Migraine Symptoms: Sneaky Signs Before Your Head Hurts

The intense, throbbing pain, sensitivity to light and sound, and occasional nausea and vomiting are telltale signs of a migraine. But for someone going through their first experience with the torturous headaches, migraines are often not so easily pinpointed.

That's because early symptoms can occur as long as 24 hours before any head pain, leaving a migraine sufferer confused and often frightened that something is horribly wrong, says Dawn C. Buse, Ph.D., associate professor of neurology at the Albert Einstein College of Medicine of Yeshiva University and the director of behavioral medicine at Montefiore Headache Center. Something significant is certainly occurring, but many are often relieved to find out it's "just" a migraine. "While it's disturbing, it's not dangerous," says Buse.

In an attempt to help soothe any future fears -- and maybe dispel some of the very real stigma facing migraine sufferers -- here are some of the most common signs it's a migraine -- before your head even hurts.

The Prodrome Stage
Migraines typically consist of four stages, although each individual migraine sufferer may not experience all four. Prodrome is the very first, and can start anywhere from 12 to 24 hours before you notice any head pain, says Buse. About 60 percent of migraine sufferers experience the symptoms related with this stage, she says, which include:

  • Constipation or diarrhea
  • Food cravings
  • Irritability, confusion, restlessness or difficulty concentrating
  • Muscle stiffness, especially neck stiffness
  • Uncontrollable yawning
  • Increased urination
  • Fatigue
  • Depression or euphoria

"Physiologically, there's a kind of cascade of neurochemical events that happen as the migraine begins," says Buse, causing this complex web of symptoms. Changes in the brainstem and brain chemical imbalances have both been implicated, but there's still much we don't understand about why migraines occur, according to the Mayo Clinic.

Right before pain starts or at the beginning of the headache is the second stage, called aura, which can consist of a host of sensory signs. About one in five people who get migraines experiences aura, according to WebMD, which can last anywhere from five to 60 minutes, Buse says. "Symptoms can be different from person to person, and may change over time," she adds. Aura, too, is still rather mysterious to experts, but the Mayo Clinic explains it may be due to "an electrical or chemical wave that moves across the part of your brain that processes visual signals." Visual symptoms are the most common, says Buse, including:

  • Spots or flashes of light
  • Vision loss
  • Shimmering spots or stars
Other symptoms can include:
  • Numbness or tingling, especially in the arms, legs or face
  • Speech problems
  • Confusion

Generally, aura should resolve pretty quickly, according to Buse, which is what distinguishes it from the more harrowing health conditions that share similar symptoms. However, if symptoms continue for more than an hour, seek medical attention.

When experiencing aura for the first time, keeping migraine risk factors in mind can help quell some of the confusion and fear. Women are more likely than men to have migraines, as is anyone with a family history. While a blind spot in your vision and some arm numbness might immediately make you think the worst, don't rule a migraine out, says Buse.

Headache And Postdrome
In stage three, the crux of the headache, intense throbbing pain is no surprise. Some migraine sufferers experience sensitivity to light, sounds or even smells, according to the Mayo Clinic. The pain, unfortunately, can last up to 72 hours, says Buse, before the final stage, postdrome. After the pain subsides, some people may feel drained of energy, while others have reported feeling joyous, according to the Mayo Clinic. Others may still feel foggy or confused, says Buse.

When To See A Doctor
The good news is that treatment options can make living with migraines much easier. "It's very common that people are living with migraine and don't realize it," Buse says, treating themselves with over-the-counter medications that aren't specifically targeted to migraines. More than half of all people living with migraines have never been diagnosed or even seen a healthcare provider about head pain, she says.

If you get moderate to severe headaches, sensitivity to light, sound or odor or feelings of nausea or vomiting, it's worth bringing up with your physician next time you two are chatting, she says. If, however, headache is interfering with your life, meaning you're missing school or work or family time on two or more days a week with killer headaches, a doctor may consider preventive treatment with migraine-specific medication, she says. A number of lifestyle habits -- like staying hydrated, getting regular sleep and keeping a headache diary to recognize your own triggers -- can help keep migraines at bay, too.

Have you ever dealt with the early signs of a migraine? Tell us how you handled the experience in the comments below.

Marcia Cross

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