The Different Stages of a Migraine

Migraine is a complex neurological disorder that can stop your life in its tracks. When you suffer a migraine attack, you may experience a range of disabling symptoms, including:

• Severe, throbbing head pain
• Nausea
• Vomiting
• Sensitivity to light, smells, or sounds
• Worsening pain with physical activity

A migraine attack lasts anywhere from four hours to several days. The pain and sensations may be so crippling that you can’t perform daily tasks, including going to work or school.

At Advanced Medical Care in Brooklyn and Queens, New York, our experienced neurologists work with you to help you avoid migraine attacks whenever possible and to control the pain when one occurs. Here’s what you should know about the five stages of migraine so you can get help quickly enough to avoid progression.

Stage one: Prodrome (early warning)

The prodrome phase of a migraine attack may occur anywhere from a few hours to days before the headache and other disabling symptoms. Stay alert for warning symptoms in the prodrome stage, such as:

• Sleepiness or fatigue
• Yawning
• Irritability
• Depression
• Trouble concentrating
• Difficulty sleeping or insomnia
• Increased urination
• Nausea
• Food cravings
• Increased sensitivity to light or sound
• Muscle stiffness
• Difficulty speaking or reading

When you’re in the prodrome phase, engage in relaxation techniques, such as deep breathing, and avoid migraine triggers, including alcohol. Contact us for medication or treatment to help minimize the severity of the coming attack.

Stage two: Aura (warning for some)

Only about 20% of migraine sufferers experience a phenomenon known as aura. If you have an aura, you may:

• See flashing lights or geometric patterns
• Experience blurry vision or have blind spots in your vision
• Temporarily lose your vision
• Notice tingling in arms and legs
• Feel dizzy
• Have trouble hearing or speaking

If you experience an aura, you’re usually about 60 minutes away from a headache attack. You may wish to take your pain medication in this stage. For some people, the aura accompanies the next stage.

Stage three: Attack

Migraine attacks often cause a severe headache on only one side of your head. However, the headache can shift from one side to the other, or affect other areas of your head. Pain may range from mild and pulsating to severe and throbbing. Accompanying symptoms could include:

• Nausea and vomiting
• Sensitivity to light, smells, and touch
• Sensitivity to movement

The attack stage of your migraine lasts anywhere from 4-72 hours. Painkillers are most effective when you take them as soon as you notice symptoms. 

Stage four: Resolution

Eventually, your migraine attack fades and resolves. Sometimes, migraines resolve quickly. Fast resolutions often occur after:

• Sleeping (even just 1-2 hours)
• Vomiting
• Crying

Most attacks fade gradually, but some can stop suddenly.

Stage five: Postdrome (recovery)

Once your migraine attack ends, you rarely bounce right back to your normal routine. In fact, it’s usual to feel drained and even hungover.

You may experience symptoms very like those in the prodromal stage, such as food cravings, hunger, or fatigue. You could also experience the exact opposite of the symptoms you had at the start. For instance, if you were tired in prodrome, you may feel energized in postdrome.

Get help managing migraines

Paying attention to your migraine stages and your unique migraine triggers helps you manage your disorder. By recognizing that you’re prodromal, you may be able to stop or reduce a migraine’s progression.

Contact one of our offices by phone or book an appointment online as soon as you notice you’re in the prodrome or attack phase of a migraine so you can get the treatment you need to better navigate the attack. We also offer Botox® treatments for chronic migraines to reduce the number and severity of attacks.