Migraine 

Introduction 

Stages of migraine

There are five distinct stages to a migraine, although not everyone goes through all the stages:

1. 'Prodromal' (pre-headache) stage. Some people experience changes in mood, energy levels, behaviour and appetite, and sometimes aches and pains several hours or days before an attack.

2. Aura. Some people experience a sensation, or aura, just before their migraine starts. Symptoms of aura include flashes of light or blind spots, difficulty focusing, and seeing things as if you are looking through a broken mirror. This stage normally lasts around 15 minutes to an hour.

3. Headache stage. This is usually a pulsating or throbbing pain on one side of the head. You usually have nausea or vomiting, and extreme sensitivity to bright light and loud sounds, with a strong desire to lie down in a darkened room. This stage lasts for four to 72 hours.

4. Resolution stage. Most attacks gradually fade away. Some people find the headache stops suddenly after they have been sick. Sleep often relieves the symptoms.

5. 'Postdromal' or recovery phase. There may be a stage of exhaustion and weakness afterwards.

A migraine is a severe headache usually felt as a throbbing pain at the front or on one side of the head.

Some people also have other symptoms, such as nausea and sensitivity to light.

Migraine is a common health condition, affecting about 15% of adults in the UK.

There are two types of migraine:

  • Migraine with aura is when there is a warning sign, known as aura, before the migraine begins. About a third of people with migraine have this. Warning signs may include visual problems (such as flashing lights) and stiffness in the neck, shoulders or limbs.
  • Migraine without aura 

Learn more in symptoms of migraine.

There are five stages to a migraine (see box, left), although not everyone will experience all of these.

Who is affected by migraines?

Migraines affect one in four women and one in 12 men in the UK.

Hormones may be the reason why migraines affect more women than men. For example, some women find that migraine attacks are more frequent around the time of their period. However, this association has not been proven.

Migraines usually begin in young adults. About 9 in 10 have their first migraine before they are 40 years old. However, it is possible for migraines to begin later in life.

How often do they occur?

Everyone will experience migraines differently. Some people have attacks frequently, up to several times a week. Other people only have a migraine occasionally. It is possible for years to pass between migraine attacks.

Some people find that migraine attacks are associated with certain triggers, which can include stress and certain foods. Learn more in causes of migraine.

Outlook

Migraines can severely affect your quality of life. During and after a migraine, some people need to stay in bed for days at a time.

However, there are effective treatments, and methods that can help to prevent migraines. Most people find ways of managing their migraines so that there is little disruption to their lives. Learn more in treatment for migraine.

Last reviewed: 14/05/2012

Next review due: 14/05/2014

Comments

20 Comments

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Comments are personal views. Any information they give has not been checked and may not be accurate.

James Ingram said on 20 April 2012

I have just had a migrain. Luckily i was able to catch it early on and prevent it from getting much worse, by using some strong pain killers. I keep them with me at all times as it is the only medication that has worked so far.

The medication was described for a severe pain after damaging my AC joint n an accident. I know i should not use this prescribed medication for this as it is not the intended use, but when i run out, i plan to go to my GP and explain the situation with the migrains, then ask for some more.

Causes:
I have just started going to the gym and using whey protein powder. I believe this to be a cause of my migrains as i have had two this week, compared to having 1 every 3-6 months.

I have also been told that full fat milk and processed foods can cause them.

There are also other factors such as tiredness, stress, dehidration and too much strong coffee.

These are just some of my suggestions based on experience, and so may just be specific to me.

Symptoms:
I usually start by having blind spots in my vision which start off very small and grow over a short period of time.
If i get a full blown migrain, symtoms go on to include severe headaches, vomiting and the inability to articulate how i am feeling to others. Sometimes i am also unable to recoginse written or spoken language. I often have to plan what i am going to say, and plan it in my head several times before i try to say it. Even then i'm not sure if it sounds right.

Thanks to the others here for sharing you experiences and i hope mine help some of you too.

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GB2310 said on 04 December 2011

In reply to Barnacle's: I have suffered from what I call migraines all my life (I am now 76). However according to the above "A migraine is a severe headache ..." (and to Wikipedia) I don't. I have never had any sort of headache..."
Your case is similar to mine, although I'm 55. So you are not alone but I am also concerned about whether my diagnosis is correct.
Suffice to say, these messages do not offer expert advice so I also question their use.

