The 3 (Sometimes 4) Phases of Migraine

Migraine is more than just the episode itself – it’s surrounded by a series of warning signs, called the Prodrome, an optional Aura, and a hangover, called the Postdrome.

It is not uncommon for someone with chronic or near-chronic migraine to be constantly affected by at least one of these phases, making it extremely difficult to experience a day fully free from migraine symptoms.


Prodrome

When: Several hours to several days before the episode

What: The prodrome period is your body’s way of telling you a migraine episode is eminent, but it also gives you a chance to take action before things get bad. Symptoms often experienced during Prodrome include:

  • yawning
  • irritability
  • fatigue
  • brain fog
  • food cravings
  • sensitivity to light and sound
  • nausea
  • difficulty sleeping
  • increased urination

Self Care for this phase: now is the time to use all the tools in your migraine toolkit! Act early and act often when you’re in the prodrome phase – this is the time to use those natural treatments like ginger and magnesium.

Aura

WhenLess than one hour before the episode

What: You may or may not experience aura, a sign that an episode is less than an hour away. Symptoms of aura include:

  • flashes of light
  • zigzags
  • static
  • shimmers
  • blind spots
  • ringing in ears

Aura is thought to be caused by a phenomenon called cortical spreading depression – almost like a wave of radio silence in your brain where certain neurons (aka the cells of your nervous system) stop communicating. 

Self Care for this phase: same as the prodrome, plus be safe and avoid driving if possible during the aura phase.

The Episode

WhenLasts between 4 and 72 hours, on average

What: The episode itself (also referred to as an attack) involves the classic symptoms of migraine such as:

  • head pain
  • nausea and vomiting
  • nasal congestion
  • altered mood
  • sensitivity to light/sound/smell
  • dizziness
  • allodynia (painful skin/hair)

Self Care for this phase: listen to your body’s needs and do your best to follow them. Stay hydrated and eat snacks every 2-3 hours if possible. Rest when possible and use tricks (like quick meditations, sunglasses, and ear plugs) when rest is not an option.

Postdrome

When: 24 to 48 hours after episode has resolved

What: Migraine doesn’t end after the episode is over. The postdrome period, or “migraine hangover”, occurs after your main symptoms have resolved (either on their own or with the help of medication). The severity and length of your postdrome depends on a lot of factors, including type of medication used, severity of the episode, length of the episode, and your ability to care for yourself after the episode. Symptoms of the postdrome period may include: 

  • fatigue
  • brain fog 
  • confusion
  • depressed mood
  • euphoric mood
  • cravings
  • low appetite

Self Care for this phase: be kind to yourself, rest as much as possible, and remember to eat and drink fluids. Some gentle stretching and deep breaths will help keep your nervous system calm.

Atlanta, GA·Updated Thu, September 10, 2020

Kelli Yates, RDN, CLT

Kelli Yates, RDN, CLT 

Host

Hey friends! I’m Kelli, your favorite dietitian and trusty migraine guide.

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