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Prodrome: Migraine Warning Signs

As soon as I woke up yesterday morning, I was pretty sure a migraine was coming on. I couldn’t put a finger on the exact symptoms, but I felt “off” and sluggish. As a chronic migraineur, I can’t stay in bed whenever I feel “off” — I’d rarely be vertical if that were the case. Within five minutes of hauling myself out of bed, however, tears began streaming down my face, a sure sign a migraine is on the way. Although it doesn’t happen every time I have a migraine, I’m grateful when this prodrome symptom warns me so I can take a triptan and try to abort the migraine before it happens.

Tearing is the most reliable warning sign for me. Sometimes it is accompanied by yawning, but not always. Frequent sighing is often a predictor, though I also sigh a lot when I’m physically tired and it can be hard to tell which is which. Other prodrome symptoms, according to the Migraine Association of Ireland, can include:

Neck or other muscle stiffness
Feeling hot or cold
• Increased thirst
• Increased urination
Food cravings
Loss of appetite
• Yawning
Constipation
Diarrhea
• Fluid retention
Sensitivity to light and/or sound
Depression
• Euphoria
Irritability
• Restlessness
• Hyperactivity
Fatigue
• Drowsiness
Difficulty concentrating

These aren’t even all the possible vast and varied symptoms. Many people can’t pinpoint anything specific, but just say they feel “off” or “out of sorts.” What reliable symptoms signal a migraine is coming on for you?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Migraine Association of Ireland. Available at: http://www.migraine.ie/index.php?id=161-. Accessed September 2012.

Comments

  • surrattjm
    3 weeks ago

    Eye twitch

  • LouiseJC
    4 weeks ago

    I get a blocked nose only on the side I get the migraine. I wake up with this and then I know is likely to turn into a migraine.

  • Fabric softener
    4 weeks ago

    When Smells are starting to really bother me, increased sensitivity to fragrances, cologne, car-truck exhaust, Fabric Softener is huge!!! Air fresheners!!!

  • mcadwell
    5 months ago

    Seeing flashes of light, extreme hunger, feeling “off kilter”, being clumsy, words not coming out right, fatigue, difficulty concentrating

  • kateymac
    4 years ago

    Sensitivity to light and sound are always listed. But I also have awful sensitivity to any movement around me. For instance, I can be with my family, wearing earplugs, in low light, and still feel increased pain & nausea just by their presence and movements. It can almost feel like everyone around me is walking right through me with every movement, in a wave like seasickness but also annoyance on my skin as if being touched; but no one is touching me.

    I have to leave when this happens, and go home to be completely alone no matter how much I want to stay.

    Does anyone else have this excessive reaction to movement in the space around them during migraine? I never see it listed among the sensitivities.

  • Amy
    4 years ago

    I have a lot of problems with both sight and movement during a migraine. For me I think it’s overstimulation. My brain struggles to process the movement around me. I have to go to a room alone without any external stimulation.

  • blueangel1980
    4 years ago

    People tell me they see my eyes change. I realize that I get really clumsy.

  • Erin Kenny
    4 years ago

    Apparently my eyes change colour – usually from blue to a bright green.

  • blueangel1980
    4 years ago

    My vision also tunnels out.

  • shine4him
    7 years ago

    My biggest one is that I start having to pop my neck a lot. I don’t know if it’s just stiffness or a pinched nerve, but my family knows when they see me stretching my head, a migraine is on its way.

  • TGG1804
    4 years ago

    I get that too, I also get my left eye closing down but as I am almost blind in that eye I dont notice that. I also get the yawning, I didnt realise that weeping eyes was one though! I always thought that was just my contact lens, I’ve have to keep an eye on that (pun intended) 🙂

  • taralane
    7 years ago

    I think I get all of the prodrome’s listed – some are just effects of whatever meds I am on and others may be the sign of a real migraine. Since I am still having migraines 3-5 times every week, the only thing I know for sure is that if I see even the tiniest bit of aura, I know one is coming within a short time. My prophylactic medicines don’t last long so now I have to rely on the aura’s and unusual thirst. My aura’s are changing which is also disturbing. I have been having half circle shapes on both sides of my peripheral vision, every evening, and sometimes during the day. Now they are smaller than they first were about a month ago, but I am also getting auditory auras – I hear sound out of one ear and then the other as if I am listening to one speaker on the R, and then one on the L, but my other ear does not feel like it is hearing anything. Also I think just finding words to finish a sentence. This is starting to become a big frustration for me, but I don’t know if it is in the prodrome category or not. Anyone else experience this?

