Video Q & A:

Migraine 101


What are the phases of a migraine?

Expert:   Lawrence C. Newman, MD, Director, The Headache Institute, Roosevelt Hospital Center »

A migraine attack plays out in four uncomfortable and sometimes very painful phases. Let Dr. Newman guide you through each one so you'll know what's coming next time.

Transcript: Migraine attacks happen in FOUR phases, although not EVERYONE experiences all of them. So let’s explore what the phases are AND the symptoms that characterize them. The premonitory—or prodromal—phase provides advanced warning that a migraine attack is coming. Starting several hours to a couple DAYS before the headache pain begins, a person experiences INEXPLICABLE changes in mood, behavior and energy levels. They can also have constipation, diarrhea, increased urination, uncontrollable yawning or food cravings. The symptoms of a prodromal phase vary widely, but they ALL have one thing in common—they signal that a migraine attack is coming. Sometimes, a migraine sufferer will SKIP this phase. Other times, the symptoms are so subtle that they’re only identified in RETROSPECT. Aura is the SECOND phase of a migraine attack. This may sound familiar if you’ve heard of Serene Branson, the TV reporter who started speaking nonsensical words on-air. She was being hit by the aura phase of her impending migraine. However, her symptoms were a little unusual—most COMMONLY, the aura phase involves VISUAL disturbances such as blurred vision, blind spots, flashing or bright lights, geometrical lines and shapes in your visual field, and hallucinations. These symptoms can start from 15 minutes to one hour before a migraine fully comes on. And, Branson is in the minority—only one in five people with migraine experience the aura phase. The main event of a migraine—the headache—is the THIRD phase of an attack. Migraine headaches most commonly involve an INTENSE, pulsating PAIN on one side of the head. Sometimes, vomiting, nausea and other symptoms accompany the pain. Often, even slight movements make the pain WORSE, which is why many people with migraines go to bed for the entirety of their headache, which can last for a few HOURS or for a few DAYS. And that room will probably be dark, too, since sensitivity to light is another common symptom of a migraine headache. The POSTDROMAL, or recovery phase, is the fourth and LAST part of a migraine attack. The migraine has slowly faded away and the pulsing pain has FINALLY subsided, but an individual will still feel weak, worn out and confused. It may take them a day before they feel completely healthy again. More »

Can't Find an Answer? Send us your question »