Migraines often begin in childhood, adolescence or early adulthood. Migraines may progress through four stages: prodrome, aura, headache and post-drome, though you may not experience all stages.
One or two days before a migraine, you may notice subtle changes that warn of an upcoming migraine, including:
- Mood changes, from depression to euphoria
- Food cravings
- Neck stiffness
- Increased thirst and urination
- Frequent yawning
Aura may occur before or during migraines. Most people experience migraines without aura.
Auras are symptoms of the nervous system. They are usually visual disturbances, such as flashes of light or wavy, zigzag vision.
Sometimes auras can also be touching sensations (sensory), movement (motor) or speech (verbal) disturbances. Your muscles may get weak, or you may feel as though someone is touching you.
Each of these symptoms usually begins gradually, builds up over several minutes and lasts for 20 to 60 minutes. Examples of migraine aura include:
- Visual phenomena, such as seeing various shapes, bright spots or flashes of light
- Vision loss
- Pins and needles sensations in an arm or leg
- Weakness or numbness in the face or one side of the body
- Difficulty speaking
- Hearing noises or music
- Uncontrollable jerking or other movements
Sometimes, a migraine with aura may be associated with limb weakness (hemiplegic migraine).
A migraine usually lasts from four to 72 hours if untreated. The frequency with which headaches occur varies from person to person. Migraines may be rare, or strike several times a month. During a migraine, you may experience:
- Pain on one side or both sides of your head
- Pain that feels throbbing or pulsing
- Sensitivity to light, sounds, and sometimes smells and touch
- Nausea and vomiting
- Blurred vision
- Lightheadedness, sometimes followed by fainting
The final phase, known as post-drome, occurs after a migraine attack. You may feel drained and washed out, while some people feel elated. For about 24 hours, you may also experience:
- Sensitivity to light and sound
When to see a doctor
Migraines are often undiagnosed and untreated. If you regularly experience signs and symptoms of migraine attacks, keep a record of your attacks and how you treated them. Then make an appointment with your doctor to discuss your headaches.
Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.
See your doctor immediately or go to the emergency room if you have any of the following signs and symptoms, which may indicate a more serious medical problem:
- An abrupt, severe headache like a thunderclap
- Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
- Headache after a head injury, especially if the headache gets worse
- A chronic headache that is worse after coughing, exertion, straining or a sudden movement
- New headache pain if you're older than 50