Stages of Migraines

Unraveling the Mystery: The Four Stages of Migraines Explained

Anyone who suffers from migraines can tell you that the pain is intense, complex and unpredictable.

Stages of Migraines

An attack may last just an hour or linger for several days. Symptoms vary wildly and seem completely unrelated to one another. Some patients report never having symptoms at all aside from an aching head.

Ancient Egyptians had trouble describing migraines back in 1200 B.C. Modern scientists are mystified as well, but they know that attacks typically occur in four distinct stages. Knowing what to expect will eliminate unpleasant surprises and help you prepare.


Up to a full day before the migraine sets in, you may experience one or more of the following symptoms:

  • Unusual energy
  • Depression
  • Excitability or irritability
  • Extreme thirst or food cravings
  • Drowsiness
  • Excessive yawning
  • Stomach upset
  • Frequent urination

If you notice any of these warning signs, notify your doctor.


Unnatural symptoms might signal the headache or accompany its onset. They usually last from five minutes to one hour. Vision, sensation and speech may be affected.

An irregularly shaped light may appear in your peripheral vision. Over the next several minutes, it may flicker or grow in size.

At the same time, blind spots might limit your field of vision. Don’t attempt to drive if you notice blind spots, the flashing light or both.

Some patients also report hallucinating or experiencing flashbacks from the past. These may worsen through the course of the migraine, but they’re not harmful. When the headache passes, the hallucinations will stop.

Not all migraine sufferers have significant visual symptoms. Others have them only infrequently. Still others report experiencing symptoms but never getting the migraine that they expected.

The aura phase may also include tingling or numbness that starts in the face and hands. The sensation gradually creeps to other parts of the body.

If language skills are affected, you might have trouble speaking, writing or typing. Confusion or lack of concentration could prevent you from understanding others.

Onset of Pain

Headaches can last anywhere from an hour or two to several days. Most people describe their discomfort this way:

  • Beginning just above the eyes
  • Throbbing
  • Concentrated on one side of the head at a time
  • Sometimes spreading to the face and neck
  • Most painful during movement

You’ll probably be hypersensitive to noise, light and smells. You may also feel lightheaded or have fainting spells. Nausea and vomiting are not uncommon.

When symptoms are at their most severe, it’s probably best to cancel activities. If possible, stay in bed and rest quietly until the headache passes.


It could take a full day or longer before you feel like yourself again. The postdromal phase is marked by physical exhaustion and mental fatigue. You might feel sluggish, as though you’ve been drugged, and have difficulty getting anything done. Bending over or moving suddenly may cause a brief but intense flash of pain.


Migraines seem to have a life of their own, and every attack is different. Some don’t even progress through all four stages. That’s why scientists struggle with solutions.

Over the last few years, however, some experimental remedies have shown promising results. A noninvasive procedure called transcranial magnetic stimulation has helped some patients. Feverfew is an herbal supplement that might provide relief. Botox is another possibility.

Conventional medicines are also prescribed, but migraines are unpredictable; there is no one drug that works for everybody.

The best way to be prepared for anything is to talk to your doctor.