Migraine Symptoms

Migraine Symptoms are important to recognise.

I would see many people each year who are worried about a serious cause for headaches, but whose symptoms clearly point to a diagnosis of migraine or migraine with aura.

Knowing that symptoms are migraine is very important as migraine is usually succesfully prevented or treated.

There are 2 main migraine symptoms:

• First there is the frequent headache
• Second there is migraine aura

The Main Symptom of Migraine is a Frequent Headache

It is important not to confuse normal migraine with the more severe condition called chronic migraine.

The head pain will usually build up over the course of an hour or so, until it reaches its maximum.

At its maximum the pain of migraine is usually bad enough to make you want to stop what you are doing. If possible, most people would prefer to lie down in the dark.

Migraine Headache Episodes will then last for about 2-12 hours on average.

It is very common for people to experience a dull ache in the head for a day or more after a migraine episode.

After the dull ache is over they are free of head pain until the next Headache Episode occurs.

During a Migraine Attack the quality of the pain in the head is usually described as throbbing, pounding or pulsating.

However, not everyone will describe this and some people will just say it is a sharp headache.

Some are even less descriptive and say it is quite simply a severe headache!

The key features are the build up of pain, and freedom from pain between attacks.

If you do not have complete freedom from pain between attacks then you may be experiencing a phase of Chronic Migraine.

About 10% of people with Migraine will experience Migraine Aura Symptoms

Of all the migraine symptoms, Migraine Aura is probably best understood.

Migraine aura is due to the surface of the brain slowing down its rate of activity (a process called spreading depolarisation).

Usually this slowing down of activity is restricted to the area of the brain that processes vision - the occipital cortex.

When the occipital area is slowing down, the usual experience is to see a zig-zag or shimmering light is one part of the eye. Over a few minutes this then spreads to involve more of the eye.

If one eye is covered during a migraine aura attack, you will often be aware of an identical migraine symptom in the other eye (called homonymous hemianopic aura)

A visual aura will usually take about 5 minutes to build up, and lasts about one hour.

Some people will experience a more prolonged aura called migraine with prolonged aura - this can go on for days or even weeks, and brain scans are normal.

Another variation of prolonged migraine aura is called Migraine with Unilateral Motor Symptoms (called MUMS). In MUMS people experience a persistent heaviness or weakness of arms and legs of one side for weeks at a time, as well as near constant headaches.

Aura wil also affect the sensory areas of the brain (parietal lobe). This can cause tingling or numbness of the face, lip or arm. It can affect the leg too.

The classic feature of migraine sensory aura is that it spreads over a few minutes from one part of the body to the next.

Speech can also be affected in migraine aura.

Many people who are eventually diagnosed with migraine aura will be worried that they have taken or be about to take a stroke.

If migraine symptoms build up very rapidly, it can be impossible to tell the difference and brain scans may be necessary to rule out a serious stroke.

There are occasions where migraine aura can cause drowsiness, vertigo, tingling or sensory loss in both arms or both sides of the face at the same time.

When drowsiness or vertigo occur the correct headache diagnosis may be basilar-type migraine.

People with basilar type migraine may black out or go into a deep sleep. Because they seem to lose consciousness, basilar-type migraine can be misdiagnosed as a form of epilepsy.

Migraine Headache is accompanied by "Sensory Sensitivity"

In addition migraine may result in nausea and vomiting.

At least two of these senses should be affected to make a diagnosis of migraine.

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