Migraine: Symptoms and Forms

Migraine is a very common condition characterized by a rapid-onset, sometimes throbbing-pulsating headache, accompanied by nausea and/or sensitivity to light and noise. The pain is often, but not always, one-sided, and can switch sides. Left untreated, an attack typically lasts between 4 and 72 hours. Physical exertion typically makes symptoms worse.

These characteristics describe a typical migraine attack, but not all symptoms need to be present. According to the International Headache Society's diagnostic criteria, one of several typical symptom patterns must be present.

Aura

Some people experience a so-called aura as a warning sign before the headache. This can include visual disturbances (e.g. seeing zigzag lines, flickering, visual field loss, distorted vision) or one-sided sensory disturbances in the body. Rarely, one-sided paralysis or speech disturbances occur. These symptoms usually last 10 to 30 minutes, and are typically followed by the headache itself. Some people experience only recurring auras, which can make diagnosis unclear for a long time. Depressive moods, severe tiredness, nervousness and irritability, cravings, and increased urination or bowel movements can also accompany an attack.

During pregnancy or at an older age, migraine relatively often improves, changes in how it presents, and/or aura-only episodes may occur.

Special forms

Special forms include vestibular migraine and basilar migraine. These can involve recurring dizziness/vertigo attacks, possibly with further symptoms such as double vision, slurred or unclear speech, or even loss of consciousness. In children particularly, recurring dizzy spells without headache, or attack-like abdominal pain, can be the first sign of a migraine that later develops its typical form.