Medical What Are the Four Phases of a Migraine Episode?

[zoobyshoe]

When many people think "migraine" they think only of the pain of migraine. In reality, a migraine episode consists of far more. The typical migraine episode actually consists of four parts, referred to as phases or components. It's important to note that not every migraineur experiences all four phases. Also, episodes can vary with different phases experienced during different episodes. The four phases of a migraine episode are:

* Prodrome
* Aura
* Headache
* Postdrome

http://headaches.about.com/cs/headpain101/a/anatomy_mig.htm

Here's an interesting thing to note:

As noted earlier, not all migraine episodes include all phases. Although not the majority of episodes, there are some migraine episodes in which migraineurs experience aura but no headache. There are several terms used for this experience, including "silent migraine," "sans-migraine," and "migraine equivalent."

So, interestingly enough, having a migraine attack does not necessarily mean having a headache.

 

[lisab]

Interesting, zooby. I never knew us migraine sufferers were referred to as "migraineurs" lol .

There was a time in my life when I was crippled by migraines. A non-sufferer wouldn't undersand how they interrupt normal life.

But once I got my allergies under control, the headaches basically went away. Yet all those years I never had the classic allergy symptoms, i.e., nasal congestion, sneezing, etc.

 

[waht]

I have spring allergies, with nasal congestions and the whole nine yards, plus once in a while I will get that migraine too, but only during allergy season. I read about the aura before but never actually experienced it though, it's pretty scary.

 

[zoobyshoe]

Interesting, zooby. I never knew us migraine sufferers were referred to as "migraineurs" lol .

Leave it to the French!

There was a time in my life when I was crippled by migraines. A non-sufferer wouldn't undersand how they interrupt normal life.

But once I got my allergies under control, the headaches basically went away. Yet all those years I never had the classic allergy symptoms, i.e., nasal congestion, sneezing, etc.

Did you experience the four stages?

 

[berkeman]

But once I got my allergies under control, the headaches basically went away. Yet all those years I never had the classic allergy symptoms, i.e., nasal congestion, sneezing, etc.

Interesting. I'd heard about the connection for some migrane sufferers between menstrual cycle and migranes, but hadn't heard about the allergy connection. Is it common?

 

[zoobyshoe]

Interesting. I'd heard about the connection for some migrane sufferers between menstrual cycle and migranes, but hadn't heard about the allergy connection. Is it common?

I can't find anything in the way of a hard science paper about this. Only this sort of thing:

http://health.families.com/blog/allergies-and-migraines-linked

Allergies are not mentioned as prime suspects in discussions of Migraine cause. More often you read it being laid to genetic disposition.

 

[waht]

I had one allergy doctor tell me my headaches are not related, while another doc said definitely. Now as I take allergy shots, migraines are triggered more often.

 

[zoobyshoe]

I had one allergy doctor tell my headaches are not related, while another doc said definitely. Now as I take allergy shots, migraines are triggered more often.

What were your allergy symptoms?

 

[waht]

What were your allergy symptoms?

Sneezing, running nose, watery itchy eyes, and congestion.

 

[zoobyshoe]

Sneezing, running nose, watery itchy eyes, and congestion.

And the allergy shots trigger severe headaches? What's in the allergy shots?

 

[waht]

And the allergy shots trigger severe headaches?

I used get migraines and nausea without the shots only during the allergy season. But with the shots it can occur any time during a year, but with less frequency as in the allergy season.

What's in the allergy shots?

I have custom prepared allergen doses, which are the actual things that the immune system responds to, and there is a plethora of those. If it works, it should reduce sensitivity of the immune system to these allergens.

 

[zoobyshoe]

I have custom prepared allergen doses, which are the actual things that the immune system responds to, and there is a plethora of those. If it works, it should reduce sensitivity of the immune system to these allergens.

So, you're essentially triggering the allergic response, which supports the alleged link between the allergy and the headaches, right?

 

[somasimple]

The four phases of a migraine episode are:

* Prodrome
* Aura
* Headache
* Postdrome

The most interesting thing in the sequence is that migraineurs are aware of the sequence itself.
If you know the images of a movie you may change the end and/or play it, actively.
It just means that you have some control on it: principally, headhaches which is the painful state.

 

[Andy Resnick]

I had spring allergies while in graduate school (Tennessee Valley region), and would get regular migraines during allergy season. When I left the area, the allergies subsided, and so did the migraines.

Feeling the 'aura'- and there's no question what that feels like- was never a good day.

 

[zoobyshoe]

I had spring allergies while in graduate school (Tennessee Valley region), and would get regular migraines during allergy season. When I left the area, the allergies subsided, and so did the migraines.