  • amf194
    7 years ago

    I get a really strong chocolate craving as part of my prodrome, and often crave something very salty as well, like Cheetos. I also become irritable and depressed. This isn’t a conscious mood change, but something I have come to realize is part of the migraine attack.

  • Janet
    7 years ago

    In answer to your question…what’s a prodrome for me…numbness in my left hand and pretty much everything on the list….but as you said Kerrie, you have to get up or we’d be vertical always, watching life go by without us.

    Janet Jones

  • Lori in PA
    7 years ago

    I usually get blurry vision or the words on the page look like they’re crawling around. In rare cases, I get the sparkling, flashing lights at the edges of my vision. They usually look like flashing X’s. One very weird sensation is that often I smell an overpowering scent of bananas. It wouldn’t be so bad, except I HATE bananas! :-/ Fortunately, my Botox is working really well, so i seldom get migraines now. *Does the happy dance.*

  • Nancy Harris Bonk moderator
    7 years ago

    Thanks for sharing with us. You are right, Migraines can be extremely disabling and isolating. But coming to sites like Migraine.com can be very therapeutic. I’m also thinking the doctor you work with is not very well educated in Migraine disease, is he?

  • mwebb1963
    7 years ago

    I too am an RN and I was admitted over the summer for a change in my hearing on my right side, right facial numbness, an inability to swallow and once to the ED, I couldn’t find words. I didn’t develop the migraine until after I had gotten to the ED. It scared me and scared my husband even more. I am finally seeing a neuologist and tryng to get my migraines under control. I wish I could convey to people how bad and debilitating these migraines are. There isn’t a magic potion to take or anything I am doing right or wrong. Even the doctor I work with says well you must be feeling better today…no, I am not, it is more tolerable today.

  • Rebecca
    7 years ago

    I get very similar symptoms to most previous posters, I see flashes of light and start having trouble with speech and balance. My words become slurred and I have difficulty finding the right words. I’ve even been accused of being drunk before when in fact I was experiencing a migraine aura! I also get pain in my right cheek/gums below my eye. The trouble is that I often sleep through the aura and wake up with a migraine. I am currently taking Maxalt for my migraines, but it doesn’t work if I take it after the onset of the pain. To be completely honest, relief is hit-and-miss if I take Maxalt in time!

  • Julie
    7 years ago

    I’ll get the aura’s-little silver flashing lights, zig zag lines in vision, throbbing twitching in the eye, blind spot in the eye (usually LH eye), extreme fatigue, yawning, dizziness, walking of balance, difficulty w/speech & making full sentences. I’m already sensative to light, but more so in the beginning of a migraine, as well as smells-I will smell burning when nothing is, and my neck will be very sore down to my shoulder and stiff.
    So my big question is some of these signs are the same as stroke. How would you be able to distinguish the difference between a stoke and your regular signs of migraine?? I asked a few of my former neurologists and they could not give me a concrete answer. That was comforting to know. NOT.

  • Teri-Robert
    7 years ago

    You’re welcome, Rebecca! Hemiplegic Migraine isn’t very common, and it can be confusing.

  • Rebecca
    7 years ago

    Teri,
    You’re very right! I haven’t seen a whole lot of people with Hemiplegic Migraines and I forgot that hemiplegia could also be associated with migraine. Thanks for reminding me!
    Rebecca

  • Julie
    7 years ago

    That’s good to know because it is normal for me to have migraines that will last for 3 days. I’ve told my many different neurologist this and they seem to think it’s no biggie. Sometimes it makes me, the patient, very frustrated and not taken very seriousy. My sister gets migraines infrequently and she’s had to go to the ER a time or two. The ER’s around here are disgusting. They treat you like drug seeking addicts. Her horror stories make me cringe and I hope and pray I never ever have to resort to going there for a really bad migraine. I’ve ridden out some bad ones at home rolling on my bathroom floor in pure agony just so I don’t get mistreated by the local ER’s here. I know I should not do that, but in the middle of the night who wants to go 45 min (we live in a very rural area) to the nearest ER and be treated like a druggie under those horrible lights in horrible pain to be sent home no better off than when you went in? There is still too much stigma about Migraines and some ER doctors need to have something shoved up their rumps or better yet yanked out of them! It’s a scary place to be in when you feel isolated and alone with no one to back you up. Makes it all the more depressing.

  • Teri-Robert
    7 years ago

    Rebecca,

    Those same symptoms can be Migraine symptoms. Hemiplegic Migraine can cause weakness on one side of the body, and the other symptoms can be from hemiplegic or other forms of Migraine. If someone has these symptoms for the first time, I’d think they’d be better off to get to the hospital for evaluation rather than wait because of the time issue. Of course, if these symptoms are “normal” for them, that’s entirely different.

