Migraine timeline, stages, durations, and recovery

Migraine is a neurological condition that typically causes moderate-to-severe headaches and other symptoms that recur periodically.

Episodes may happen occasionally, in a condition called episodic migraine, or very frequently, which is called chronic migraine.

During a migraine episode, a person may experience sensitivity to light or sound, nausea, and vomiting.

Migraine is three times as common in women, compared with men. However, the rates in children of different sexes are roughly similar. Scientists believe that levels of female sex hormones, which rise during puberty, play a role in the difference among adults.

The four stages of migraine are:

1. prodrome
2. aura
3. headache
4. postdrome

However, an episode may not include every stage.

Prodrome

This is the first stage of a migraine episode. It can begin hours or days before a headache, and it can involve:

• yawning or tiredness
• difficulty concentrating, reading, or speaking
• unexplained mood changes
• depression
• muscle aches
• sensitivity to light or sound
• food cravings
• increased urination
• constipation or diarrhea

For some, these symptoms are difficult to identify because they can stem from so many other factors, such as a lack of sleep or stress. However, if a person can spot the early signs of a migraine, they can take preventive action.

A person might try:

• preventive medications
• avoiding migraine triggers, when possible
• relaxation techniques, such as meditation

Learn more about migraine medications and home remedies.

Aura

Around 25% of people with migraine experience aura. The aura phase can occur immediately before or during a headache. It may involve:

• visual disturbances, such as seeing zig-zagging lines or flashes of light
• auditory disturbances, such as hearing a noise, possibly a ringing sound, that is not there
• physical sensations, such as numbness, tingling, or muscle weakness
• language disturbances, such as difficulty finding or understanding words

The aura phase may last 60 minutes or longer, and it may overlap with the headache phase.

Learn more about migraine aura.

Headache

If a migraine episode progresses to the headache stage, the pain typically starts gradually and becomes more severe. It eventually peaks and dissipates.

The intensity and location of the pain can vary, but it often starts on one side of the head. It may spread or switch to other areas as the episode continues. The pain may get worse with physical activity.

At this stage, a person may also experience:

• nausea
• vomiting
• sensitivity to light, noise, or smells

It is also possible to experience migraine without a headache. This is informally called a silent migraine.

Taking medications to reduce the pain may help at this stage. But people often find that medication is most effective during the early phases.

Postdrome

This is the last phase of a migraine episode, and some call it a migraine “hangover.” This phase can last up to 1–2 days. Around 80% of people with migraine experience it.

A person may feel:

• weak
• exhausted
• confused
• dizzy
• achy

Some people also report euphoria or intense relief after a migraine episode.

The headache stage might last anywhere from 4–72 hours without medical treatment, though it may last longer.

If an episode lasts longer than 3 days, even with medication, the doctor may refer to it as status migrainosus. This phenomenon is a complication of migraine, and experts are unsure why it happens. Another name for the condition is intractable migraine.

The doctor may recommend changes to an existing migraine treatment plan, or in some cases, a visit to a hospital. Doctors can use strong medications to stop the pain of an intractable migraine. These medications might include dexamethasone or nerve-blocking drugs.

The recovery time can depend on whether a person experiences postdrome, or migraine hangover, symptoms. People who do may need 1–2 days to fully recover once the headache subsides. Others may recover more quickly.

People with postdrome symptoms may benefit from these strategies:

• staying hydrated
• avoiding bright lights and strong smells
• trying relaxation techniques, such as gentle yoga or meditation
• avoiding stress, when possible

If a migraine headache lasts longer than 72 hours without responding to regular migraine medication, the person may need additional treatment. Anyone who has experienced this pain for longer than 3 days should speak with a doctor as soon as they can.

Many other health issues can cause headaches, so it is important to receive a professional diagnosis. Anyone experiencing migraine symptoms for the first time should contact a healthcare professional.

In addition, anyone who has at least four migraine episodes within a month — or any episode that is disabling — should receive professional care.

A doctor may diagnose chronic migraine if a person has had 15 or more days of headaches per month, with at least 8 of these days meeting the criteria for migraine.

Many different migraine treatments are available. Some can prevent the symptoms and others can stop them.

Some headaches signal a need for immediate care. If a person experiences any of the following, call 911 or the local emergency number immediately:

• a sudden, severe headache with the worst pain ever
• a headache alongside paralysis, drooping on one side of the face, difficulty speaking, or sudden blurry vision
• a headache along with neck stiffness, a rash, muscle or joint pain, or a fever

Migraine is a complex neurological disorder that can cause recurring headaches and other symptoms. A migraine episode can have four stages as it worsens and then recedes.

• prodrome
• aura
• attack
• post-drome

The headache stage may last about 4–72 hours. After the pain improves, the person may experience a migraine “hangover,” which may involve fatigue, aching muscles, and confusion.

Anyone who experiences migraine symptoms for the first time or any debilitating symptoms should contact a doctor. Many preventive and abortive treatments are available.