Headaches and Migraines

Is My Headache a Migraine or Something Else?

Migraine Signs and Symptoms

Experiencing a migraine attack can be scary, even bizarre, and this makes sense because a migraine is more than a drumming headache; it is often associated with other strange phenomena like mood changes, nausea, and auras.

You may be surprised to learn that a migraine attack occurs in phases—four, actually (although not everyone experiences all of them). These phases are:

  • prodrome
  • aura
  • headache
  • postdrome

    Signs & Symptoms of a Migraine Prodrome

    The prodrome phase begins hours to days (up to two days) prior to a migraine attack.

    Common signs and symptoms of the prodrome phase include:

    • increased or decreased levels of activity from normal (e.g., feeling more energized or sleeping more)
    • emotional changes, like experiencing a low mood
    • food cravings
    • nausea
    • repetitive yawning
    • tiredness
    • cognitive problems—like difficulty reading and writing
    • neck stiffness
    • light or sound sensitivity

    Signs & Symptoms of a Migraine Aura

    About one in five migraineurs experience a migraine aura—a neurological disturbance that classically entails a visual change, but may also include sensory, movement, or speech-related changes (either alone or in combination with visual changes).

    Auras can be frightening, if not strange experiences. They tend to creep up slowly and be so short (a few minutes) that some people even question if it was real. Also, some people experience longer auras, up to one hour. The good news is that aura symptoms are reversible—they do go away.

    Examples of common aura signs and symptoms include:

    • seeing flashing, waving, or zigzag lights or spots (sometimes they appear to march across your field of vision)
    • blurry vision
    • blind spots
    • increased sensitivity to touch 

    • decreased sensation

    • difficulty speaking or finding words
    • seeing, hearing, or smelling things that are not there
    • muscle weakness 
    • numbness and tingling (on the side of the body where the migraine pain is located)

    Signs & Symptoms of a Migraine Headache

    The headache phase of a migraine attack is characterized by a throbbing or pulsating head pain, almost like someone is beating a drum on their brain. The pain can be pretty brutal, enough to prevent a person from working or performing their usual daily routine. But the pain is not the worst pain of their life (this would indicate a need to go to the emergency room).

    Another common migraine sign is that the pain is usually worsened by everyday physical activities like walking, climbing stairs, or performing household chores. In fact, many people with migraines will opt to lie down, as simple movements can be quite aggravating.

     

    Other common symptoms of migraines include:

    • nausea and/or vomiting
    • light sensitivity (photophobia)
    • sound sensitivity (phonophobia) 

     The light and sound sensitivity incurred by a migraine explains why people often retreat to a dark room and put a pillow over their ears to muffle out sounds (even voices can irritate the pain of a migraine). 

    Signs & Symptoms of Migraine Postdrome

    After the pain of a migraine subsides, a person often feels wiped out. In fact, many people describe this phase as feeling like they are "hungover" or "out of it." It's thought to be due to abnormal blood flow throughout the brain, which can last up to one whole day after the headache phase.

    Common symptoms of the postdrome phase include:

    • feeling down (although some people actually experience an elevated mood)
    • decreased energy
    • difficulty thinking or paying attention
    • weakness
    • dizziness
    • lightheadedness

    Signs & Symptoms of Migraines in Children

    Up to one in 10 children get migraines, and in children, migraine symptoms are usually different from those of an adult.

    For one, migraines typically occur on one side of the head in adults, but both sides of the head in children. 

    In addition to being different, the symptoms of migraine in children are usually not as obvious. For example, children may have a hard time describing what feeling nauseous is like. They may state instead that their tummy aches, the car makes them feel sick, or that their head is spinning.

    Behavioral problems in school, like difficulty paying attention or withdrawing from peers, may also be clues of a migraine in a child. Of course, these behavioral or emotional disturbances can be from a slew of other issues (not necessarily health-related). But if you suspect your child is suffering from migraines, these behavioral clues may help you and your child's doctor piece the diagnosis together.

    Headache Disorders That Mimic Migraines

    Migraines can be tricky to diagnose, as their symptoms may overlap with those of other types of headaches. For instance, tension headaches are sometimes confused with migraines.

    Tension headaches occur on both sides of the head (migraines can too but are more likely on one side), and they feel like a tightening grip, almost like a rubber band is being stretched around your forehead and scalp.

    Another key distinguisher between the two is that the pain of a tension headache is not as disabling as that of a migraine. A person experiencing a tension headache can usually go on with their day, but just feel a bit uncomfortable. Simple movements, like walking around their home or office, will not impact their headache, as it often does in the case of a migraine.

    Sinus headaches and migraines are also commonly confused. In fact, the majority of sinus headaches are actually migraines. According to a 2007 study in Headache, 63 percent of patients who self-diagnosed themselves as having a sinus headache were actually experiencing a migraine. 

    When to See Your Doctor

    While the majority of headaches or migraines are nothing to worry about, there are some warning signs which may indicate your head pain is something more serious. A headache that is associated with new neurological symptoms like numbness, weakness (like difficulty walking or dropping things), or difficulty speaking could indicate a serious condition like a stroke. In this instance, be sure to get medical attention right away.

    Vision changes that are not typical of your migraine auras (or if new for you) need emergent medical attention as well. Thunderclap headaches—severely painful headaches that are often described as the worst headache of your life—can indicate a potentially fatal brain bleed and need emergent care.

    Other clues that warrant a doctor's eye are if your headaches are associated with worrisome whole-body symptoms like night sweats, fevers, weight loss, body aches, or extreme fatigue. A new headache or one that is following a different pattern (like becoming more frequent) is a good hint that you need a doctor's evaluation. 

    A Word From Verywell

    Migraines are complex brain disorders that are associated with a variety of symptoms unique to an individual. This diversity of symptoms is a big reason why experts are still puzzled over the precise origin  of migraine development.

    That being said, the good news is that migraine research is continuously evolving—this means even better medications and therapies (both preventive and therapeutic) are on the horizon.

    Sources:

    American Headache Society. Types of Headaches. Accessed July 5th 2016. 

    American Headache Society. Migraine Attack: The Four Phases. Accessed July 6th 2016. 

    Eross E, Dodick D, Eross M. (2007). The sinus, allergy and migraine studyHeadache, 47:213–24.

    Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders: 3rd Edition (beta version). Cephalalgia. 2013;33(9):629-808.

    Maniyar FH, Spregner T, Monteith T, Schankin CJ, Goadsby PJ. The premonitory phase of migraine—what can we learn from it? Headache. 2015;55(5):609-20.

    Ng-Mak DS. Key concepts of migraine postdrome: a qualitative study to develop a post-migraine questionnaire. Headache. 2011.;51(1):105-17.

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