18 Signs of a Migraine

How can you tell if you’re having or about to have a migraine? Look for these signs.

Migraines, affecting approximately 12% of the U.S. population, are recognized as one of the most prevalent headache disorders. However, the impact of migraines transcends the boundaries of mere headaches. Migraine episodes are often accompanied by a multitude of severe symptoms, encompassing nausea, vomiting, and profound fatigue. Moreover, individuals susceptible to migraines frequently grapple with an array of warning signs, heralding the impending onset of this debilitating condition. These early indicators may include mood fluctuations, sleep disturbances, and cognitive impairments, which manifest days prior to the actual headache.

In this comprehensive exploration, we aim to delve deeper into the multifaceted landscape of migraines, shedding light on the diverse warning signs that precede or accompany these episodes. By understanding these cues, individuals can better prepare for, mitigate, or even prevent the onset of migraines, significantly improving their quality of life.

1. Aura: A Migraine’s Enigmatic Prelude

Approximately 30% of migraine sufferers experience what is known as an aura either before or during a migraine episode. Auras are characterized by a spectrum of sensory disturbances, most commonly visual in nature. These visual disturbances may manifest as flickering lights, zigzag lines, or blind spots. Furthermore, some individuals contend with auditory disturbances, such as tinnitus (ringing in the ears), auditory hallucinations, or heightened sensitivity to sounds. Approximately 10% of individuals with migraines experience linguistic alterations, leading to difficulties in comprehension or word-finding challenges. In rare cases, motor auras can manifest as muscle weakness affecting one side of the face or the entire body.

Typically, auras persist for durations ranging from five minutes to an hour, with their onset occurring either within an hour before the headache or concurrently with it. Intriguingly, some individuals may encounter auras devoid of an ensuing headache, adding to the complexity of migraine experiences.

2. Mood Oscillations: Unmasking the Prodromal Phase

Migraine’s influence extends beyond physical discomfort, as it often casts its shadow over one’s emotional well-being. These mood changes make their appearance during the prodromal phase, the initial stage of a migraine attack that may commence hours or even days before the onset of auras or headaches. This phase, distinguished from auras by its prolonged duration (spanning several hours to days), serves as a precursor to the forthcoming migraine experience.

Individuals navigating the prodromal phase may find themselves grappling with a spectrum of mood alterations, encompassing depression, irritability, and heightened excitability. Remarkably, the prodromal phase’s manifestations are highly variable, with some individuals reporting intense euphoria—a state characterized by profound excitement and happiness. Moreover, it is essential to recognize that migraines are intrinsically linked to higher rates of mood disorders, including depression, anxiety, and post-traumatic stress disorder (PTSD). This nexus between migraines and psychiatric conditions not only complicates migraine management but also escalates the risk of developing chronic migraines—defined as experiencing “15 or more headache days per month, with eight of those days involving migraine headaches.”

3. Sleep Disruption: The Vicious Cycle

Sleep, an essential element of well-being, often becomes collateral damage when migraines strike. Migraine episodes significantly disrupt sleep patterns, leading to a vicious cycle that exacerbates the condition. Dr. Edmund Messina, Medical Director of the Michigan Headache Clinic in East Lansing, notes that many migraine sufferers grapple with insomnia as a direct consequence of their condition.

Furthermore, sleep disturbances rank among the most frequently cited migraine triggers, according to a recent review published in the journal Frontiers in Neurology. The inability to obtain restful sleep not only exacerbates migraine symptoms but also perpetuates the cycle by potentially triggering further episodes.

4. Sinus Symptoms: Misleading Indicators

Some individuals afflicted by migraines encounter sinus-related symptoms, such as nasal congestion, clear nasal discharge, droopy eyelids, or excessive tearing. These manifestations often lead healthcare providers to misdiagnose the condition as a sinus headache—a type of headache induced by bacterial or viral sinus infections. However, a critical study published in the Journal of Family Medicine and Primary Care in June 2019 underscores the frequency of such misdiagnoses, emphasizing that many sinus-like headaches are, in fact, migraines. This revelation highlights the importance of recognizing migraines’ diverse presentations and avoiding misclassification, which could impact the choice of treatment.

