Information for sufferers
The most common symptoms of a migraine attack include throbbing headache, sensitivity to light and noise, nausea (feeling sick), vomiting (being sick) and lethargy (lack of energy).
In some people, changes in the cortex area of the brain cause changes in their sight, such as dark spots, coloured spots, sparkles or ‘stars’, and zigzag lines. Numbness or tingling, weakness, and dizziness or vertigo (the feeling of everything spinning) can also happen. Speech and hearing can also be disturbed, and sufferers have reported memory changes, feelings of fear and confusion, and more rarely, partial paralysis or fainting. These neurological symptoms are called the ‘aura’ of migraine. In adults, they usually happen before the headache itself, but in children, they may happen at the same time as the headache.
Types of migraine
A system is in place to give different names to the migraine attacks that involve different symptoms. This helps doctors to diagnose and treat migraine. The two common forms of migraine are called migraine without aura, and migraine with aura. The 'migraine with aura' label is also used for some of the rarer forms of migraine, which also have another name. These include basilar migraine, where symptoms such as loss of balance, double vision, or fainting can occur. Familial hemiplegic migraine, where reversible paralysis occurs, is also classed as 'migraine with aura'.
There are other rare forms of migraine, which are classed separately.
Migraine attack phases
It is often difficult to predict when a migraine attack is going to happen. However, you can often predict the pattern of each attack. In adults, we can divide a migraine attack into four or five phases that lead on from each other:
- The pre-headache, or warning phase
- Aura (not always present)
- The headache
Learning to recognise the different phases of a migraine attack can be useful. You might suffer from one, all, or a combination of these stages, and the combination of stages may vary from attack to attack. Recognising different symptoms at different times during your headache attack can give a doctor information which may help diagnosis. Also, taking medication before the symptoms have fully developed may reduce the effect of an attack. A child's migraine attack is often much shorter than an adult’s attack, and it may therefore not be possible to fully make out the different headache phases.
The aura of migraine includes a wide range of neurological symptoms. This stage can last for between 5 and 30 minutes, and usually happens before the headache. Only 15% of migraine sufferers have aura. Migraine without aura does not include this stage.
- The headache
This stage involves head pain which can be severe, even unbearable. The headache is typically throbbing, and made worse by movement. Some sufferers describe a pressing or tightening pain. The headache is usually on one side of the head, especially at the start of an attack. Some sufferers get pain on both sides of the head, or over the forehead, but not usually at the back of the head. Nausea (sickness) and vomiting (being sick) can happen at this stage, and the sufferer may feel sensitive to light or sound, or both.
Most attacks slowly fade away, but some stop suddenly after the sufferer is sick, or cries a lot. Sleep seems to be the best 'cure' for many sufferers, who find that even an hour or two can be enough to end an attack. Many children find that sleeping for just a few minutes can stop their attack.
This is the final stage of an attack, and it can take hours or days for a ‘hangover’ type feeling to disappear. Symptoms can be similar to those of the first stage, and often they are mirrored symptoms. For example, if you lost your appetite at the beginning of the attack, you might be very hungry now. If you were tired, now you might feel full of energy.