Feeling the 'aura'- and there's no question what that feels like- was never a good day.

Of what did your aura consist?

 

[ViewsofMars]

I'd get a nasty cold every year around Christmas until I realized it was an allergy reaction to the decorated pine tree in my home.

I've had one migraine in my lifetime which occurred when I was twelve years old. That was a mighty long, long time ago.

Some scientists believe that people who get migraines have inherited a tendency for their nervous systems to react differently to changes in their bodies or their environment. Certain things may trigger a reaction in the person's nervous system and start a migraine attack.

Some common triggers are:

stress
menstruation (having a period)
skipping meals
too much caffeine (like cola drinks)
certain foods (cheese, pizza, chocolate, ice cream, fatty or fried food, lunch meats, hot dogs, yogurt, or anything with MSG, a seasoning often used in Asian foods)
too much or too little sleep
weather changes
travel

No one is really sure why people get migraines. But chances are, if you get migraines, another member of your family gets them as well. That's because scientists think migraines are genetic, which means that certain genes passed on from parents make a kid more likely to get them.
http://kidshealth.org/kid/ill_injure/aches/migraines.html#

 

[waht]

So, you're essentially triggering the allergic response, which supports the alleged link between the allergy and the headaches, right?

That seems to be the case. When I started this immunotherapy before spring, got a migraine three to four days after the first shot, and so for the first three weeks at same time intervals. And the shots were administered every week as well. Then later on I've been getting less migraines, and they happen very erratically.

 

[zoobyshoe]

I've had one migraine in my lifetime which occurred when I was twelve years old.

Only once? Why do you think it was a migraine?

The basic problem may well stem from not communicating this one basic fact: A migraine is not a headache. Yes, you read that correctly. A Migraine is not a headache.

Whether you call it "Migraine,' "Migraine Disease," or "Migraine Disorder," Migraine is actually a recurrent, episodic, genetic, neurological disease. What does that mean? It means that Migraineurs have a genuine neurological disease -- all the time.

When Migraineurs have a Migraine episode or attack, the headache is just one symptom of the episode. It is not the actual episode. The point is, the term "Migraine headache" is not only incorrect, it's misleading, and may be a source of the misunderstanding of Migraine. As Migraineurs, we don't experience "Migraine headaches;" we experience "Migraine episodes" or "Migraine attacks."

http://headaches.about.com/cs/education/a/mig_not_ha.htm

 

[ViewsofMars]

Only once? Why do you think it was a migraine?

Zoobyshoe, a licensed physician diagnosed it as a *migraine* due to the onset of my first menstrual period. (Please note previous post on p.g.1) I was flat on my back unable to do anything. It was horrible, and I won’t ever forget it even at my age (over fifty)! Apparently, that migraine that occurred in my youth was a once in a lifetime event, which is rare. As far as headaches, I should mention that I’ve only had a few. I'll leave it at that since I don’t think it wise to conduct a full blown clinical trial study on an internet forum about migraines and headaches.

 

[zoobyshoe]

...a licensed physician diagnosed it as a *migraine* due to the onset of my first menstrual period.

I see.

 

[Evo]

I've had Opthalmic Migraines, painless, with just visual images as I first described in the post below. So bizarre and beautiful. Similar to this except much more complex.

http://www.richmondeye.com/images/migraine2.jpg

Ophthalmic migraine

I had a very weird experience earlier today. I suddenly noticed a thin glowing white crescent filled with black geometrical designs in my peripheral vision.

The only way I can explain it is if you were to take a thin glowing ring and cut it in half, keeping only the left half. It's glowing white, but is filled with portions of concentric circles and diagonal lines as if parts of triangles were visible, these are all black. The light is somehow flickering very fast, but not getting darker or brighter.

The half ring continued to grow larger, then the designs at the top started rotating to the left as the bottom designs started rotating to the right, then the designs in the middle started undulating. The entire ring started to turn clockwise very slowly.

I was very concerned, to say the least. I could tell it had to do with my vision as the half ring remained in my peripheral vision when I moved my eyes. I found online a description that might explain what I was seeing. It is called ophthalmic migraine. The ring finally drifted out of my vision after about 15 minutes, changing the entire time. When I was reading online I noticed the the letters under the "ring" were not visible at all.

It was absolutely fascinating.

Has anyone here experienced one of these or know about them?

Here is the explanation: "Ophthalmic migraine is quite common. Patients usually experience visual symptoms of seeing bright zig-zag type lines in their central or peripheral (side) vision. These bright lines may have associated flashing light sensations and sometimes can interfere with vision. There are many variations of symptoms. These symptoms usually resolve spontaneously after several minutes but usually less than one hour. Often, rest in a darkened room can be helpful during a migraine attack. Medical treatment is usually not necessary."

http://eugeneeyecare.com/conditions/..._Migraine.html

https://www.physicsforums.com/showpost.php?p=533806&postcount=1

 

[Andy Resnick]

Of what did your aura consist?

