The symptoms of a migraine are typical and occur in almost the same manner in various individuals. People who have migraine usually present with one-sided recurrent headaches associated with certain atypical migraine signs, which can vary from person to person and even in the same person during different attacks.

This is a chronic condition and the frequency of the attack can vary from once or twice a year to even occurring daily. There is no fixed period for it to occur and has been seen to occur even during sleep. It mostly comes on when the person is exposed to trigger factors 

The pain of a migraine headache is often of intense severity so as to affect the daily routine of the person and keep him or her absent from work or school. The symptoms can last from 4 hours to 3 days. At times, relief can often occur when vomiting takes place.

It is three times more common in women than in men. The migraine pain can even cause the person to get hospitalized as was NY Governor Patterson in 2008.

Stages of migraine symptoms

Though migraine symptoms vary in different people, there are four stages of how the symptoms can be described. Not all people experience all four stages.

  • Stage 1: Prodrome
  • Stage 2: Migraine Aura.
  • Stage 3: Migraine Headache
  • Stage 4: Postdrome

The Prodrome or the Preheadache

The prodromal symptoms often present hours or days before the onset of the migraine headache pain and you see it in 40% to 60% of people suffering from migraine.

Such symptoms of prodrome are:

  • Fatigue
  • Psychological changes such as mood swings, depression or euphoria, irritability
  • Cravings for certain foods especially chocolates
  • Excessive sleep
  • Diarrhea or constipation
  • Neck stiffness
  • A patient who is aware from previous experience can often predict an oncoming migraine from these symptoms.

Symptoms of migraine with aura

A migraine aura is a group of symptoms seen in less than 20% of the sufferers. Migraine auras are visual, sensory, motor as well as speech disturbances, visual disturbances being the most common.

Auras usually last from 10 to 30 minutes but not more than 60 minutes. A Migraine aura may precede the headache pain or can occur along with it.

  • Visual disturbances of the migraine aura can cause you to lose normal vision. You may see a small area in your visual field called the blind spot or zigzag lines in your visual field. You may also see bright spots or flashes. You may have a partial loss of vision, which is called scotoma. Some people experience blurred or cloudy vision.
  • Sensory disturbances of migraine aura can occur with visual disturbances or just after. These disturbances are seen as tingling or numbness that travels up your arm and can spread to the face and nose area of the same side and to the tongue. This can last for 10 to 20 minutes. Rarely the limbs and the face on one side of the body may become weak.
  • Speech disturbances of migraine aura are temporary disturbances in speech wherein the speech becomes slurred. This is referred to as the dysphasic aura.

Migraine headache phase

The headache phase usually begins about 60 minutes after the aura phase but can be delayed for several hours. In silent migraines, the headache phase is absent altogether. At times, the headache phase can start before the migraine aura has ended.

  • The headache pain of a migraine is usually unilateral but can occur on both sides of the head. It can also be located on the forehead, around one eye, or at the back of the head.
  • Unilateral migraine headaches typically change sides in subsequent attacks. A constant same-sided headache should be checked for secondary causes such as a tumor.
  • Pain starts gradually
  • It can be of a moderate or severe intensity
  • Later, it can be of throbbing or pounding nature
  • It is aggravated by physical exertion
  • The pain can last from 2 hours to 3 days
  • It is usually accompanied by photophobia (sensitivity to light – meaning cannot stand bright light). That is why you will want to lie down in a quiet dark room.
  • It is usually accompanied by phonophobia (sensitivity to loud sounds) and/or photophobia (intolerance to bright lights)
  • The pain can be accompanied by osmophobia (sensitivity to strong odors)

Other accompanying symptoms with a migraine that may occur include nausea and vomiting, blurred vision, diarrhea, tinnitus (ringing in ears), sweating, cold hands and feet, neck stiffness, low mood, difficulty concentrating, and vertigo.

Postdrome or Post-headache

This is the period after a migraine headache has subsided, which can stay for a few days. Some people experience euphoria while some feel low. Symptoms of the prodrome stage of migraine include:

  • Soreness at the site where the headache pain was located
  • Inability to think properly
  • Mood changes
  • Gastrointestinal disturbances
  • Weakness and tiredness

What is a silent migraine?

A silent migraine is an attack, which presents with other symptoms associated with a migraine but the headache pain is absent. It affects about 3% of migraine sufferers or about 0.5 to 1% of the general population.

Headache is a common migraine symptom. But not all forms of migraine cause a headache. “Migraine aura without headache”—previously called “acephalgic migraine” and now called “silent migraine”—is when someone has a migraine aura without any head pain.

Aura is an extremely miserable phase of migraine. A silent migraine is therefore described as “migraine aura without headache.” Basically, it is a migraine attack without the headache phase.

The tests in the diagnostic procedure are the same for both migraine with headache and silent migraine and are done primarily to rule out other causes of symptoms.

Treatment of typical migraines and silent ones does not cure the migraine for good but only gives symptomatic relief. Ideally, taking preventive measures is the only way to fight migraine.