What Does the Start of a Migraine Feel Like? Signs & Symptoms

Warning signs of amigraine may include increased urination, constipation, food cravings, mood changes, tiredness, and sensitivity to light or sound

Warning signs that a migraine is coming on may include:

Increased urination
Constipation
Food cravings
Mood changes
Extreme tiredness
Frequent yawning
Sensitivity to light or sound
Blurred vision
Flashes of light or zigzag shapes
Numbness or tingling

What are typical migraine symptoms?

Migraine is a debilitating neurological disease characterized by one-sided throbbing pain that is often associated with nausea and visual disturbances triggered by movement, light, smells, and sound. Symptoms typically include:

Throbbing or pulsating headache (mostly one-sided, shifting from one side of the head to the other or affecting the front or back of the head)
Nausea
Vomiting
Numbness and tingling
Tiredness
Irritability
Difficulty speaking
Sensitivity to light, noise, and smell
Visual disturbances
Blurred vision
Upset stomach
Abdominal pain
Decreased appetite
Pale skin
Neck stiffness
Dizziness or lightheadedness
Feeling warm (increased sweating) or cold (chills)
Insomnia

What are the stages of a migraine?

Migraines may go through four stages, although this varies from person to person.

1. Prodrome

Also known as a “preheadache” or premonitory phase, prodrome may last a few hours to days, with symptoms such as:

Difficulty concentrating
Stiff muscles
Fatigue
Difficulty speaking
Food cravings

2. Aura

Some people experience an aura before or during a migraine attack that lasts for 10-60 minutes and may include symptoms such as:

Numbness or tingling
Seeing bright flashing dots
Blind spots
Changes in speech pattern
Tinnitus (ringing in the ears)
Temporary loss of vision
Seeing wavy or jagged lines
Changes in smell or taste

3. Attack

During a migraine attack, you may experience drilling, throbbing, or pulsating headache on one side of the head that lasts for 4-72 hours.

4. Postdrome

About 80% of people with migraines experience a postdrome phase or migraine “hangover” characterized by:

Inability to concentrate
Confusion
Fatigue
Depression
Elation

What are different types of migraine?

Common migraine (migraine without aura): Most common type of migraine, in which there is no aura phase.
Migraine with aura (previously called complicated migraine): About 15%-20% of people experience aura with migraines.
Migraine with brainstem aura: Headache along with other symptoms such as vertigo, slurred speech, double vision, loss of balance, ringing in the ears, and vomiting.
Silent or acephalgic migraine: Aura symptoms are not typically followed by headaches.
Hemiplegic migraine: Headache is associated with temporary numbness, extreme weakness or hemiplegia (temporary paralysis on one side of the body), tingling, loss of sensation, and dizziness or vision changes.
Ocular or retinal migraine: Involves partial or complete loss of vision in one of the eyes, along with a dull ache behind the eyes along with a headache.
Chronic migraine: Occurs at least 15 days a month with varying severity.
Status migrainosus: Rare and severe type of migraine that lasts longer than 72 hours.

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What can trigger a migraine?

Commonly reported migraine triggers include:

Stress (anxiety and excitement can increase muscle tension, dilate blood vessels, and release certain chemicals, leading to an attack.)
Missing or skipping a meal
Sensitivity to certain foods (aged cheese, alcoholic beverages, chocolate, food additives such as nitrates, and fermented or pickled foods)
Caffeine (excessive coffee consumption or withdrawal from caffeine)
Routine use of pain-relief medications
Flashing lights
Loud noises
Not drinking enough water
Not getting enough sleep
Overexertion
Being tired
Perfumes and strong odors
Excessive dieting
Change in weather conditions or changes in altitude
Hormonal changes
Certain medications

What are risk factors for migraines?

Risk factors that make someone more vulnerable to developing migraine headaches include:

Gender: Women ages 15-55 are 3 times more likely to develop migraines than men.
Genes: About 80% of people with migraines have a first-degree relative with the condition or a family history of migraine.
Stress: Stress can act as both a causative and triggering factor.
Smoking: People who smoke are more prone to migraines than those who do not smoke.

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How are migraines treated?

While migraines cannot be cured, symptoms can be improved with certain measures.

Abortive approach

Resting in a dark room
Scalp massage
Heat application (a heating pad may relax tense muscles)
Over-the-counter painkillers (acetaminophen and ibuprofen)
Prescription drugs such as:
- Triptans
- Calcium channel blockers
  - Verapamil
- Calcitonin gene-related peptide monoclonal antibodies
  - Erenumab
  - Fremanezumab
  - Galcanezumab
  - Eptinezumab
- Beta-blockers
- Antidepressants
- Antiseizure drugs
  - Valproic acid
  - Topiramate

Preventive approach

Avoid food triggers
Maintain a healthy weight
Exercise regularly
Get enough sleep
Manage stress
Practice meditation (breathe deeply and slowly to relax each group of muscles for at least 10 minutes every day)
Keep a migraine journal to note your triggers, type of pain, severity, and duration of various stages