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A migraine is an intense headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It is often accompanied by nausea, vomiting and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with daily activities.

For some, a warning symptom known as an aura occurs before or with the headache. An aura can include visual disturbances, such as flashes of light or blind spots, or other disturbances, such as tingling on one side of the face or in an arm or leg and difficulty speaking.


Migraines can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines experiences all stages.

  • Prodrome – subtle changes that occur one to two days before a migraine.
    • Constipation
    • Mood changes
    • Food cravings
    • Neck stiffness
    • Increased urination
    • Fluid retention
    • Frequent yawning
  • Aura – an aura acts as a warning signal that a migraine is about to begin. They can last up to an hour.
    • Visual disturbances (seeing shapes, bright spots or flashes of light)
    • Vision loss
    • Pins and needles sensations in an arm or leg
    • Weakness or numbness in the face or one side of the body
    • Difficulty speaking
  • Attack – migraines usually last 4 to 72 hours is left untreated.
    • Pain usually on one side of the head
    • Pain that throbs or pulses
    • Sensitivity to light and sound (sometimes smell and touch)
    • Loss of appetite
    • Nausea and vomiting
    • Dizziness and blurred vision
    • Feeling very warm or cold
    • Pale skin color (pallor)
  • Post-drome – after a migraine attack.
    • Drained, confused and “washed out”
    • Sudden movement may briefly bring back migraine pain
    • For some, feelings of euphoria

Seek medical attention immediately for the following signs and symptoms:

  • An abrupt severe headache (thunderclap headache)
  • Headache with fever, stiff neck, confusion, seizures, double vision, numbness or weakness in any part of the body, which could be a sign of a stroke
  • Headache after a head injury
  • A chronic headache that is worse after coughing, exertion, straining or a sudden movement
  • New headache pain after age 50


  • Hormonal changes in women
  • Alcohol
  • Caffeine
  • Stress
  • Sensory stimuli (bright or flashing lights, strong smells)
  • Sleep changes
  • Intense physical exertion
  • Weather changes
  • Medications
  • Certain foods (salty and processed foods, food additives such as aspartame and MSG)


Symptoms should be discussed with a primary care physician first to diagnose migraines and prescribe treatment. In serious cases, a primary care physician can refer patients to a neurologist to diagnose migraines and conduct a physical and neurological examination. Tests can include magnetic resonance imaging (MRI) and computerized tomography (CT or CAT) scan.


Individualized treatment options depend on the frequency and severity of migraines and the symptoms associated with migraines. Pain-relieving medications can be taken during migraine attacks to stop symptoms. Preventative medications can be taken regularly to reduce the severity or frequency of migraines.

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