An Inside Look at When a Migraine Hits

When I first started getting migraines, I did not know what was happening. I was around 20 years old and knew nothing. While on active duty, no one put what I came in for, as having a migraine attack. Maybe I did not describe it accordingly. After a hospitalization in my 20s, they realized my symptoms now were migraines all along. So what have my migraine attacks looked like since they've started?

What are my typical prodrome symptoms?

First phase of a migraine attack, the prodrome phase, is my warning phase. I have certain symptoms that arise:

• Sensitivity to Light/Sound: Have you ever had a time when lights, sounds, or even smells bothered you? If you know someone with migraine, many of them will have one or all of these.
• Vertigo/Ringing in the Ear: Vertigo and ringing in the ear occur together for me. It was these, that led to my migraine diagnosis: vestibular migraine (migraine with vertigo). It starts with my left ear ringing (tinnitus). Then comes the vertigo. Sitting or lying down helps. Otherwise, I feel like I am going to fall. Have you ever felt like you were on a merry-go-round while just standing? It is not fun. It is best to sit or lay down, to prevent falling. This sometimes stays with me even after the migraine is gone.

How does aura present for me?

There is a second phase known as aura. My migraines do not always include this. Other times though, I will just have aura and no head pain. During aura, I only experience:

• Changes in Vision: My auras include zig zag flashes usually in the middle of one eye. It reminds me of someone shining a bright light over my eyes. It is hard to see when this happens. I normally just lay down until it passes.
• Aura Without Pain: I do not have aura each time. Then, there are moments when I will just have aura, without the head pain.

What do I experience in the headache phase of an attack?

Now comes the phase everyone is familiar with, the actual headache. But, did you know that this phase can have more than head pain? My symptoms in this one are below:

• Nausea/Vomiting: I have nausea, daily, as I have gastroparesis as well. I know it is related to migraine when I start vomiting, or, the nausea intensity has changed. I also know when the normal medications are not working. At the same time as this, or shortly after, the pains start.
• Head Pain: This is the symptom that everyone knows about. My pain is throbbing and right-sided. It is always above the right eye.
• Sinus Pain/Pressure: It may be hard to believe, but one can have sinus pain and pressure with other migraine symptoms. I can get sinus pain from the right side of my nose to under my right eye. I used to think that it was continuous sinus infections that were unresolved. Then, my doctor suggested that it was probably migraine. What do you know!? I used my abortive migraine medication when sinus pills did not work and got relief!!
• Neck Stiffness: I also tend to have tension in my neck. My shoulders are tight and I have lots of stiffness at the base of my head at the head/neck junction. Something that often helps me is heat. I use a heating pad across the tops of the shoulders. Rubbing diclofenac gel (Voltaren) on the back of my neck and shoulders provides relief as well.

What are my postdrome symotoms?

There is one more phase, the postprome (migraine hangover). I do not think I experience of symptoms of this phase except for exhaustion.

What other symptoms can occur with migraine?

The symptoms that I mentioned, are not the only ones related to migraine. I do not get any of the ones below, but I know some who do.

• Food Cravings: Some people crave sweet or salty items at some point during their migraine episode.
• Yawning: I have heard that yawning can be a sign that a migraine is getting ready to occur.
• Mood Changes: Did you know that some get extremely irritable or depressed when they get a migraine?

While all of these can occur before, during, or after migraines, these symptoms are not all inclusive. There are other symptoms that a person can experience. If you have had any of these, with/without head pain, you could possibly have migraine disease. Consider reaching out to a headache specialist, or a regular neurologist for an evaluation.