5. Cravings: Migraine’s Palate Predicament

Intriguingly, some individuals experience specific food cravings before a migraine attack. Notably, chocolate often emerges as a common craving among migraine sufferers. However, it is crucial to acknowledge that certain foods, including chocolate and certain cheeses, have been identified as potential migraine triggers, as outlined by MedlinePlus.

Recent research published in the Journal of Neurology in January 2021 suggests that what individuals perceive as migraine triggers, such as chocolate, may indeed constitute early symptoms of migraines. This novel perspective challenges conventional notions about migraine triggers and further underscores the intricacies of this condition.

6. Throbbing Pain: The Signature of Migraines

A pulsating, throbbing pain is the hallmark of migraines. Most individuals grappling with migraines experience this type of pain on one side of their head. This distinctive feature serves as a valuable diagnostic criterion, aiding healthcare providers in distinguishing migraines from other headache disorders, as highlighted by MedlinePlus.

7. Eye Pain: A Distinctive Migraine Phenomenon

Migraine pain frequently localizes in specific regions around the eye. It can affect the temples, the area behind one eye or ear, and even extend into the eye socket itself, as documented in an April 2015 paper. This eye-related discomfort often leads individuals to attribute their symptoms to eye strain, leading them to consult optometrists. However, Dr. Messina emphasizes that addressing eye-related issues rarely provides relief from migraine-related headaches.

8. Neck Pain: A Precursor to Migraines

Some individuals report experiencing neck stiffness or discomfort before the onset of a migraine. This symptom, often dismissed as unrelated, is actually an early harbinger of an impending migraine, notes Dr. Messina. Furthermore, some individuals may experience throbbing pain at the back of their neck following a migraine episode. It is crucial to note that if neck stiffness accompanies a headache along with fever, nausea, and vomiting, seeking immediate medical attention is essential, as these symptoms could potentially indicate a more severe underlying condition, as outlined by MedlinePlus.

9. Frequent Urination: An Early Warning Sign

Frequent urination emerges as a prominent indicator that a migraine is on the horizon. This symptom typically surfaces during the prodromal phase, signaling the body’s preparations for the impending migraine. Simultaneously, fluid retention may occur, leading to the accumulation of fluid in bodily tissues and cavities, potentially resulting in localized swelling. Additionally, some individuals may experience frequent urination and diarrhea as the headache progresses, as detailed in the April 2015 paper.

10. Excessive Yawning: An Involuntary Prelude

Excessive yawning, distinct from regular tiredness-induced yawning, can serve as a significant indicator that a migraine episode is imminent. This type of yawning is often uncontrollable and may occur at shorter intervals, sometimes every few minutes. According to a September 2017 study in the journal Headache, yawning is reported by approximately 45% of individuals with migraines, particularly during the prodromal phase. Notably, individuals who experience yawning tend to be more susceptible to auras, nausea, and vomiting during their migraine episodes.

11. Numbness or Tingling: The Sensory Auras

Some individuals with migraines encounter sensory auras, characterized by temporary sensations of numbness or a “pins-and-needles” feeling. These sensations typically manifest on one side of the body, commencing at the fingertips and progressing through the arm before extending across the face. Such sensory disturbances are documented in medical literature, as detailed in StatPearls.

12. Nausea and Vomiting: Intrinsic Migraine Symptoms

According to the International Classification of Headache Disorders (ICHD-3), a diagnosis of migraine without aura necessitates the presence of specific symptoms. These include either a combination of nausea and/or vomiting or heightened sensitivity to light and sound during a migraine episode. Often, all four of these symptoms may co-occur, further intensifying the overall distress experienced by migraine sufferers.

Managing severe migraine pain, particularly when accompanied by nausea and vomiting, frequently involves the administration of pain medications through non-oral routes, such as injections or infusions. Additionally, antiemetics, medications designed to alleviate nausea and vomiting, may be prescribed in conjunction with pain relief measures.

