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Migraines (Part 2) (Last Edited: 2009 Nov 19)

2008 August 9

Go back to Part 1 | Go on to Part 3

This is part two of a four part series about migraine. You can use the links above or at the end of this page to go back or forward. Or you can jump to any part from the Migraine FAQs page link.


Migraine can occur with what are called “aura”. These are mild hallucinations that vary from person to person, or between attacks. Not all sufferers have aura. In those that do, not all migraine attacks have aura. They can occur at different stages of migraine: before, during or after the pain phase. Some migraines, and some migraine sufferers, do not get headache even though they get aura. And some migraine sufferers can have permanent aura.

Typical precursory auras include a variety of “scintillating scotoma”. These appear as a small spot of flashing light that generally expands into the visual field. They can take on several forms; the most typical is a zigzag line. Other aura can include “paresthesia”: pins-and-needles sometimes followed by numbness, which spreads through certain parts of the body. Some form of “aphasia” can also follow: ranging from problems speaking, through to whole loss of language comprehension. All auras are temporary.

Migraine can occur with or without aura, and with or without headache. Migraines typically last from seven hours to a day or so, passing through four distinct phases. The first, or “prodrome”, phase can occur hours or sometimes days before the pain phase. This occurs in forty to sixty percent of sufferers. It may manifest as altered mood, irritability, depression, fatigue, food cravings, muscle stiffness, and so on.

The second, or “aura”, phase occurs before the pain phase. Twenty to thirty percent of sufferers have migraine with aura. The aura can include visual disturbance, pins-and-needles, numbness, phantom smells, problems speaking, and so on. This phase usually lasts less than sixty minutes. The pain phase manifests as moderate to sever head pain. It is usually on one side of the head and worsened by physical activity. This phase can last between four and seventy-two hours in adults. Children generally have shorter pain phases.

The pain itself has been compared to being worse than childbirth or a gun-shot wound. It is usually accompanied by other symptoms like nausea and (if untreated) vomiting. Sensitivity to light and sound are commonplace.

The final phase of migraine, or “postdrome”, may last a similar length of time to the headache phase. Usually a good night’s rest ends the attack. The postdrome phase may leave the sufferer “washed out”, listless, irritable or moody, whereas others may feel refreshed or euphoric.

Go back to Part 1 | Go on to Part 3

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