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The Four Phases of a Migraine

Posted by Migraine Relief Center on Nov 22, 2013 7:00:00 AM

What do Serena Williams, Carly Simon and Whoopi Goldberg all have in common? They are famous migraine stricken women who have learned to manage their migraines. One thing they may or may not have in common is the way their migraine attacks become manifest. For some people, migraine attacks will arrive in four phases; however, these stages are not guaranteed for everyone. Migraine_Stages

1 - The Prodrome 

This initial phase does not bring on actual pain. During the prodrome phase, patients will become aware of certain symptoms or signs of an impending migraine attack. Some of the common symptoms include:

  • Loose bowels
  • Exhaustion or unexplained fatigue
  • Disorientation
  • Stiff neck and muscular discomfort
  • Strange speech patterns
  • Unusual food cravings

Those who live with migraine conditions learn that the prodrome phase can warn of an attack that may arrive in a few hours or in a couple of days. As expected, this initial phase can produce a significant amount of stress and consternation on migraine patients, and in some cases the attack may never come.

2 - The Aura Phase

Although the prodrome phase is more common than the aura phase, this second stage leading up to a migraine attack gets more attention due to its spectacular visual component. In fact, this phase serves to classify migraines into two major categories.

Migraines with aura involve certain changes to a patient’s vision or sensory system. These changes include photophobia or sensory auras. The former refers to sensitivity to bright lights while the latter is an aura that patients can feel as tingling of extremities or one side of the face. Less frequent auras will involve hearing things or vertigo.

The aura phase serves as a stronger warning than the prodrome phase, and it is more likely to result in a migraine attack. At this point, patients can still take their preventive migraine medication to attenuate the pain.

3 - The Headache Phase

In many cases, an onset migraine may begin with this phase. This is when the debilitating headache occurs, and it may radiate to other parts of the body. Silent migraines are those that jump to the headache phase without the forewarnings of the earlier prodrome and aura phases. 

One characteristic of this phase is that the pain often starts on one side of the patient’s face and may shift entirely to the other or assume a bilateral location. This phase may last for 72 hours and can be treated symptomatically with medication and certain therapeutic activities.

4 - The Postdrome Phase

As long as there is a headache phase, migraine patients will invariably go through a postdrome migraine phase of fatigue, confusion and ultimate relief. 

*Image courtesy of

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Topics: Symptoms

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