Fortunately, I haven't had a migraine in years, so my memory is faulty (I mean, why would I want to remember that?)...

Going by the website you posted, I guess I am referring to both the prodrome and aura. I would get muscle stiffness in my neck (specifically, along the back of the neck) which would preceed to hypersensitivity to touch (all over) and a 'tingling sensation'... that's not exactly right, it was like I could feel the inside of my head. There was always a clear mental image of glowing light located at the locus of pain.

Ok, now I can remember... and my head hurts. I better stop now.

 

[zoobyshoe]

I've had Opthalmic Migraines, painless, with just visual images as I first described in the post below. So bizarre and beautiful. Similar to this except much more complex.

I remember when you posted about this.

Has this happened again since then?

 

[zoobyshoe]

Fortunately, I haven't had a migraine in years, so my memory is faulty (I mean, why would I want to remember that?)...

Going by the website you posted, I guess I am referring to both the prodrome and aura. I would get muscle stiffness in my neck (specifically, along the back of the neck) which would preceed to hypersensitivity to touch (all over) and a 'tingling sensation'... that's not exactly right, it was like I could feel the inside of my head. There was always a clear mental image of glowing light located at the locus of pain.

Ok, now I can remember... and my head hurts. I better stop now.

Do you drink coffee or tea or caffeinated soda fairly often?

When I was a kid I used to get wicked unilateral headaches now and then but they started to diminish in frequency in high school, which is also when I started drinking coffee everyday. Oliver Sacks reports in his book Migraine that caffein is sometmes the only thing that will sooth some people's migraines. I was never taken to the doctor for these headaches so I don't know if I'd have been told they were Migraine attacks, there was no prodrome or aura, but in college I made the specific association between coffee and headache relief. First I'd try an aspirin. Sometimes that worked. If it didn't I go get a coffee, and that always worked. I reccomended this to a friend who had a headache and he came back ready to kill me because the coffee had made his much worse. That made no sense to me till I read what Oliver Sacks had said, and suspected I'd been having Migraine attacks.

 

[Evo]

I remember when you posted about this.

Has this happened again since then?

Yes, it happened again shortly after that, but not since. Very cool though. Amazing what you can see that is not there. Of course it was scary at first since I wasn't sure what was happening. I wonder why it is always recognizable geometric patterns?

 

[zoobyshoe]

Yes, it happened again shortly after that, but not since. Very cool though. Amazing what you can see that is not there. Of course it was scary at first since I wasn't sure what was happening. I wonder why it is always recognizable geometric patterns?

Well, with a bit of googling I discovered that Oliver Sacks, himself, turns out to be a migraineur:

...But we still have only a very primitive understanding of what, to my mind, are among the most intriguing phenomena of migraine — the geometric hallucinations it so often evokes. What we can say, in general terms, is that these hallucinations reflect the minute anatomical organization, the cytoarchitecture, of the primary visual cortex, including its columnar structure — and the ways in which the activity of millions of nerve cells organizes itself to produce complex and ever-changing patterns. We can actually see, through such hallucinations, something of the dynamics of a large population of living nerve cells and, in particular, the role of what mathematicians term deterministic chaos in allowing complex patterns of activity to emerge throughout the visual cortex. This activity operates at a basic cellular level, far beneath the level of personal experience. They are archetypes, in a way, universals of human experience.

The whole article is pretty fascinating:

http://migraine.blogs.nytimes.com/2008/02/13/patterns/

 

[Evo]

Thanks for the article! I would actually like to see it again, it was that fascinating. Sure beats the painfull migraines.

 

[zoobyshoe]

Thanks for the article! I would actually like to see it again, it was that fascinating. Sure beats the painfull migraines.

The next article by Siri Hustvedt is also a great read, on the same subject of migraine aura:

I was lying in bed reading a book by Italo Svevo, and for some reason, looked down, and there they were: a small pink man and his pink ox, perhaps six or seven inches high. They were perfectly made creatures and, except for their color, they looked very real. They didn’t speak to me, but they walked around, and I watched them with fascination and a kind of amiable tenderness. They stayed for some minutes and then disappeared. I have often wished they would return, but they never have.

http://migraine.blogs.nytimes.com/2008/02/17/lifting-lights-and-little-people/

 

[waht]

can you actually experience aura without the headache?

 

[zoobyshoe]

can you actually experience aura without the headache?

See the opening post.