Migraine

Overview

A migraine can cause severe throbbing pain or a pulsing sensation, usually on just one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound.

Migraine attacks can cause significant pain for hours to days and can be so severe that the pain is disabling.

Warning symptoms known as aura may occur before or with the headache. These can include flashes of light, blind spots, or tingling on one side of the face or in your arm or leg.

Medications can help prevent some migraines and make them less painful. Talk to your doctor about different migraine treatment options if you can't find relief. The right medicines, combined with self-help remedies and lifestyle changes, may help.

Symptoms

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.

Prodrome

One or two days before a migraine, you may notice subtle changes that warn of an upcoming migraine, including:

Constipation
Mood changes, from depression to euphoria
Food cravings
Neck stiffness
Increased thirst and urination
Frequent yawning

Aura

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).

Attack

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

Post-drome

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:

Confusion
Moodiness
Dizziness
Weakness
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