The Different Phases of a Migraine Attack

Although each person’s experience with migraines will vary there are strong similarities in the stages or phases of each attack. For each migraine there’s a period where just a few symptoms are experienced, followed by the onset of head pain, and ending with a gradual return to normal. These phases are commonly referred to as the preheadache, headache, and the postheadache:

Phase I: The Preheadache

This phase can begin hours before the actual headache occurs. During this phase the patient may experience:

  • mood swings
  • bloating
  • constipation
  • frequent urination
  • increased thirst
  • irritability
  • cravings for carbohydrates or sweets
  • aura, which usually begins between 30 minutes to 2 hours before the next phase. It usually ends 1 hour before the head pain begins.

Phase II: The Headache

It is during this phase that the migraine symptoms are the most severe. It is primarily characterized by head pain and nausea or vomiting however other parts of the body may be affected as well:

  • head pain
  • nausea or vomiting
  • coldness in the hands or feet
  • nasal congestion or runny nose
  • sensitivity to light
  • sensitivity to odors
  • irritability
  • depression
  • inability to concentrate
  • loss of appetite
  • facial swelling
  • a bloodshot eye
  • sensitivity to being touched
  • water retention

The headache phase can last from 4 to 72 hours. If the headache phase extends past 72 hours seek medical attention immediately because it may indicate the presence of a more serious condition.

Phase III: The Postheadache

This is the 24-hour period following the headache phase. Some people experience tiredness, fatigue, or feelings of depressions at this stage. Surprisingly, some people react just the opposite they feel happy, elated, or euphoric.

Other common postheadache symptoms include:

  • frequent yawning
  • inability to engage in physical activity
  • inability to concentrate

Because many of the symptoms overlap and occur in more than one phase it’s important to pay close attention to what occurs during a migraine attack. Developing the ability to distinguish between the 3 migraine phases will improve your ability to take preventative measures when the symptoms first occur.

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