Migraine can cause severe, recurrent, and potentially disabling headaches that typically last from 4–72 hours.
Many people associate migraine episodes with feelings of nausea, heightened sensitivity to light and sound, and occasionally skin and muscle sensitivity.
Migraine is surprisingly common. Around 39 million people in the United States experience this neurological disease’s incapacitating symptoms.
This article looks at how long migraine attacks last, migraine stages, causes, and common triggers. It then explores treatments, prevention, and when someone should seek help for symptoms.
Migraine is a complex condition with different stages and contributing factors. They can last from 4–72 hours if left untreated.
The length and frequency of migraine varies from person to person.
There is an especially intense form of migraine called status migrainosus (SM).
These long-lasting migraine headaches can cause symptoms for more than 72 hours, even with treatment.
Although exact epidemiological data is lacking, an 11-year study showed that SM affects around 3% of people with migraine.
Migraine progresses through different phases that lead on from each other. Not everyone will experience each phase with every migraine attack they have. The four stages are:
Each stage lasts a different length of time, varying between people and between each migraine attack.
Understanding the distinct phases of a migraine attack can help people manage the condition.
When someone recognizes the earliest symptoms of a migraine episode, they can take measures to prevent the situation from progressing.
Here is an outline of the stages, including duration and the most common symptoms someone may experience:
This stage is also called the premonitory or warning stage. It may begin several days or just a couple of hours before the onset of the aura stage.
During this stage, an individual may notice subtle changes that are not necessarily headache-related. The symptoms serve as a warning of an upcoming migraine attack.
Prodrome symptoms include:
Not everyone who has migraine also experiences the aura stage with each attack. It only occurs in around 25% of individuals with migraine.
The aura stage typically occurs shortly before the main migraine attack and lasts around 20–60 minutes. Auras are sensory disturbances that range from flashes of bright light to the inability to speak normally.
Aura symptoms include:
- hearing noises
- impaired vision, or hearing
- numbness or pins and needles in the limbs
- seeing bright or flashing lights, sparkles, colored spots, or zigzag lines
- slurred speech
- weakness in the face or body
The symptoms during the headache stage are usually the same, no matter if someone experienced the aura stage or not. Headache symptoms include:
- blurred vision
- dizziness and lightheadedness
- extreme sensitivity to light and noises
- possible sensitivity to odors, touch, and movement
- stiffness in the shoulders and neck
- throbbing pain on one or both sides of the head that worsens with movement or activity
- upset stomach, nausea, or vomiting
This stage is the most acute, with more than 90% of people experiencing symptoms severe enough to prevent them from functioning normally.
Postdrome happens at the end of the primary headache stage for around 80% of people. It can last for 24–48 hours and may include the following symptoms:
- aching body
- difficulty concentrating
- elation or depression
- feeling drained
Some people find that sudden head movement or a return to strenuous activity may cause the headache to return, but only briefly.
Identifying migraine causes and triggers can help people avoid them and prevent a migraine attack from occurring.
Triggers are different for everyone, but some common ones include:
Migraine treatments can involve using medications and home remedies to reduce the severity of symptoms.
Home remedies include:
- increasing water intake
- resting in a dark and quiet room
- using a cold compress
- taking an over-the-counter pain reliever such as aspirin, ibuprofen, or naproxen
If home remedies do not relieve symptoms, an individual can ask their doctor for prescription medication.
A doctor may recommend the following medications:
The American Migraine Foundation estimate that less than 50% of people with migraine seek help from a doctor.
If a migraine episode lasts for longer than is typical for an individual, they should seek a doctor’s advice.
They should visit the emergency room if a migraine episode becomes too severe and at-home treatments do not alleviate symptoms.
An individual should seek immediate medical attention if they have the following symptoms:
- an extremely severe headache
- a headache that starts abruptly like a thunderclap, especially if the individual is aged over 50 years
- a migraine headache accompanied with a stiff neck, or fever, confusion, slurred speech, or seizures
- speech, vision, movement, or balance problems that differ from the regular migraine pattern
Always seek medical attention if someone has a headache following a head injury.
Preventing migraine involves identifying and avoiding an individual’s specific triggers.
With that in mind, keeping a headache diary that records migraine details and triggers can help someone predict when a migraine attack could occur.
There are also a number of apps that can help people to track migraine symptoms and identify their triggers.
If someone finds that their triggers are weather-related, for example, extreme cold and wind, they could choose to stay indoors during this time.
When stress plays a role in someone’s migraine pattern, looking for ways to relax and relieve stress may be enough to prevent future migraine attacks.
In children, changing sleeping habits and improving their night-time routine may be enough to curtail migraine attacks.
Magnesium, vitamin B2, and Coenzyme q10 may have some success in preventing migraine.
Migraine attacks are severe headaches frequently accompanied by nausea and neurological symptoms.
There are four stages of migraine that have different durations. Overall, an attack may last for 4–72 hours, or even longer.
People with migraine may be able to identify particular events or circumstances that trigger the condition. They can use this information as part of a migraine prevention routine.
If someone has an especially severe migraine episode, an extreme or sudden headache, one accompanied with fever or seizures, they should seek urgent medical attention.