Clinical Features: Migraine Symptoms

Migraine is associated with combination of neurologic, gastrointestinal, and autonomic symptoms. Gastrointestinal disturbances are almost universal with migraine, and photophobia, phonophobia, or osmophobia occur frequently. Other common symptoms include blurry vision, nasal stuffiness, tenesmus, polyuria, pallor, and sweating.[1]

Symptoms Associated with Migraine Phases

Symptoms associated with the four migraine phases are shown in Table 2. Symptoms that occur during the prodromal phase of migraine may include irritability, fatigue, and cravings for certain foods (often for carbohydrates and chocolate). Symptoms during this phase may occur hours or days before the headache onset.[2] During migraine aura, symptoms including a variety of visual, cognitive, sensory, motor, or language disturbances that may develop over 5 to 20 minutes and last up to 1 hour.[2,3]

The symptoms associated with migraine headache include severe, throbbing head pain that can be disabling and can worsen with exposure to noise, light, or movement. Migraine headache has a duration ranging from 4 to 72 hours. About 60% of individuals with migraine report pain is located on one side of the head, typically behind or in the vicinity of one eye. Symptoms that typically occur during this phase include nausea, vomiting, dizziness, increased urination, diarrhea, pain in extremities, and tingling or numbness in lips, tongue, or face, or in fingers on same side as headache. Personality changes may also be noted.[2]

Typical symptoms associated with the postdrome phase of migraine include fatigue, confusion, loss of memory, and difficulty carrying out common physical tasks. During this phase, the migraine sufferer may desire to be left alone. Some patients may experience a surge of energy, euphoria, and increased appetite.[2]

Table 1. Symptoms of a Migraine Attack
Prodrome
  • Fatigue
  • Irritability
  • Food cravings
Aura
  • Vision disturbance (flashing lights or blind spots)
  • Numbness or weakness on one side of the body
  • Slurred speech
  • Sensitivity to light and sound
Headache
  • Throbbing headache
  • Nausea and vomiting
  • Diarrhea
  • Lightheadedness
  • Dizziness
  • Tinnitus
Postdrome
  • Fatigue
  • Euphoria
  • Surge in energy
  • Increased appetite
  • Confusion
Adapted from Paulino J, Griffith, CJ. Headache Sourcebook : The Complete Guide to Managing Tension, Migraine, Cluster, and Other Recurrent Headaches in Adults, Adolescents, and Children. New York, NY: Contemporary Books; 2001.

 

Common Migraine Symptoms: Survey of Migraine Sufferers

A survey of 500 self-reported individuals who suffered from migraines to evaluated the frequency and severity of neurologic, gastrointestinal, and autonomic symptoms.[1] Head pain, nausea, problems with vision, and vomiting were the most common reported symptoms. Figure 1 shows rates of the most common migraine symptoms reported. Nausea occurred in over 90% of all migraine sufferers and affected one third of these individuals during every migraine episode. Vomiting occurred in almost 70% of all migraine sufferers, and affected nearly one third of these individuals during the majority of attacks. Common migraine symptoms experienced during the most recent migraine episode were rated as moderate-to-severe in intensity by a majority of respondents (Table 2).

 

Figure 1. Prevalence of Common Migraine Symptoms

Table 2. Severity of Common Symptoms During the Most Recent Migraine Episode
Symptom Mild Moderate Severe
(% respondents)
Headache pain (n=394) 7.4 16.8 75.9
Nausea (n=285) 24.2 35.8 40
Visual problems (n=209) 18.2 42.6 39.2
Vomiting (n=87) 17.2 29.9 52.9
Light sensitivity (n=52) 5 34.6 55.8
Hearing problems/noise sensitivity (n=139) 17.6 35.3 47.1
Dizziness (n=34) 26.5 44.1 29.4
Neck pain (n=28) 7.1 21.4 67.9
Written by: Jonathan Simmons, PhD | Last review date: March 2012.
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