Headache Care Center: What is Migraine?

Migraine headache typically consists of 4 phases: prodrome, aura, pain, and postdrome. Some migraine sufferers do not experience all 4 phases. Effective migraine management begins with the ability to recognize your pattern of prodrome and headache.
Comprehensive migraine management requires a balance of lifestyle changes and treatment with proper medication. Measures should be taken at the onset of prodrome to minimize risk factors. To be most effective, medications should be taken before the pain reaches peak intensity. Recognition of prodrome is an important link to minimize or possibly prevent the pain of migraine by learning to treat early in the headache process. Medication is more effective if taken before the pain escalates to severe. Other techniques, such as biofeedback, are also more effective if done early in the headache process. Learning to recognize your prodrome will give you greater control and success managing migraine.

Prodrome
> Pre-headache phase that is the body’s warning that it is out of balance
> Caused by chemical changes in the brain, prodrome is an early signal that a migraine is brewing
> Symptoms may include, but are not limited to, changes in mood, irritability, nausea, stiff neck, muscle tension, muscle pain or tenderness, an increase or decrease in energy, sleepiness, yawning, an increase or decrease in appetite, nasal stuffiness or drainage, and changes in mental function
> Treatment at this phase may prevent the development of the pain phase of headache

Aura
> Caused by electrical changes in the brain, aura occurs in 15% of headache sufferers
> A typical aura lasts 5 – 60 minutes, may occur before, during, or after headache, and may occur without headache pain
> The most common aura is characterized by visual distortions such as wavy lines, dots, or colored patterns in the visual field
> Alterations in taste and smell, numbness, and speech difficulties may also occur
> Treatment at this phase may prevent the development of the pain phase of headache

Pain Phase
> During the mild to moderate pain phase, medication is more effective than later in the cycle
> During the severe pain phase, medication is not as effective

Postrome
> This phase follows the pain phase, also known as a “headache hangover”
> Commonly associated with fatigue