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The Phases of a Migraine Attack

When you experience a migraine attack, there are many different symptoms that come and go at different times. You may not even experience the same symptoms every time you suffer an attack. This is because a migraine attack actually consists of individual stages. Each stage is marked by its own set of symptoms, and not all migraine attacks involve every single stage (and so not all migraine attacks will involve the same symptoms). Here is a quick overview of the phases that make up a migraine attack:

diagram showing migraine phases
Migraine attack phases

Prodrome

This is the very first phase and marks the beginning of a migraine attack. Most people who have the disease will pass through a prodrome phase, experiencing for example fatigue or food cravings (which can last as little as an hour or two, or can go on for multiple days). Not all migraine attacks, however, necessarily begin with prodrome.

Aura

Like prodrome, not all migraine attacks will include an aura phase. In fact, migraine without aura is the most common type of migraine. According to The Migraine Trust, only around 10% of children with migraine experience this phase. Aura typically lasts between 5 and 60 minutes, during which you may experience changes to your senses, especially your vision. For example, you may begin to see flashing lights, dots, or blind spots.

Main Attack Stage

You may also hear this phase called the ‘headache stage’ or the ‘pain stage’. During this phase, the main pain associated with an attack will begin. The main attack stage usually last from 4 hours to 72 hours (3 days).

Postdrome

This phase begins when most of the severe pain experienced during the main attack stage has started to fade. This phase tends to last a day or two. You are still recovering during postdrome, and so you will usually feel a little unwell – you may be tired, confused, or experience flares of pain if you lean forward or move quickly.

Why do we need to know the phases of a migraine attack?

Becoming familiar with the stages described above could have a massive impact on helping you to predict any oncoming attacks and manage your migraine. For example, because the prodrome and the aura stages are usually (although not always!) followed by the pain of the main attack stage, it means anyone who experiences them can tell that they will be feeling the pain of a headache pretty soon. These individuals can then take action to help relieve or deal with any pain before it starts.

Furthermore, knowing the different phases of a migraine attack can also be useful when it comes to working out the specific type of migraine you are experiencing. For example, there are two main categories of migraine: migraine with aura and migraine without aura. If you can tell which stages have or haven’t been skipped during a migraine attack, then you can tell more easily which specific kind of migraine you are experiencing. This means you can then take the best action or seek the best treatment to relieve any symptoms and manage your condition.

Sources

The Migraine Trust on Symptoms and Stages

American Migraine Foundation on The Timeline of a Migraine Attack

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