Migraine attack phases
It is often difficult to predict when a migraine attack is going to happen. However, you can often predict the pattern of each attack. In adults, we can divide a migraine attack into four or five phases that lead on from each other:
The pre-headache, or warning phase
Aura (not always present)
The headache
Resolution
Recovery
Learning to recognise the different phases of a migraine attack can be useful. You might suffer from one, all, or a combination of these stages, and the combination of stages may vary from attack to attack. Recognising different symptoms at different times during your headache attack can give a doctor information which may help diagnosis. Also, taking medication before the symptoms have fully developed may reduce the effect of an attack. A child's migraine attack is often much shorter than an adult’s attack, and it may therefore not be possible to fully make out the different headache phases.
Aura
The aura of migraine includes a wide range of neurological symptoms. This stage can last for between 5 and 30 minutes, and usually happens before the headache. Only 15% of migraine sufferers have aura. Migraine without aura does not include this stage.
The headache
This stage involves head pain which can be severe, even unbearable. The headache is typically throbbing, and made worse by movement. Some sufferers describe a pressing or tightening pain. The headache is usually on one side of the head, especially at the start of an attack. Some sufferers get pain on both sides of the head, or over the forehead, but not usually at the back of the head. Nausea (sickness) and vomiting (being sick) can happen at this stage, and the sufferer may feel sensitive to light or sound, or both.
Resolution
Most attacks slowly fade away, but some stop suddenly after the sufferer is sick, or cries a lot. Sleep seems to be the best 'cure' for many sufferers, who find that even an hour or two can be enough to end an attack. Many children find that sleeping for just a few minutes can stop their attack.
Recovery
This is the final stage of an attack, and it can take hours or days for a ‘hangover’ type feeling to disappear. Symptoms can be similar to those of the first stage, and often they are mirrored symptoms. For example, if you lost your appetite at the beginning of the attack, you might be very hungry now. If you were tired, now you might feel full of energy.