Recently I passed the six month milestone of writing this blog, which prompted some reflection and also a little looking forward. As a result, I’ve planned some new content around migraine, and thought I’d start with this one on the four phases of an attack.
At one time, I had planned to write a more consistent series around Migraine Basics, but so far I’ve only posted one. Here then is my attempt to get back on track with that topic.
The Four Phases of a Migraine Attack
The first phase signals the onset of a migraine attack, and can be considered a “warning stage”. It will last anywhere from a few hours to a few days. There is a lengthy list of potential symptoms, including mood changes, food cravings, fatigue, brain fog, nausea, muscle stiffness and sleep disturbances. While some of these could easily be mistaken as the “cause” or “trigger” of an attack, they actually indicate the attack has already begun and should be treated if possible.
Aura is specific to the migraine diagnosis Migraine With Aura, meaning many will not experience it. It typically lasts from a few minutes up to an hour, and generally presents itself as temporary neurological disturbances like tunnel vision or visual spots of light, vertigo, numbness or tingling, or difficulty with speech.
The headache phase is commonly misunderstood as the only element of “having a migraine”. While it’s probably the most intense and most debilitating phase, it’s only part of the larger scope of an attack, and of migraine as a whole. Many vivid descriptions of headache pain exist, including words like throbbing, pounding, burning and piercing. Other typical symptoms of the headache phase include nausea, and extreme sensitivity to light, sound, smell, and movement.
The headache can last for 4-72 hours for many people if left untreated, but it can also last longer, particularly in cases of chronic migraine.
Postdrome is the final phase and usually lasts a day or two after the headache resolves. It’s marked by fatigue, brain fog and a general feeling of being drained.
Although it looks straightforward and clearly defined in theory, in real life it’s usually a lot messier. We miss recognizing the prodrome phase because it’s a little vague, and life is distracting. Sometimes the headache returns after medications have worn off. One attack can blur into the next one.
But still, understanding this basic progression is helpful. Realizing that an attack starts before the headache and persists afterwards is important. Paying attention to symptoms and timing equips us for managing an attack, and tracking it somehow is a useful way to pay attention.
Take good care of yourselves, lovely people. xx
Resting is not laziness, it’s medicine.Glenn Schweitzer
Stationery in the Photo
P.S. Completely unrelated, but there’s a gorgeous new Leonard Cohen cover out from Norah Jones that I’m listening to right now.