Migraine symptoms
Four distinct phases of migraine:
1. Prodrome
More than half of people who experience migraine report premonitory symptoms that occur hours to days before the headache. These prodromal symptoms tend to be unique to the sufferer and include: increased sensitivity to light, sound and odours; lethargy; food cravings; mood swings; excessive thirst and frequent urination and change in bowel habit (constipation or diarrhoea).
2. Aura
The migraine aura is a complex of neurological symptoms that may precede or accompany the headache phase or may occur in isolation. It usually develops over 5-20 minutes and lasts less than 60 minutes. The aura can be visual, sensory, or motor or any combination of these.
Visual auras - most common type of aura and usually commence with positive symptoms followed by negative symptoms. Positive symptoms may include an arc or band of absent vision with a shimmering or glittering zigzag border. It generally commences in the central vision and gradually enlarges and moves across the visual field before breaking up and resolving. Lights can appear to be flashes or other visual hallucinations may occur which may take various shapes or objects. Negative symptoms are an absence of area of visual field which could include complete blindness, tunnel vision, loss of right or left visual field, or a loss of central vision.
Sensory auras - occur in 40% of cases and positive symptoms include tingling, tickling, prickling, pricking, or burning (paresthesias) which can be followed by negative symptoms - numbness. Symptoms often start at the hand and travel up the arm, then travelling to the face, lips and tongue. Sensory auras rarely occur in isolation and usually follow visual auras. The rate of spread of the symptoms is useful in helping distinguish sensory auras from transient ischaemic attacks (TIAs) since it can take 10-20 minutes to spread, much longer than a TIA.
Motor symptoms - a sense of heaviness rather than true weakness they are often associated with sensory symptoms and occur in around 18% of patients.
Speech and language disturbances - have been reported in 17-20% of patients.
3. The headache
The migraine headache usually occurs when awake however it can rarely awaken patients at night. The character of the headache is usually "throbbing" however more than half of sufferers report that headaches can be non-throbbing during the attack. It is initially unilateral and usually localised over the forehead, temples or behind the eyes however the discomfort can be felt anywhere over the head or neck. The intensity of the pain typically builds over 1 to 2 hours and progresses to the back of the head and becomes more generalised. The pain intensity can be increased by movement or physical activity. The headache usually lasts between 4 hours and 3 days and the pain usually subsides gradually.
4. Postdromal symptoms
Postdromal symptoms may persist for 24 hours after the headache and can include the following: feeling tired; feeling unusually refreshed or euphoric; muscle weakness; reduced appetite or food cravings.
Other symptoms
Nausea occurs in around 80% of episodes and vomiting in around 50% of episodes. This is often associated with a reduced desire to eat and patients can appear pale and clammy. Photophobia, or light intolerance, and phonophobia, or sound intolerance, are also both commonly associated with the headache. Patient can often feel "light-headed" and dizzy. Rarely neurological symptoms can include: one sided muscle weakness (hemiparesis), inability to speak (aphasia), confusion or altered sensation.
Get frequent migraines? Act now!
If you or a member of your family suffer from frequent migraines then we may be able to help. Simply contact us to book an appointment for assessment and treatment at one of our clinics (or if you have any questions).
