Researchers believe that migraine attacks have four distinct phases. These phases are:

1. Prodrome
2. Aura
3. Migraine headache
4. Postdrome (headache termination)

Prodrome

Prodrome is experienced by approximately 60% of people with migraines, and it occurs within hours or up to days before a migraine attack. Many physical and psychological symptoms are associated with prodrome. These symptoms may vary between individuals, but they usually remain consistent for an individual.

Physical symptoms of prodrome include:

1. Stiff neck
2. Cold feeling
3. Sluggishness
4. Dizziness
5. Increased thirst
6. Increased urination
7. Loss of appetite
8. Diarrhea
9. Constipation
10. Fluid retention
11. Food cravings
12. Sensitivity to light and/or sound

Psychological symptoms of prodrome include:

1. Depression
2. Euphoria
3. Irritability
4. Restlessness
5. Mental slowing
6. Hyperactivity
7. Fatigue
8. Drowsiness

Aura

Aura is the phase that 20% of migraine sufferers experience right before a migraine attack. Those who experience aura will find that it develops 5 — 20 minutes before a migraine attack and lasts no longer than an hour. Aura symptoms usually effect the senses, especially sight, but they can also effect muscle strength.

Aura symptoms include:

1. Scintillation scotomas, which are characterized by a bright rim around an area of visual loss and flashing lights or jagged lines that block the visual field
2. Visual resizing or reshaping of objects
3. Numbness or tingling of the face, arm, or hand on one side of the body
4. Muscular weakness
5. Mild paralysis on one side of the body
6. Difficulty speaking or loss of speech

Migraine headache

Migraine headache symptoms are distinct from other types of headaches, such as tension-type or cluster headaches.

Symptoms that distinguish migraines from other headaches, include:

1. Headache on one side of the head (unilateral), behind the eyes (retrorbital), or around the eyes (periorbital)
2. Pain intensity that is moderate to markedly severe and worsened by physical activity

Some migraines may develop on both of sides of the head and then shift to one side of the head. In other individuals, the pain may develop on one side of the head and then become more generalized.

Other symptoms that occur during migraine attacks include:

• Loss of appetite
• Nausea
• Vomiting
• Sensitivity to light, sound, or odors
• Blurry vision
• Stuffed-up nose
• Pale face
• Sensations of heat or coldness
• Sweating
• Tenderness of the scalp
• Prominence of veins or arteries in the temple
• Accumulation of small pockets of fluid on the scalp or face
• Impaired concentration
• Depression
• Fatigue
• Nervousness
• Irritability

Postdrome

While migraines subside during the postdrome phase, individuals will experience the following symptoms:

• Fatigue
• Irritability
• Impaired concentration
• Scalp tenderness
• Mood changes