Migraine Attack Phases (2022 Update)

We know that migraine is more than a headache, but did you know migraine symptoms can begin up to DAYS before the head pain begins?

There are multiple phases to a migraine attack with body-wide symptoms.

In this article, we will walk through the five main migraine phases: prodrome, aura, attack, postdrome, and interictal.

Prodrome

“Prodrome” nearly directly means “pre-symptoms” of a disease or condition. This phase occurs before the painful attack phase, lasting anywhere from a few hours to several days.

This phase typically occurs after exposure to a trigger, which is essentially an internal or external event that initiates abnormal activity in your brain.

This abnormal activity leads to a variety of symptoms, including (but not limited to):

• Yawning
• Sensitivity to light/smell/sound
• Fatigue
• Mood changes
• Confusion and brain fog
• Increased urination

I like to consider prodrome as your “early warning signs” that an attack is on the way. Learning your typical symptoms can help you prepare for and more effectively treat your attacks.

Download my free migraine tracking template below to get started learning your patterns.

Aura

Aura is a term to describe a variety of sensory disturbances before a migraine attack. About 30% of people experience aura, but typically not for every attack. 

These sensory disturbances may be very short lived or occur for up to 60 minutes.

While aura typically occurs within an hour pre-attack phase, aura is infamous for showing up at any point of a migraine attack. Some people may notice aura with no following migraine attack, while some people may experience aura in the middle of their attack phase.

There are four different types of visual disturbances:

• Visual Distortions: You may have blind spots, tunnel vision, see “stars” or zig-zag lines, or flashes of light.
• Sensory Disturbances: You may feel weakness, numbness, or tingling in your fingers, face, or elsewhere.
• Speech Disturbances: You may slur words, mumble, or be unable to pronounce words.
• Auditory Disturbances: You may have difficulty hearing.

Attack

The attack phase of a migraine attack is likely the phase you are most familiar with. This is typically the most disabling phase of an attack and when symptoms are at their peak. The attack phase typically lasts up to 72 hours.

The most notable symptom during this phase is head pain… (Fun fact, there are forms of migraine that experience no head pain at all! These types of migraine can be equally disabling.)

Other common attack symptoms:

• Nausea and vomiting
• Sensitivity to light/smell/sound
• Mood changes
• Confusion and brain fog
• Fatigue
• Neck pain

Postdrome

“Postdrome” nearly directly means “post-symptoms” of a disease or condition. After the attack phase passes, you may notice lingering symptoms for the next day (or more!).

Some people report a feeling of euphoria and feeling light as a cloud, but many report symptoms commonly referred to as a “migraine hangover”.

The migraine hangover feels exactly how it sounds, including symptoms of fatigue, confusion, brain fog, aches, and a low mood.

Interictal

After the previous four stages of a migraine attack has passed, the interictal phase begins. The interictal phase is essentially migraine-related symptoms that occur between migraine attacks.

Migraine symptoms on non-attack days is actually quite common, but this phase of migraine has only recently been getting attention.

Symptoms in the interictal phase may include:

• Fatigue
• Sensitivity to light/smell/sound
• Mood changes
• Nausea
• Anxiety

Final Thoughts

Migraine attacks come in 5 distinct phases:

• Prodrome includes “early warning signs” that show up before intense migraine symptoms.
• Aura symptoms are sensory disturbances that may occur shortly before a migraine attack for some people with migraine.
• Attack stage is when the most disabling symptoms happen, often including head pain.
• Postdrome is the lingering symptoms that many people call a “migraine hangover”.
• Interictal stage includes the migraine symptoms experienced between attacks.

Download my free migraine tracker below to become more familiar with your migraine symptoms.