    Teri

  • Teri-Robert
    7 years ago

    Julie,

    I’ve asked that question too. The best answer I’ve gotten is that if it’s the worst Migraine I’ve ever had, or if I’m experiencing new symptoms that could be either Migraine or stroke, or if the symptoms of a particular Migraine are frightening, to get to the ER.

    Sometimes, even a doctor can’t tell without an imaging study, and it’s best not to take chances.

    Teri

  • Rebecca
    7 years ago

    Hi Julie,
    I am an RN who works on an Acute Stroke Unit, and it is VERY disconcerting to know that the s/s of stroke are very similar to those of a migraine. The only difference I can come up with is that often stroke patients will report weakness or numbness/tingling to the extremities on one side of their body and exhibit a facial droop. I can say that for myself if I don’t develop a migraine within the hour of symptom onset I’d likely go to the hospital to be evaluated for a CVA. What’s dangerous about that is that if someone waits too long to get treatment and it turns out to be a stroke it delays the administration of medication which can minimize damage.

  • janmacy
    7 years ago

    Wow. I wonder what kind of food cravings. My biggest craving is dill pickles or something sour like sauerkraut. I’ll have to keep track now and see if that is followed by a migraine.

    My warning signs can be difficulty speaking. Saying the wrong words or not being able to think of a word; or a zagged hole in my visual field that keeps getting bigger until it goes away; or severe nausea for no reason; or just feeling a little off balance. Sometimes I have no warning. I’ve had migraines since the 3rd grade and the warning signs have changed over the years. I inherited them from both sides of my family – paternal and maternal.

  • Janet
    7 years ago

    Wow!!! Reading your post reminds me of how frustrating it is when migraining.the words are in your brain but there’s no way to get them processed to speak..that has to be one of the most frustrating aspects of side effects that I’ve experienced for 35 years…you feel like an idiot…or your speech slurs and you sound drunk or drugged….and I become so frustrated I sigh and say to whomever, never mind…the words are gone and my brain is turned off.
    Janet Jones

  • Miss Kim
    7 years ago

    Wow! I didn’t know some of these signs were signs of a migraine coming on. I always have a lot of them so I ignore them. I tend to feel “muddy”- I see someone said sluggish so I’m guessing it’s close. I’ll have to pay closer attention next time. The one symptom someone said was chills- I would never think that because I get hot and then cold but too young for menopause! Thanks for your inputs.

  • arden
    7 years ago

    I’ll get euphoric and then not be able to sleep, disrupting the regular sleep pattern that is so important. Soon the grumps start with over emotionalism and then shortly thereafter the pain begins.I remember one post suggested that as soon as the prodrome starts one should do relaxation techniques, aerobic exercise or other stress management. Doing mindful meditation on all the parts of the body that are not in crisis helps me to get the migraine in perspective rather than taking my full attention.

  • mskatiedid
    7 years ago

    I always have issues with speech. Other people will often notice before I do, because I’ll be speaking words jumbled up or a bit slurred. Sometimes I won’t be able to say the words I want to. It’s very strange. I also get very cold, like I have a fever.

  • janmacy
    7 years ago

    Yes – so irritating and sometimes embarrassing. This lack of finding words or saying the right word is one of my warnings. But not all the time.

  • janenez
    7 years ago

    A really stiff, painful neck is almost always a sure indicator for me. But then again, I think I’ve gotten so used to practically everything on that list being almost daily in my life that it doesn’t even occur to me to think of it as a warning sign anymore. Can a person have “chronic prodrome?” I have a really hard time gauging “when” to take my Zomig. It is such a dance. Last week I waited too long and then had to take the maximum dose for any effect at all. Other times I take it when I “think” symptoms tell me it’s coming – and then I wonder, did I just waste an expensive pill? It is hard for me know.

  • greeneyedgirl
    7 years ago

    Euphoria & hyperactivity are pretty consistent indicators for me. Chills and food cravings are also good indicators. I’m ALWAYS photophobic, so that’s no help. My problem is I can’t take triptans, and need to limit the cafergot (I also get hemiplegic migraines), so unless I am out of the house, I try and wait to see how severe a migraine it is before taking any meds. The warning IS helpful if I do happen to be out though.

  • marlenerossman
    7 years ago

    I actually envy those who get euphoric before a migraine. All I get is depressed. But Kerry, you are the first person that has I have heard that has the tearing of the eyes in prodrome. It is as if the floods have appeared. I use a gel for dry eye that stops the tears from streaming down my face.

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