What Is a Migraine? Phases, Symptoms and Common Patterns

Migraine is a neurological condition

Migraine involves the brain, the nervous system and the blood vessels of the head. Alongside head pain, many people experience sensitivity to light and sound, nausea, visual disturbance and fatigue. It is one of the most common neurological conditions worldwide, and the World Health Organization lists it among the leading causes of years lived with disability.

The four phases of an attack

Not everyone experiences every phase, and phases can overlap. Recognising them helps you notice an attack early.

• 01Premonitory (prodrome): hours to days beforehand. Yawning, mood shifts, neck stiffness, food cravings, unusual tiredness.
• 02Aura: around a quarter of people. Visual zigzags or blind spots, tingling, or speech difficulty, usually lasting under an hour.
• 03Headache: throbbing or pulsing pain, often one-sided, made worse by movement, light and sound. Can last from four hours to three days.
• 04Postdrome: the 'migraine hangover'. Drained, foggy, tender, sometimes for a further day.

How it differs from a tension headache

A tension-type headache is usually a steady band of pressure on both sides of the head, without nausea, and it is not typically worsened by movement. Migraine is more often one-sided, pulsating, and accompanied by sensory sensitivity. Many people live with both, which is one reason keeping a simple diary is so useful.

Common triggers people report

Triggers are highly individual and are often a combination rather than a single cause. Frequently reported ones include:

• 01Irregular sleep, including catching up at weekends
• 02Skipped meals and dehydration
• 03Stress, and the release of stress afterwards
• 04Hormonal changes across the menstrual cycle
• 05Weather and barometric pressure shifts
• 06Prolonged screen exposure, glare and flicker

When to seek medical advice

Speak to your GP if headaches are frequent, worsening, or interfering with daily life, or if you are using acute pain relief on more than two days a week. Seek urgent care for a sudden severe 'thunderclap' headache, headache with fever, stiff neck, rash, weakness, confusion, or after a head injury. This page is general education and is not medical advice.