Stages of Migraine

A migraine attack often moves through four phases. Some people notice all four, some only the headache.

Phase 1: prodrome (hours to a day before)

Subtle changes: mood shifts, irritability, food cravings, yawning, neck stiffness, fatigue, more thirst and frequent urination. Learning to spot these can help you act early.

Phase 2: aura (5 to 60 minutes)

Only in some people. Visual changes such as zigzag lines or flashing lights, tingling or numbness, and sometimes speech difficulty. These fade fully.

Phase 3: headache (4 to 72 hours)

Throbbing pain, usually one-sided, with nausea, vomiting, sensitivity to light, sound and smell. Lying down in a dark, quiet room often helps. Pain is worse with movement.

Phase 4: postdrome (up to a day or two)

The "migraine hangover": tiredness, a washed-out feeling, difficulty concentrating, neck ache and sometimes a mood lift. Moving too quickly can bring the headache back.

Long-term course

• Episodic migraine: fewer than 15 headache days per month
• Chronic migraine: 15 or more headache days per month
• Attacks often become less frequent in older age

When the pattern changes

A sudden change in the usual pattern, or a new kind of headache after age 50, needs a doctor.

Ayurvedic view

Traditional texts describe headache cycles in terms of Dosha. This is an interpretive framework.

Key point

Spotting the prodrome and treating early often helps more than waiting for the full attack.

Key point

Spotting the early phase and acting then often helps more than waiting for the full attack.