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mfjackson said on 16 November 2011

Im now 21 and from what ive been told, experiencing and read seems to be varied, but at the same time seems similarities do accur. Its seems that im having my first migraine attack, and from i've gathered, they can last upto 3 days, this has lasted upto almost a week. But some symptoms do not accur like what over have said so could it be more? like others, i get what is called an "aura", it comes very fast with my lower jaw going through what can only be described as extremely painful, vision in my right eye goes blurry, then comes the extrememly painful headache... what is most worrying is its at its most intense when i am sitting or lieing down, and will only go until ive stood up for a while. Does anybody else experience severe toothache and what to me seems like an attack when sat or lay down ???

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freshfuit said on 06 November 2011

I keep reading in reputable sources (as above) that the "headache stage" lasts up to 72 hours. However, this stage has often lasted up to five days for me. Does anyone else have this experience?

My migraines first started when I was in my mid-20s. They have gone through various changes since that time (I’m now 34). The attacks can be presaged by an aura or may just hit me out of the blue. If I catch it immediately, aspirin, paracetamol or ibuprofen are enough to completely avoid the attack. If I don't, or if I wake up with it, then the chance is gone. My triggers used to be certain cheeses, nuts, chocolate and wine, as well as not eating as soon as I felt hungry. Now, the triggers seem to be lack of sleep and/or stress. I spend most of the headache stage lying in a dark room, sleeping. For the first two or so days, I throw up everything I eat – I basically fight hunger and nausea in equal measure. This is a relatively new addition to my attacks. After the pain finally recedes, I experience about two days of postdrome, involving complete exhaustion. Again, this is new. It is used to be that the headache stage lasted a full five days, and ended with a euphoric feeling. These days, the attacks tend to last about three days and end with feeling grey, drained and exhausted.

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jessicalauren said on 28 July 2011

I've suffered from migraines since I was four and they started to get worse as I grew older, I was violently sick and I used to have to lie on the bathroom tiles for a few hours till it eased. I went to see my GP and she advised using mefenamic acid, I just take 2 when the migraine starts, she also prescribed me some tablets for the sickness called buccal tablets which I place on my gum when I'm sick. They work fine and I notice that I'm not worrying when I'm going to have another attack.

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Lynzy265 said on 22 July 2011

I have suffered with classic migraines since I was 8 years old. I've recently devoloped an over active thyroid which seems to have increased my attacks. I used to get them once every year or two. I've now had 1 a week for the past month. I've noticed that in the 2 or 3 days before I get a migraine I start to feel lethargic, my speech slurs and I get a tingling sensation down the left side of my head. Does anyone else experience these early warning signs? And is there anything I can do to stop the migraine from surfacing? Wouldn't that be nice!!

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barnacle said on 12 July 2011

I have suffered from what I call migraines all my life (I am now 76). However according to the above "A migraine is a severe headache ..." (and to Wikipedia) I don't. I have never had any sort of headache with my migraines so I must be very lucky or perhaps it's something else. However I do have a pronounced visual aura consisting of a scintillating curved zigzag in my visual field and a reduction in peripheral vision rather like a grey cloud. It all lasts about 30 mins with no other affects although it is rather unpleasant. I find it difficult to concentrate while I have an attack but not seriously - I completed this comment while having one. Is it a migraine? If so, then some of the information available is rather misleading. I am a little concerned because my frequency of migraines has greatly increased in the last six months and I should like to know why.

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kizzy231 said on 19 May 2011

i've been having migraines on and off for about 10 yrs,now i know when its about to start cos i feel a little throbbing on the right side of my head and i take some medication. unfortunately sometimes i dont realize on time and thats when i feel like blowing my head off.i always end up in my room with all the lights off and curtains drawn,even the little light from my alarm clock is very annoying.i know it may sound embarassing but sometimes i cry while waiting for the drugs to take effect.my saliva seems to be much thicker when i have my spells. i really hate it cos it makes me very unproductive and grumpy.i always feel like a new person when it stops. its a bit of a relief to know theres other people out there with the same problem. good luck to us all

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pinkmoon77 said on 15 April 2011

