"It's just a headache, take an aspirin and let's go!"

Do you feel frustrated that many of your friends and family don't understand what you are going through?

The reason maybe that most people who don't suffer from migraines think of them as merely a bad headache.  Migraineur's on the other hand know differently.  In addition to the headaches there maybe nausea, visual disturbances, and in rarer cases blindness and even paralysis.  

The migraine attack has been broken down into clinical phases.  Each of these phases describes a part of the migraine attack, namely: prodrome, aura, headache, and resolution/postdrome.  Although there are four phases, migraine sufferers may not experience all of them.

Prodrome and Premonitory Phase 

This phase consists of symptoms that are experienced to 24 hours prior to the onset of the headache.  Symptoms may include:

• fatigue
• muscle pain in neck or nead
• food cravings
• difficulty thinking
• nasal congestion
• anxiety
• irritability
• and many more

When these symptoms occur in a recognizable pattern that helps the migraine sufferer predict the onset of a headache it is termed a prodrome.  

These premonitory symptoms are due to neurological abnormallities in the central nervous system.  

Aura 

Auras are neurological changes that typically affect vision.  Flashing lights or visual scotomas (disturbances in visual field) will occur up to 60 minutes prior to the onset of the headache.  This phase is found in about 15% of migraine attacks.

Headache

The headache phase of the migraine attack lasts typically 4-72 hours and is typically described as a throbbing, pulsating pain on one or both sides of the head.  The migraine varies from mild to moderate or severe through this phase.  

Nausea, sensitivity to light and sound are common symptoms that can be experienced during the headache.  Any activity that increases internal pressure may intensify the pain.  

Resolution and Postdrome Phases

As the headache subsides the migraine attack enters the resolution phase.  Typically the resolution phase is associated with sleep.  

After resolution the migraine sufferer will typically go through a postdrome or hangover after the resolution of headache symptoms.  Sometimes this hangover will resemble the prodrome and usually consists of:

• fatigue
• lethargy
• irritability
• mental fog
• difficulty thinking
• sore muscles
• and more

With a better understanding of the neurological process behind a migraine, one can see how migraines are more than just a headache.  Although the above phases describe the typical migraine, migraine attacks and their symptoms can vary.  There are even some types of migraines that have no headache phase associated with them!