Did you know migraine is not just a headache but a neurological condition with neurological symptoms? The symptoms may include severe throbbing pain, nausea, and visual disturbances. Migraine headaches are complex and often progress through distinct stages. Familiarising yourself with these stages can help in managing and responding to migraine episodes effectively. We spoke to our expert Dr Sonia Lal Gupta, Senior Neurologist and Director, Metro Group of Hospitals, who explained the stages of a migraine episode and how to manage it.
According to StatPearls, migraine is a complex disorder caused by genetics and characterised by recurring episodes of moderate to severe headaches. These headaches typically affect one side of the head and are often accompanied by symptoms, such as nausea, as well as sensitivity to light and sound. It is widespread, impacting approximately 12% of the population annually, with a higher prevalence observed among women (up to 17%) compared to men (6%). Additionally, among children, it is more commonly reported in girls than in boys.
Stages Of A Migraine Episode
A migraine usually progresses through four stages: prodrome, aura, attack, and postdrome. Dr Gupta explains each one of them as follows:
Prodrome Stage
Dr Gupta said, “The first stage is called the prodrome stage, which typically precedes the onset of a migraine headache by a few minutes to a few hours. Common symptoms include yawning, irritability, or fatigue. Many individuals experience a sense of forewarning, signalling the impending migraine.”
Aura Stage
“Approximately 40% of migraine sufferers experience this stage, lasting anywhere from five minutes to an hour. Auras may manifest as visual disturbances, such as coloured flashing lights, or sensory disturbances, such as numbness in the hands or difficulty speaking”, added Dr Gupta.
Also Read: Migraines And Sleep Trouble: Expert Lists Tips For Better Sleep
Headache Stage
The headache stage is characterised by intense pain, often one-sided but occasionally bilateral. The pain is typically throbbing and may be accompanied by nausea, vomiting, sensitivity to light, or sensitivity to noise. Without treatment, this phase can last from 4-72 hours.
Postdrome Stage
After the headache phase subsides, individuals might enter a postdrome stage marked by enduring fatigue and a feeling of general discomfort. Full recovery may extend up to 24 hours.
Managing Migraine and Recognising Serious Symptoms
Effectively managing migraines involves both acute and preventive approaches tailored to individual needs and frequency of episodes. Dr Gupta listed the management tips as follows:
Acute Treatment
When experiencing a migraine headache, the primary goal is to manage it effectively to prevent it from worsening. This acute treatment approach involves:
- Prompt Medication Use: Take your medication as soon as possible after the onset of symptoms to help alleviate the headache before it intensifies. Catching the migraine in its earliest stage is crucial.
- Types of Medications: Acute treatment often involves using different types of painkillers. There are also specific medications designed specifically for migraines, known as triptans.
- Individualised Medication Selection: Depending on the type of headache you're experiencing and any other underlying health conditions or risk factors, such as high blood pressure or diabetes, your doctor will determine the most appropriate medication for you.
Preventive Treatment
The preventive stage of migraine treatment is crucial for individuals experiencing frequent episodes. Dr Gupta listed the preventive tips as follows:
- Indications for Preventive Treatment: Anyone having four or more migraines in a month typically requires preventive medication to reduce the frequency and severity of attacks.
- Daily Medication: Preventive medication should be taken daily to maintain its effectiveness.
- Medication Categories: Preventive medications fall into various categories, including blood pressure medications, antiepileptic drugs, and antidepressants. These medications are prescribed in lower doses specifically to prevent migraines.
- Individualised Selection: Your doctor will determine the most suitable preventive medication based on factors, such as the frequency of your headaches, accompanying health conditions (comorbidities), and overall headache type.
Important Considerations for Preventive Medication
- Patience Required: It's essential to understand that it may take a minimum of 8 to 12 weeks to see the full effects of the preventive medication.
- Avoid Premature Discontinuation: One common mistake is discontinuing the medication prematurely due to a perceived lack of immediate impact. It's crucial to continue taking the medication as prescribed and give it time to work effectively.
Recognising Serious Symptoms
Certain symptoms during a headache episode may indicate a need for immediate medical attention.
- The sudden onset of severe headache, particularly if rated as the most severe pain ever experienced, could signal a serious condition, such as subarachnoid haemorrhage.
- Other concerning symptoms include blurry vision, high fever with neck stiffness, or any unusual neurological symptoms, warranting further evaluation with imaging studies like CT scans or MRI.
Dr Gupta said, “Understanding the stages of a migraine episode and knowing when symptoms warrant medical attention can empower individuals to effectively manage their condition and seek appropriate care when needed.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your expert if you face any health issues to get the necessary treatment.]