’s mild, but usually, it’s described as drilling, throbbing or you may feel the sensation of an icepick in your head. Typically it starts on one side of your head and then spreads to the other side.
Postdrome: The postdrome stage goes on for a day or two. It’s often called a migraine “hangover” and 80% of those who have migraines experience it.
Migraine symptoms
The primary symptom of migraine is a headache. Pain is sometimes described as pounding or throbbing. It can begin as a dull ache that develops into pulsing pain that is mild, moderate or severe. If left untreated, your headache pain will become moderate to severe. Pain can shift from one side of your head to the other, or it can affect the front of your head, the back of your head or feel like it’s affecting your whole head. Some people feel pain around their eye or temple, and sometimes in their face, sinuses, jaw or neck.
Other symptoms of migraine headaches include:
Sensitivity to light, noise and odors.
Nausea and vomiting, upset stomach and abdominal pain.
Loss of appetite.
Feeling very warm (sweating) or cold (chills).
Pale skin color (pallor).
Feeling tired.
Dizziness and blurred vision.
Tender scalp.
Diarrhea (rare).
Fever (rare).
Most migraines last about four hours, although severe ones can last much longer.
Each phase of the migraine attack can come with different symptoms:
Prodrome symptoms:
Problems concentrating.
Irritability and/or depression.
Difficulty speaking and reading.
Difficulty sleeping. Yawning.
Nausea.
Fatigue.
Sensitivity to light and sound.
Food cravings.
Increased urination.
Muscle stiffness.
Aura symptoms:
Numbness and tingling.
Visual disturbances. You might be seeing the world as if through a kaleidoscope, have blurry spots or see sparkles or lines.
Temporary loss of sight.
Weakness on one side of the body.
Speech changes.
Headache symptoms:
Neck pain, stiffness.
Depression, giddiness and/or anxiety.
Sensitivity to light, smell and sound.
Nasal congestion.
Insomnia.
Nausea and vomiting.
Postdrome symptoms:
Inability to concentrate.
Depressed mood.
Fatigue.
Lack of comprehension.
Euphoric mood.
When to seek care
Call 911 or go to an emergency department right away if:
You are experiencing the “worst headache of my life.”
You are having neurologic symptoms that you’ve never had before, including speaking difficulty, balance problems, vision problems, mental confusion, seizures or numbing/tingling sensations.
Your headache comes on suddenly.
You have a headache after experiencing a head injury.
Schedule a visit with your healthcare provider if:
The number or severity of your headaches increase or your headache pattern changes.
Your medications no longer seem to be working or you’re experiencing new or different side effects.
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