My 1st Migraine was when I was 17. I didn't have another until I was 24. They since have progressed to up to 5/6 a month. I suffer Migraine with aura. I get the flashes of light in my eyes, followed by blurred spots within the flashes folloiwed by tunnel vision. It usually takes one eye out 1st. I know it will be a bad ione if both eyes go. Within 30 mins, the pain on usually one side of my head is excrutiating. If both eyes have gone then the whole of my head feels awful. Paracetamol dont touch the sides. I used to take codiene but again, they partially dulled it. I was prescribed Zomig (A triptan) but then found out by taking it that I am allegic to triptans so it was a case of I am well and truely stuck in a hellhole here. I should add here that when I was taking paracetamol with codiene, I had to make sure that I took the tablets as soon as my eyes went otherwise, I lose feeling in my left hand, which travels up my left arm and then my speech becomes defected. Im really in trouble then. I was at the age of 31 eventually listened to and prescribed betablockers (Atenol) which really wiped me out and did nothing for my attacks. I am now 33 and under a neurologist and see them every 6 months. I have been taking Topirimate (Topimax) for the last 12 months. These are anti epileptic tablets which are licensed for my type of attacks. I have to be assessed every 6 mths due to adverse side effects they can have but.. I have to say, my attacks have declined in numbers and If I have one, a simple couple of paracetamol help. This medication I take each day. This was progressive and worth it even though the 1st 8 weeks on them was tough becuase they can make you feel down too. I know when I will get an attack these days unless I get a surprise... I dont have sugar in anything such as tea so if I wake up thinking I'll have a brew and go for the sugar.
This medication has made life bearable again.....

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Virgo4 said on 23 March 2011

I have suffered almost the same as Lumier. I had one to two migraines per year until two years ago and now they are happening almost every month sometimes more than one in a month. I get a blind spot , then a zigzag (can be in either eye) , limited vision for 30 mins then after this clears, a very painful pounding head plus nausea ....hate it.

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lumier said on 28 February 2011

I have silent migraine for 20 years it starts with a zigzag in my right eye within half an hour my right hand is numb my lips are numb and I lose my periferal vision. I can cope with this, its the dibilitating feeling I get for 2-3 days afterwards, the lethargy and almost depresion like feeling that really gets me down, I end up in bed for 2 days just because I feel so tired. I used to get them on average three times a year but for the past 2 years they are happening every month. I have always taking triptans as a cure but they cause me to feel hypersensative to heat and cold ie having to drink luke warm tea or water. Does any one else find this. I am so pleased Ihave found other people who have the same symptoms, it good to know that its not uncommon

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cazamerline said on 14 February 2011

I suffer with between 2-3 migraines a month now controlled by various medications. I suppose that I am fortunate that I suffer from visual auras (I lose my peripheral vision in my left eye and get zigzag lines and patterns) about 15-30 minutes before the attack will begin so I am able to get home/lie down and take my tablets before it gets worse and hopefully quell the attack before it starts (sometimes it works, sometimes it doesn't). I find it incredibly debilitating and am usually out of action for several hours at a time, the worst attack I had lasted for nearly 48 hours. I find the worst thing is people who know nothing about migraines and assume that a migraine is just a bad headache and cannot fathom why I cannot go to work, or why I have to leave work before the attack starts.

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ElleEff said on 28 January 2011

I suffer from silent migrane but I am also very sensitive to bright lights especially fluorescent which make me file quite ill. A couple of years ago I developed a slight visual impairment brought on by a migrane headache damaged some blood vessels in my brain after the spasm of the headache had released. Impairment is now there constantly but if I have a silent migrane it opens up from this visual impairment. Also noticed when awakening from dreams (which are vivid to say the least) that they close down into the same visual impairment. Could it be that the part of the brain which causes us to have migrane if awake causes us to dream if asleep. Could it be whilst in rem sleep the brain reacts differently and produces complicated dreams that it is unable to do whilst we are awake and when the dream part of the brain is activated if we are awakened the brain cannot deal with it and goes into spasm causing a migrane?

I would be interested to have some feedback on this theory.

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TankGirl said on 03 November 2010

Gardener74, yes like yourself I have experienced repeated auras - I think these tend to happen when I have not responded quickly to the first one. I get really angry and frustrated when this happens! I find it imperitive to swiftly ensure that all triggers are removed or avoided as soon as the first aura begins. For me, this means stopping whatever I was doing, taking painkillers and going to sleep in a dark room. My main trigger is contrasts of light - bright chinks around the edges of curtains or blinds or sudden glares of sun, particularly when driving, as the sun reflects off other cars or creates flashes of dappled light through trees at the side of the road. I find wearing polarized sunglasses really helps cut this glare and, after a particularly scary episode when I instantaneously lost most of my vision whilst driving, I now never go out in my car without them. I agree that the sense of unreality is very disturbing as are visual disturbances and I sometimes get quite irrational in my thoughts when I am experiencing a migraine but it is important to remember that these are only ever temporary sensations and you will recover each time.
If dehydration or overheating is a trigger, I find electrolyte powders (such as Dioralyte) are a very effective remedy.