13. Sensory Hypersensitivity: Seeking Refuge in Darkness and Silence

During a migraine episode, individuals instinctively seek solace in a dark, quiet environment. Bright lights, loud noises, and certain odors can serve as potent triggers for migraines or exacerbate existing pain. This heightened sensitivity to external stimuli, referred to as photophobia (fear of light) and phonophobia (fear of sound), is particularly associated with migraines without aura, as documented in StatPearls.

Remarkably, approximately 76% of individuals who experience migraines identify specific triggers that contribute to their attacks. Exposure to bright light is reported to trigger migraines in 38% of individuals who acknowledge the presence of triggers. Similarly, certain odors, including perfumes, colognes, and gasoline, serve as migraine triggers for approximately 40% of individuals who report experiencing these triggers. Notably, stress ranks as the most prevalent trigger, with a staggering 80% of migraine cases being attributed to this factor.

14. Activity-Induced Agony: Migraines and Routine Tasks

Ironically, routine activities such as walking or climbing stairs may amplify migraine-related pain for some individuals. Additionally, some individuals experience exercise-induced migraines, triggered by activities like running and weightlifting, or exertion-induced migraines stemming from events such as sexual activity. These exertion-induced headaches warrant a comprehensive evaluation to rule out underlying causes, including potential brain aneurysms.

15. Speech Impairment: Struggling for Words

The prodrome phase of migraines can manifest as difficulties in articulating thoughts and speech. Individuals may find themselves struggling to find words or experiencing difficulties in understanding language—a perplexing phenomenon that patients often describe as “blithering,” according to Dr. Messina. Importantly, if speech problems manifest for the first time or are accompanied by other concerning symptoms, such as a sudden onset of headache, fever, nausea, and vomiting, prompt medical evaluation is imperative to exclude potentially serious conditions, such as a stroke.

16. Muscle Weakness: A Subtle Sign

In some instances, migraine episodes may be heralded by muscle weakness affecting one side of the body, commonly referred to as motor auras. This phenomenon, documented in StatPearls, can add another layer of complexity to the migraine experience. However, it is essential to recognize that muscle weakness can also signify more serious conditions, including a stroke. Thus, seeking prompt medical assessment is vital in such cases to ensure accurate diagnosis and appropriate management.

17. Brainstem Aura: A Distinct Migraine Variation

Basilar migraines, a distinct subtype of migraines, are characterized by brainstem aura symptoms, as outlined in StatPearls. The brainstem, situated in the lower part of the brain and responsible for connecting the brain to the spinal cord, becomes the focal point of these migraines. Brainstem-related symptoms associated with basilar migraines are typically more severe in nature and exhibit prolonged durations compared to typical migraine auras.

These symptoms encompass vertigo (dizziness), double vision, slurred speech, tinnitus (ringing in the ears), impaired coordination, confusion, and, in some instances, a complete loss of consciousness. The distinct features of basilar migraines necessitate careful consideration and evaluation by healthcare providers to ensure accurate diagnosis and appropriate management.

18. Migraine “Hangover”: Lingering Postdrome Symptoms

The conclusion of a migraine episode does not signify an immediate return to normalcy for many individuals. Instead, they often contend with postdrome symptoms, a phase known as the postdrome phase, as elucidated by MedlinePlus. This phase is characterized by a range of lingering symptoms, including fatigue, concentration difficulties, weakness, dizziness, lightheadedness, and a pervasive sense of depleted energy. These post-migraine symptoms can be profoundly fatiguing and impact daily functioning, further highlighting the enduring nature of migraines beyond the acute attack.

In conclusion, migraines represent a complex and multifaceted neurological condition that extends far beyond the realms of a mere headache. By recognizing the diverse warning signs that precede or accompany migraines, individuals can better understand and manage this debilitating condition. Moreover, acknowledging the intricate interplay of symptoms during various migraine phases—prodrome, aura, headache, and postdrome—enables a more comprehensive approach to migraine management and empowers individuals to seek timely medical intervention when needed. To effectively navigate the labyrinthine landscape of migraines, it is crucial to prioritize awareness, education, and personalized healthcare strategies, ultimately improving the quality of life for migraine sufferers worldwide.