12 Common Migraine Symptoms You Should Know About

Migraine is a neurological condition that affects millions of people worldwide, causing intense, debilitating headaches and a range of other symptoms. Unlike regular headaches, migraines are complex episodes that can last from a few hours to several days, significantly impacting daily activities and quality of life. Understanding the symptoms of migraine is crucial for early recognition and proper management of this condition.

Migraines typically progress through different stages, each with its own characteristic symptoms. Not everyone experiences all stages or symptoms, and the severity can vary greatly from person to person. Some people may experience warning signs hours or even days before the actual headache begins, while others may have symptoms that persist long after the pain subsides.

This comprehensive guide explores the most common migraine symptoms to help you identify whether you or someone you know might be experiencing this neurological condition.

1. Intense Throbbing or Pulsating Head Pain

The hallmark symptom of migraine is severe, often debilitating head pain that differs significantly from ordinary headaches. This pain typically manifests as a throbbing or pulsating sensation that intensifies with physical activity.

Key characteristics of migraine headache pain include:

• Usually affects one side of the head, though it can occur on both sides
• Moderate to severe intensity that interferes with daily activities
• Pulsating or throbbing quality that seems to beat in rhythm with your heartbeat
• Pain that worsens with routine physical activities like walking or climbing stairs
• Duration typically lasting from 4 to 72 hours if left untreated

The location of the pain can vary, commonly affecting the temples, forehead, or back of the head and neck. Some people describe the sensation as if their head is being squeezed in a vise or as though pressure is building from inside their skull.

2. Visual Disturbances (Aura)

Approximately 25-30% of people with migraine experience aura, a series of neurological symptoms that typically occur before the headache phase begins. Visual aura is the most common type and serves as a warning sign that a migraine attack is approaching.

Visual aura symptoms include:

• Seeing zigzag lines, geometric patterns, or shimmering spots
• Flashing lights or bright spots in your field of vision
• Temporary blind spots or loss of peripheral vision
• Tunnel vision or narrowing of visual field
• Wavy or blurred vision, similar to looking through heat waves

These visual disturbances usually develop gradually over 5-20 minutes and typically last less than an hour. While they can be frightening, especially when experienced for the first time, visual aura symptoms are temporary and reversible. However, if you experience visual changes for the first time, it’s important to consult with a healthcare provider to rule out other conditions.

3. Nausea and Vomiting

Gastrointestinal symptoms are extremely common during migraine attacks, with nausea occurring in up to 80% of people with migraine and vomiting in about 40-50% of cases. These symptoms can sometimes be as debilitating as the headache itself.

The nausea associated with migraine can range from mild queasiness to severe stomach upset that makes it impossible to eat or drink. This can be particularly problematic because it may prevent you from taking oral medications or staying hydrated during an attack.

Gastrointestinal symptoms during migraine may include:

• Persistent nausea that worsens with movement
• Loss of appetite or aversion to food
• Vomiting, which may sometimes provide temporary relief
• Stomach discomfort or upset
• Difficulty keeping down food, water, or medication

Some people find that vomiting marks the end of their migraine attack, while for others it occurs during the peak of the headache. The intensity of these gastrointestinal symptoms can make migraine sufferers feel extremely unwell beyond just the head pain.

4. Sensitivity to Light (Photophobia)

Photophobia, or extreme sensitivity to light, is one of the defining symptoms of migraine and occurs in approximately 80-90% of migraine attacks. During an episode, normal levels of light that wouldn’t typically bother you can become unbearably intense and painful.

This sensitivity isn’t just about bright lights; even moderate lighting, computer screens, television, or natural daylight can worsen migraine pain and other symptoms. Many people with migraine instinctively seek dark, quiet rooms during an attack.

Light sensitivity during migraine manifests as:

• Pain or discomfort when exposed to light sources
• Squinting or inability to keep eyes open in normal lighting
• Worsening of headache pain in bright environments
• Preference for complete darkness during attacks
• Difficulty looking at screens or reading
• Seeing halos or glare around light sources

The light sensitivity can persist even after the headache subsides, sometimes lasting into the postdrome phase of the migraine. Wearing sunglasses indoors or using specially tinted glasses can help some people manage this symptom.

5. Sensitivity to Sound (Phonophobia)

Similar to light sensitivity, sound sensitivity or phonophobia affects a majority of people during migraine attacks. Sounds that are normally tolerable or even pleasant can become painfully loud and irritating during a migraine episode.

This heightened sensitivity to sound can make it difficult to function in normal environments. Everyday noises like conversations, traffic, television, music, or even the hum of appliances can feel overwhelming and intensify migraine pain.

