Phases of migraine
Phases of migraine
0 - 24 hrs
With migraine
1 - 72 hrs
12 hrs
Premonitory
In this phase a person will likely experience a sense that something is different in their world. They feel different. It may be difficult to pinpoint the feeling or explain to others. Some people experience: irritability, elation or sadness, talkativeness or social withdrawal, increased or decreased appetite, food cravings or food avoidance, water retention, and sleep disturbances. 1 These feelings and associations let a person know that their migraine is coming on they may experience it for a full 24 hours before the headache occurs. Not everyone appears to experience this phase. 2
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Aura
Aura does not happen for everyone and only about 10-20% of children will have an aura phase to their migraines. Aura is described as happening immediately before or with a migraine. It commonly includes visual disturbances but can also be changes in other senses like hearing or smell. Visual disturbances are most often described as a curved zigzag figure seen next to where they are starring but can also be flashes or sparkles of light, a partial loss of vision (like a blind spot), or a full loss of vision in one eye. Aura can include other symptoms like attention loss, confusion, agitation, dizziness, a pricking or burning sensation in the hands, arms, legs or feet, or a weakness or inability to move one side of the body. 1
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Headache
The headache can last between 1-72 hours (After 72 hours it is referred to as status migrainosus and medical attention should be sought). Migraine headache can be different in children than it is in adults. It is also different at different ages of childhood. To read about how headaches present read: Recognizing migraine in your child or teen.
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Postdrome
This is what doctors and researchers call the phase after the headache. Generally, most people feel exhausted and tired. This can last from hours to days. Most children experience this phase for about 12 hours. Some children, however, may feel elated and energized. In children, the postdrome may include thirst, sleeplessness, visual disturbance, food cravings, abnormal tingling or prickling sensations, or pain behind the eyes. 3
1. Dodick, D. W. A Phase-by-Phase Review of Migraine Pathophysiology. Headache J. Head Face Pain 58, 4–16
2. Blau, J. N. Migraine Prodromes Separated From The Aura: Complete Migraine. Br. Med. J. 281, 658–660 (1980).
3. Mamouri, O., Cuvellier, J.-C., Duhamel, A., Vallée, L. & Nguyen The Tich, S. Postdrome symptoms in pediatric migraine: A questionnaire retrospective study by phone in 100 patients. Cephalalgia Int. J. Headache 38, 943–948 (2018).
4. Wang, S.-J., Lirng, J.-F., Fuh, J.-L. & Chen, J.-J. Reduction in hypothalamic 1H-MRS metabolite ratios in patients with cluster headache. J. Neurol. Neurosurg. Psychiatry 77, 622–625 (2006).
