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Migraine affects about 39 million people, including children, in the United States. Migraine isn’t just a headache; it’s a neurological condition with neurological symptoms.

  • severe throbbing pain, typically on one side of the head
  • visual disturbances
  • nausea
  • vomiting
  • dizziness
  • heightened sensitivity to light, smell, and touch
  • tingling or numbness in the face or extremities

Migraine can be a chronic condition that severely affects quality of life, making it a serious health concern. Knowing the stages of migraine can help you address the symptoms early and potentially help minimize its effects.

infographics about the stages of a migraine episodeShare on Pinterest
Infographic by Maya Chastain

The prodrome stage is also called the premonitory phase, and it can begin 1 to 3 days before the headache itself.

Symptoms can include:

  • food cravings
  • fatigue
  • depressed mood
  • hyperactivity
  • irritability
  • neck pain or stiffness
  • trouble concentrating
  • sensitivity to light or sound
  • yawning

Halting migraine

The key to stopping a migraine episode is early recognition and treatment. Treatments are more likely to be successful when started early, instead of waiting to see if the symptoms get worse.

If you’ve been prescribed a medication like a triptan, taking it during the prodrome stage can help stop a migraine episode.

Not every migraine episode has an aura. Aura occurs in about one-third of migraine episodes.

For those who have migraine with aura, the headache is accompanied by neurological symptoms (the aura) about 10 to 30 minutes before the headache.

Visual symptoms, like flashing lights, zigzag lines, and blind spots, are most common in auras. Other aura symptoms can include:

  • numbness or tingling in the face or limbs
  • impairments or disturbances in taste, smell, or touch
  • weakness in the face or limbs
  • partial vision loss
  • changes in speech

Rescue treatments for migraine

Putting a cold compress on your forehead can relieve symptoms. Also, if you’ve been prescribed a medication for migraine, taking it can help decrease symptoms.

These medications can include:

  • over-the-counter (OTC) drugs like acetaminophen (Tylenol)
  • triptans like rizatriptan and sumatriptan
  • dihydroergotamine
  • anti-nausea drugs
  • gepants like ubrogepant or rimegepant
  • ditans like lasmiditan

The classic throbbing pain of a migraine headache is the headache stage. This can last hours to days. The average length is about 4 hours.

Symptoms can vary, but they may include:

  • increased sensitivity to light and sound
  • nausea, vomiting, or both
  • dizziness
  • pulsing or throbbing head or neck pain
  • mood changes
  • difficulty sleeping

Migraine treatment

Most treatments for migraine work best when used as soon as possible after the symptoms appear.

Many people carry their medication with them all the time for this reason. If you can’t take your medication as soon as symptoms appear, take it when you can.

OTC treatments like aspirin and nonsteroidal anti-inflammatory drugs like ibuprofen help some people.

If these don’t work, a prescription medication may be necessary. Prescription medications can fall into one of several classes:

  • Triptans. These balance the chemicals in the brain. Examples include sumatriptan, rizatriptan, and zolmitriptan, among others.
  • Ergot derivatives. These work like triptans. Examples include ergotamine tartrate and dihydroergotamine.
  • Gepants. These are a newer type of therapy. They target receptors on sensory nerves to treat migraine headaches.
  • Ditans. These are also fairly new. Ditans don’t affect blood vessels so they may be better for older adults with a history of heart disease or stroke.

Sometimes you have to try different medications to find the one that works best for you. Speak with a doctor if your current treatment isn’t relieving symptoms or working for you.

The postdrome stage is also known as a migraine hangover. It starts when the peak pain of the headache has lessened.

Migraine can affect the entire body. During the postdrome stage, the resulting pain or discomfort can occur anywhere in the body.

Postdrome can last 24 to 48 hours, but it doesn’t affect everyone, and it doesn’t have to occur after each headache. People with migraine can experience the stage differently, and not everyone’s symptoms will be the same.

Symptoms of postdrome can include:

  • fatigue
  • body aches
  • mental “fogginess”
  • dehydration
  • depressed mood
  • euphoric mood
  • trouble concentrating

Treatment

You can reduce or prevent postdrome symptoms by:

  • staying hydrated throughout the migraine episode
  • stretching or doing light activities after the headache
  • reducing stress, if possible
  • avoiding migraine triggers, if possible
  • using a migraine medication early in the episode

Contact a doctor if:

  • You have several headaches per month, with each lasting hours to days.
  • Your headaches affect your work, home life, or school functioning.
  • You have nausea, vomiting, or sensory disturbances with your headaches.
  • You have severe headaches with a stiff neck.
  • You have pain around the ear or eye.
  • Your headaches just started out of the blue.

Some people can feel a migraine episode coming on because of the associated sensory symptoms.

Sometimes there are known triggers for migraine. Avoiding these triggers can help you reduce the risk of having a migraine episode. It’s hard to predict a migraine episode before any symptoms occur.

Knowing the difference between a headache and migraine can also be helpful.

There are different stages to migraine. Although not everyone will have all of the stages all of the time and the symptoms can vary, knowing the general stages can be helpful in seeking treatment and finding ways to reduce the symptoms.