Common experiences with sound sensitivity include:

• Normal volume sounds seeming extremely loud
• Physical pain or discomfort triggered by noise
• Need for complete silence during attacks
• Difficulty tolerating high-pitched or sudden sounds
• Increased irritability in response to noise
• Worsening headache in noisy environments

Many migraine sufferers seek quiet, isolated spaces during an attack where they can avoid both light and sound. Some people use earplugs or noise-canceling headphones to help manage this symptom when complete silence isn’t possible.

6. Sensory Aura (Tingling or Numbness)

In addition to visual aura, some people experience sensory aura symptoms before or during a migraine attack. These neurological symptoms typically affect sensation in various parts of the body and can be quite alarming when they occur for the first time.

Sensory aura usually develops gradually and spreads over several minutes. It commonly begins in the fingertips of one hand and slowly travels up the arm, potentially affecting the face, tongue, or other body parts.

Sensory aura symptoms include:

• Tingling or “pins and needles” sensation, typically starting in the fingers
• Numbness affecting the hands, arms, or face
• Feeling of heaviness in limbs
• Temporary loss of sensation in affected areas
• Symptoms that move or spread from one area to another

Like visual aura, sensory aura symptoms are temporary and completely reversible, typically lasting less than an hour. However, because these symptoms can mimic more serious conditions like stroke, especially when experienced for the first time, it’s important to seek medical evaluation to ensure proper diagnosis.

7. Neck Pain and Stiffness

Neck pain is an extremely common but often overlooked symptom of migraine. Research shows that up to 75% of people with migraine experience neck pain or stiffness, which can occur before, during, or after the headache phase.

Many people mistakenly believe their neck pain is causing their headache, when in fact the neck symptoms are part of the migraine itself. This neck discomfort can be a warning sign that a migraine attack is approaching, sometimes appearing hours or even a day before the headache begins.

Neck-related symptoms during migraine include:

• Stiffness or reduced range of motion in the neck
• Tenderness or pain in neck muscles
• Tightness extending from the neck to the shoulders
• Pain that radiates from the neck to the head
• Difficulty finding a comfortable position for the head and neck

The relationship between neck pain and migraine is complex and bidirectional. While neck pain can be a symptom of migraine, tension and poor posture can also trigger migraine attacks in some people.

8. Fatigue and Exhaustion

Overwhelming fatigue is a common symptom that can occur during any phase of a migraine attack. Many people experience profound exhaustion before a migraine begins (as part of the prodrome phase) and after it ends (during the postdrome phase), in addition to feeling drained during the headache itself.

This isn’t ordinary tiredness—it’s a deep, debilitating exhaustion that makes even simple tasks feel impossible. The fatigue can be so severe that it significantly impacts your ability to work, socialize, or perform daily activities.

Fatigue related to migraine includes:

• Extreme tiredness that isn’t relieved by rest
• Feeling physically and mentally drained
• Difficulty concentrating or thinking clearly
• Need for extended sleep or rest periods
• Reduced energy levels lasting beyond the headache phase
• Feeling “wiped out” or “hung over” after an attack

Some people describe the post-migraine fatigue as similar to recovering from the flu. This exhaustion can last for a day or more after the headache resolves, affecting productivity and quality of life even after the pain subsides.

9. Difficulty Concentrating and Brain Fog

Cognitive symptoms, often described as “brain fog,” are frequently reported during migraine attacks and can significantly impact mental function. These symptoms can occur before, during, or after the headache phase and can be just as disabling as the pain itself.

People experiencing cognitive symptoms during migraine often describe feeling mentally cloudy, confused, or unable to think clearly. This can affect work performance, decision-making, and communication.

Cognitive symptoms during migraine include:

• Difficulty concentrating or focusing on tasks
• Problems with memory or word-finding
• Confusion or feeling mentally foggy
• Slowed thinking or processing information
• Difficulty reading or comprehending written material
• Trouble following conversations or instructions
• General feeling of mental cloudiness

These cognitive difficulties can be particularly frustrating for people who need to work or make important decisions during or shortly after a migraine attack. The mental fog can persist into the postdrome phase, sometimes lasting for 24-48 hours after the headache ends.

10. Mood Changes

Emotional and mood changes are common during migraine attacks and can occur in any phase. Many people experience significant mood shifts in the hours or days before a migraine begins, which can serve as a warning sign of an approaching attack.

