Migraine Phases

Migraine Phases

Like a Shakespearean tragedy, a migraine has 5 acts or ‘phases’ once it has been triggered.

  • The Prodromal Phase or Premonitory Phase

  • Aura Phase (not always present)

  • The Headache Attack Phase

  • Resolution Phase

  • Postdrome or Recovery Phase

Each phase can last for varying lengths of time with varying levels of severity from migraineur to migraineur, and from migraine attack to migraine attack. Not everyone will experience every stage with every attack. Understanding the different phases and their accompanying symptoms can help you find predictable patterns within your own attacks, allowing you to prepare, get off the road if traveling, take prophylactic medications, or put on your photophobia glasses prior to the onset of photophobia.

The Prodromal Phase or Premonitory Phase

This is your ‘heads up’, your warning that it’s about to get real. You may experience symptoms such as:

  • Yawning
  • Mood Changes
  • Feeling thirsty
  • Stiff Neck
  • Depression
  • Euphoria
  • Fatigue
  • Face Sensitivity
  • Eye Discomfort
  • Visual Disturbances
  • Sensitivity to smell, sound, light

This phase can last anywhere from 1 hour to 24 hours.

Aura Phase

This migraine phase is included only in the migraine with aura subtype, and not all migraineurs will experience aura. Lasting anywhere from 5-60 minutes, this phase is characterized by various neurological symptoms, some of which can be frightening. The aura can happen with or without the headache attack phase. Changes to the brains visual cortex causes visual disturbances such as:

  • Coloured spots
  • Dark spots
  • Sparks, flashes, or ‘stars’
  • Colours and light from objects and people
  • Visual ‘burn in’ from lights
  • Zigzag lines
  • Lengthening of coronas around lights at night

You may also experience some disorienting physical symptoms such as:

  • Nausea
  • Dizziness or vertigo
  • Weakness
  • Numbness and/or Tingling - pins and needles sensation
  • Speech or hearing disturbances
  • Memory difficulties
  • Feelings of depression, fear, euphoria

Headache Attack Phase

This stage is typified by a severe, often disabling pain which usually manifests as throbbing focused on one side of the head, but may affect both sides. Depending on the sufferer, the pain is made worse by movement, sensitivity to light, sound, or smell.

Nausea can appear and intensify during this stage, and couple with unbearable pain, may cause you to vomit. If you do vomit, make sure to drink water and replenish your fluids to avoid lengthening the headache attack.

Depending on the migraineur, massage, photophobia glasses, darkness, a cool cloth, and silence can help ease the suffering to some extent.

Resolution Phase

Most migraine fizzle out over a period of 4 hours to 3 days. Some migraines may be eased more quickly with sleep, a bath in the dark or after vomiting if very nauseous. The pain, dizziness and associated symptoms may persist for hours or days.

Postdromal or Recovery Phase

The last phase of a migraine can be like a hangover. You may experience symptoms either similar to or mirrored from your prodromal premonitory phase. You may feel euphoria instead of depression for example.

This phase may last hours or days.