For some people, certain symptoms may precede a migraine and may signal that one is starting. Doctors refer to these as pre-migraine symptoms, which is the prodrome phase. These may include extreme tiredness, irritability, nausea, and sensitivity to light.
Migraine is a neurological disease that affects about
Most people are familiar with the severe headaches associated with migraine, but the condition can cause other symptoms. Some people may experience symptoms that alert them that a migraine is coming.
This article reviews some common pre-migraine symptoms, stages of migraine, and treatment options.
Before a migraine, a person may experience certain symptoms. For some, early signs and symptoms may warn of an impending episode and allow them to take medications.
Prodrome can occur anywhere from a few hours or days before the onset of a migraine headache. An aura typically occurs 5–60 minutes ahead of a migraine headache.
Common symptoms associated with prodrome include:
- irritability or moodiness
- extreme tiredness
- trouble concentrating
- craving certain foods
- depressed mood
- trouble sleeping
- sensitivity to sound or light
- increased need to urinate
- trouble speaking or reading
- fatigue or muscle stiffness
About 75% of people with migraine experience prodrome and one or more of the associated symptoms. However, they may not experience them every time before a migraine headache develops.
- visual disturbances
- sensory disturbances, such as numbness and tingling
- speech, such as difficulty finding words or slurred speech
- weakness in muscles, such as on one side of the face
In some cases, a person’s headache may occur at the same time that the aura starts. Others may only experience aura without a headache, known as migraine equivalent or acephalgic migraine.
If a person notices symptoms associated with the prodrome phase, they may find that the following may help to lessen the severity of their headache or potentially prevent it from occurring:
- taking medications
- avoiding triggers
- practicing stress-reducing methods, such as breathing techniques
Migraine treatment involves a
Abortive therapies typically include one or more of the following:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter or prescription medications that help reduce inflammation and relieve pain.
- Triptans: These are the first-line abortive treatment for migraine. People may take these with some NSAIDs, such as naproxen, but for no more than
10 daysa month.
- Calcitonin-gene-related peptide antagonists: These drugs may work for people not responding to other therapies or as preventive therapy.
- : Doctors often prescribe these with NSAIDs to help reduce nausea or vomiting.
- Selective serotonin 1F receptor agonist: These medications are for acute migraine in adults.
- Transcutaneous supraorbital nerve stimulation: These may reduce the intensity of migraine.
- Dexamethasone: This helps reduce the recurrence of early headaches.
- Ergots: Doctors may use these for acute attacks or overuse headaches.
- Transcranial magnetic stimulation
- Peripheral nerve blocking
- Nonpainful remote electric neurostimulation
Preventive treatments aim to help reduce the frequency, duration, and intensity of migraine attacks. They can include medications such as:
- Calcitonin gene-related peptide (CGRP) antagonists and monoclonal antibodies
In addition to medications, a doctor or healthcare team will likely recommend lifestyle changes for a person to avoid their known triggers. Lifestyle changes can include:
Migraine has four distinct phases that can occur, though a person may not experience every stage during a migraine episode.
- Prodrome: This occurs anywhere from a few days to a few hours before a migraine and often involves early warning signs or symptoms.
- Aura: This stage occurs 5–60 minutes ahead of a migraine and can include auditory, visual, or sensory disturbances.
- Headache: This typically lasts for a few hours to about 3 days and may include pain on one or both sides of the head. Other symptoms may include:
- Postdrome: This stage affects about 80% of people with migraine. It may include symptoms such as:
- trouble concentrating
- body aches
- sensitivity to light
Pre-migraine symptoms can include an increased need to urinate, fatigue, irritability, and others.
When they occur, they can act as an early warning sign. A person may find that taking medications during this time may help prevent or reduce the severity of their migraine headache.
Not everyone will experience early symptoms. They also may not experience them before every headache.
A person can take steps to help prevent migraine headaches through a combination of medication and lifestyle changes.