These mood changes are not simply a reaction to being in pain; they are neurological symptoms resulting from the brain changes that occur during migraine. Understanding this connection can help both migraine sufferers and their loved ones recognize these symptoms as part of the condition.

Mood-related symptoms include:

• Irritability or feeling unusually short-tempered
• Depression or feelings of sadness
• Anxiety or feeling on edge
• Euphoria or unusually elevated mood (less common)
• Emotional sensitivity or tendency to cry easily
• Restlessness or feeling unable to relax

Family members and close friends often notice these mood changes before the person experiencing them realizes a migraine is approaching. Tracking mood changes can be helpful in predicting and preparing for migraine attacks.

11. Sensitivity to Smells (Osmophobia)

Heightened sensitivity to odors, known as osmophobia, occurs in approximately 25-50% of people during migraine attacks. Smells that are normally pleasant or neutral can become overpowering, unpleasant, or even trigger nausea during a migraine episode.

This symptom can make everyday environments challenging to navigate, as common scents from perfume, food, cleaning products, or other sources can intensify migraine symptoms or prolong an attack.

Smell sensitivity during migraine manifests as:

• Overwhelming response to normal scents
• Pleasant smells becoming unpleasant or nauseating
• Ability to detect faint odors that others don’t notice
• Worsening of headache or nausea when exposed to smells
• Need to avoid perfumes, cooking odors, or chemical smells
• Preference for odor-free environments during attacks

Some scents, such as strong perfumes, cigarette smoke, or certain foods, may also act as migraine triggers for some individuals, making them particularly problematic both before and during an attack.

12. Dizziness and Vertigo

Vestibular symptoms, including dizziness, vertigo, and balance problems, are more common in migraine than many people realize. Some individuals experience a specific subtype called vestibular migraine, where dizziness is a prominent feature, but many people with regular migraine also experience these symptoms.

These symptoms can range from mild lightheadedness to severe vertigo where the room appears to spin. They can occur before, during, or after the headache phase and can be extremely disabling.

Vestibular symptoms include:

• Dizziness or feeling lightheaded
• Vertigo (sensation that you or your surroundings are spinning)
• Balance problems or unsteadiness
• Difficulty walking or standing
• Motion sensitivity or worsening symptoms with head movement
• Nausea related to the sensation of movement
• Disorientation or spatial confusion

These vestibular symptoms can make it dangerous to drive or operate machinery and may require lying still in a dark, quiet room until they subside. For some people, the dizziness can be as debilitating as the headache itself.

What Causes Migraines?

Migraine is a complex neurological condition, and while researchers don’t fully understand all the mechanisms involved, several factors are known to contribute to migraine development and attacks.

Biological Factors:

• Genetics: Migraine tends to run in families, with genetics playing a significant role. If one or both parents have migraine, their children have a higher likelihood of developing the condition.
• Brain Chemistry: Changes in brain chemicals, particularly serotonin, play a role in migraine attacks. When serotonin levels drop, blood vessels may dilate, contributing to migraine pain.
• Nervous System Sensitivity: People with migraine appear to have a more sensitive or hyperexcitable nervous system that responds more intensely to triggers and environmental changes.
• Hormonal Fluctuations: Changes in estrogen levels significantly affect migraine, which is why women are three times more likely to experience migraine than men. Many women notice their migraines are linked to their menstrual cycle, pregnancy, or menopause.

Common Migraine Triggers:

• Stress: Both emotional stress and the relaxation period after stress can trigger attacks
• Sleep Changes: Too much or too little sleep, irregular sleep patterns
• Dietary Factors: Skipping meals, dehydration, alcohol (especially red wine), caffeine (too much or withdrawal), aged cheeses, processed meats, artificial sweeteners
• Environmental Factors: Bright lights, loud noises, strong smells, weather changes, barometric pressure changes
• Hormonal Changes: Menstruation, ovulation, birth control pills, hormone replacement therapy
• Physical Factors: Intense physical exertion, poor posture, neck tension
• Sensory Stimuli: Flickering screens, fluorescent lights, strong perfumes

It’s important to note that triggers vary greatly between individuals, and what causes migraine in one person may not affect another. Additionally, migraine attacks often result from a combination of factors rather than a single trigger.

Prevention Strategies

While migraine cannot always be prevented entirely, many people can reduce the frequency and severity of attacks through lifestyle modifications and trigger management.