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TankGirl said on 03 November 2010

Gardener74, yes like yourself I have experienced repeated auras - I think these tend to happen when I have not responded quickly to the first one. I get really angry and frustrated when this happens! I find it imperitive to swiftly ensure that all triggers are removed or avoided as soon as the first aura begins. For me, this means stopping whatever I was doing, taking painkillers and going to sleep in a dark room. My main trigger is contrasts of light - bright chinks around the edges of curtains or blinds or sudden glares of sun, particularly when driving, as the sun reflects off other cars or creates flashes of dappled light through trees at the side of the road. I find wearing polarized sunglasses really helps cut this glare and, after a particularly scary episode when I instantaneously lost most of my vision whilst driving, I now never go out in my car without them. I agree that the sense of unreality is very disturbing as are visual disturbances and I sometimes get quite irrational in my thoughts when I am experiencing a migraine but it is important to remember that these are only ever temporary sensations and you will recover each time.
If dehydration or overheating is a trigger, I find electrolyte powders (such as Dioralyte) are a very effective remedy.

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JJ101 said on 03 November 2010

For Gardener74 I have had migraines with multiple aura's, and the way you describe them is just the same for me. Usually I have just one aura and once that goes I get the headache but on a couple of occasions one aura has finished for another to start in 5 minutes, recently I had about 4 aura's one after the other, it left me off my feet for several days. Stress is a common cause of migraine, and getting stress out when an aura appears in my experience makes the symptoms much worse - I've found the best action is to sit somewhere dark and quiet with eyes closed and relax, concentrate on your breathing and staying calm - by doing this it has definitely reduced the severity of the headache which followes.

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JJ101 said on 03 November 2010

For Gardener74 I have had migraines with multiple aura's, and the way you describe them is just the same for me. Usually I have just one aura and once that goes I get the headache but on a couple of occasions one aura has finished for another to start in 5 minutes, recently I had about 4 aura's one after the other, it left me off my feet for several days. Stress is a common cause of migraine, and getting stress out when an aura appears in my experience makes the symptoms much worse - I've found the best action is to sit somewhere dark and quiet with eyes closed and relax, concentrate on your breathing and staying calm - by doing this it has definitely reduced the severity of the headache which followes.

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Gardener74 said on 23 October 2010

I tend to get the visual symptoms but with a stiff neck and tension headache afterwards, which responds to pain killers.
The last one I had was horrible It was the visual aura for about 30 minutes then it weant away and 10 minutes after that it started again but on the other side of my vision field and even worse!
For me the visual aura is the biggest and worst part of the attack. Some times before I feel a slight bit unreality for about 10 minutes. Then It starts with a tiny spot like when you have looked at a bright light, but can't quite shake off the glare spot. It then elarges to disrupt one half of my visual field and develops into different colours and looks like looking through a broken window. It usually lasts about 30 minutes foolwed a while later with a stiff neck and tension headache. I feel washed out and rattled after. They really terrify me, thinking I will loose my vision or something terrible will happen!
I staterted getting them in 2006 and as a result have developed panic attacks fearing passing out unreality etc but I am getting councelling for that. But this last one where I got two auras has really freaked me out and made me scared of going into town etc, which is so annoying because I was getting over my panic attacks :(
Has anyone experience having one aura after the other?

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Wiggie said on 25 March 2010

I absolutely agree about getting dehydrated and then suffering with migraines. Although mine are often linked to hormonal changes they can occur when I've been too busy to drink enough water. They can also be eased by drinking lots of water as suggested above. It is nice to see that my own diagnosis is also shared by someone else. Migraines are misery!

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Pricklyhead said on 07 February 2010

I have suffered from migraine headaches since I was about twelve years old. It has only been in the last few years that I have realised that most attacks occur when I have been concentrated so hard on my work that I have forgotten to drink some liquid. Each attack is usually preceded by a feeling of wellbeing, almost euphoria. The attack starts with visual interference which is minor for about two minutes. This then gets worse and I can't see or understand anything. If it happens to start when I am asleep, I will wake up with numbness down one side, nausea and headache that lasts for at least 24 hours. If I am awake, I can control the symptoms by drinking quite a lot of water and walking for about two miles (quickly). When I then rest, I have a dull headache on one side of my head but the full-blown migraine does not develop. Have had an attack today and know that it was only due to my own stupidity by forgetting to rehydrate that it happened. It is now three hours since it started and I have a slight one-sided headache. Please spread the word . . . keep hydrated, avoid migraine.

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Useful links

NHS Choices links

External links

Headaches and migraines

How to spot the different types of migraine and headaches, and what you can do to ease them.

Headaches in children

Advice for parents on recognising headaches in children and how to treat them

Relaxation therapy for headaches

These relaxation methods can help relieve headaches and may prevent them developing in the first place

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