Lifestyle Modifications:

• Maintain Regular Sleep Patterns: Go to bed and wake up at the same time every day, even on weekends. Aim for 7-9 hours of quality sleep per night.
• Stay Hydrated: Drink adequate water throughout the day. Dehydration is a common migraine trigger.
• Eat Regular Meals: Don’t skip meals, especially breakfast. Maintain stable blood sugar levels by eating at consistent times.
• Manage Stress: Practice stress-reduction techniques such as meditation, deep breathing exercises, yoga, or progressive muscle relaxation.
• Exercise Regularly: Engage in moderate aerobic exercise for 30 minutes most days of the week. Start slowly if you’re new to exercise, as intense exertion can trigger migraine in some people.
• Limit Caffeine: Keep caffeine intake consistent. Both excessive caffeine and caffeine withdrawal can trigger migraine.

Trigger Identification and Avoidance:

• Keep a detailed migraine diary tracking attacks, potential triggers, and symptoms
• Identify patterns in your migraine occurrence
• Once triggers are identified, take steps to avoid or minimize exposure to them
• Be aware that triggers can be cumulative—you may tolerate one trigger but experience migraine when multiple triggers occur together

Environmental Adjustments:

• Use appropriate lighting—avoid fluorescent lights when possible and reduce screen brightness
• Take regular breaks from screens using the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds)
• Create a migraine-friendly sleep environment that is dark, quiet, and cool
• Avoid strong perfumes and fragrances
• Maintain good posture, especially when working at a computer

When to Seek Medical Advice:

If you’re experiencing frequent migraine attacks that interfere with your daily life, consult with a healthcare provider. They can help develop a comprehensive prevention plan, which may include lifestyle modifications, trigger management, and if appropriate, preventive approaches. Your doctor can also rule out other conditions and ensure you receive proper diagnosis and care.

Frequently Asked Questions

How long does a migraine typically last?

A migraine attack typically lasts between 4 and 72 hours if left untreated. However, the entire migraine cycle, including the prodrome (warning phase) and postdrome (recovery phase), can last several days. The duration varies significantly between individuals and between different attacks in the same person.

What’s the difference between a migraine and a regular headache?

Migraines are more severe and complex than regular headaches. They typically involve moderate to severe throbbing pain (often on one side of the head), accompanied by other symptoms like nausea, sensitivity to light and sound, and sometimes aura. Regular tension headaches usually cause milder, steady pressure on both sides of the head without these additional symptoms.

Can you have a migraine without a headache?

Yes, this is called “silent migraine” or “acephalgic migraine.” People experience migraine aura symptoms and other migraine features like nausea, visual disturbances, or dizziness without the characteristic headache pain. This occurs in approximately 15-20% of migraine cases.

Why are migraines more common in women?

Hormonal fluctuations, particularly changes in estrogen levels, play a significant role in migraine. Women are three times more likely to experience migraine than men, with many women reporting attacks linked to their menstrual cycle. Estrogen influences brain chemicals and pain pathways, making women more susceptible to migraine triggers.

Are migraines dangerous or life-threatening?

While extremely painful and disabling, migraines themselves are not typically life-threatening. However, they significantly impact quality of life. In rare cases, migraine with aura may slightly increase the risk of stroke, particularly in women who smoke or use certain hormonal contraceptives. It’s important to seek immediate medical attention if you experience sudden, severe headache unlike your usual pattern, or headache accompanied by fever, confusion, seizures, vision loss, or difficulty speaking.

Can children get migraines?

Yes, children can and do experience migraines. Childhood migraine may present differently than adult migraine, with attacks sometimes lasting shorter periods and pain occurring on both sides of the head rather than one side. Children may have difficulty describing their symptoms, and gastrointestinal symptoms like nausea and vomiting may be more prominent than head pain.

Do I need to see a doctor for migraine?

Yes, if you’re experiencing recurring severe headaches, it’s important to consult a healthcare provider for proper diagnosis. This is especially important if this is a new symptom, if your headaches are changing in pattern or severity, or if they’re interfering with your daily activities. A doctor can help rule out other conditions, provide an accurate diagnosis, and discuss management strategies appropriate for your situation.

Can stress cause migraines?

Yes, stress is one of the most common migraine triggers, reported by approximately 70% of people with migraine. Interestingly, migraine attacks often occur not during peak stress but during the “let-down” period after stress, such as on weekends or the beginning of a vacation. Managing stress through relaxation techniques, regular exercise, and adequate sleep can help reduce migraine frequency.

References:

• Mayo Clinic – Migraine: Symptoms and Causes
• National Institute of Neurological Disorders and Stroke – Migraine Information
• Johns Hopkins Medicine – Migraine Headaches
• World Health Organization – Headache Disorders
• American Migraine Foundation – Understanding Migraine