Migraine symptoms go far beyond a bad headache. A migraine attack unfolds in up to four distinct phases, each with its own set of symptoms that can start days before the head pain begins and linger after it ends. The headache itself is typically a moderate to severe throbbing pain, often on one side of the head, accompanied by nausea, light sensitivity, and sound sensitivity. But many people are surprised to learn that some of the earliest and latest symptoms, like food cravings, excessive yawning, or post-attack brain fog, are part of the migraine too.
Early Warning Signs Before the Pain
One or two days before the headache hits, your body may send subtle signals that a migraine is coming. This early phase, called the prodrome, can last several hours or stretch across multiple days. The signs are easy to dismiss or attribute to something else, but recognizing them gives you a window to act early.
Common prodrome symptoms include:
- Food cravings, especially for sweets or carbohydrates
- Neck stiffness
- Frequent yawning, even when you’re not tired
- Mood shifts ranging from irritability or sadness to unusual giddiness
- Constipation
- Increased urination
- Fluid retention or bloating
Not everyone experiences a prodrome, and the specific symptoms vary from person to person. Over time, though, many people learn to spot their own personal warning pattern. Keeping a headache diary that tracks these early signals can help you identify yours.
Aura Symptoms
About one in three people with migraine experience aura, a set of sensory disturbances that typically develop gradually over at least five minutes and last up to an hour. In roughly 20% of cases, aura can persist longer than 60 minutes. Aura usually appears before the headache phase, though it sometimes overlaps with it.
Visual disturbances are the most common type. You might see flashing lights, zigzag lines, shimmering spots, or expanding blind spots in your field of vision. These visual changes tend to start small and spread across your visual field over several minutes.
Other aura symptoms include tingling or numbness that starts in one hand and creeps up the arm into the face, difficulty speaking clearly, ringing in the ears, and dizziness. These sensory changes are temporary, but they can be alarming if you haven’t experienced them before. They develop and resolve gradually, which helps distinguish them from the sudden onset of a stroke.
What the Headache Phase Feels Like
The headache phase is what most people think of as “the migraine.” It typically lasts anywhere from four hours to three days if untreated. The pain has a distinct character that sets it apart from tension headaches or sinus pressure.
Migraine pain is usually pulsating or throbbing rather than a steady ache. It often affects one side of the head, though it can shift sides between attacks or affect both sides. The intensity is moderate to severe, enough to interfere with your ability to work, think, or carry on with normal activities. Routine physical movement like walking up stairs or bending over makes the pain noticeably worse.
The headache rarely comes alone. During the attack, you’ll typically experience at least one of the following: nausea (sometimes with vomiting), sensitivity to light, or sensitivity to sound. Many people experience all three. This combination is why people with migraine often retreat to a dark, quiet room during an attack. Some people also become sensitive to certain smells, and even mild odors can feel overwhelming.
The “Migraine Hangover”
After the headache fades, the migraine isn’t necessarily over. Many people enter a recovery phase that can feel like a hangover. You might feel drained, mentally foggy, and physically achy. Stiff neck, lingering nausea, and continued sensitivity to light and sound are all common during this window.
Concentrating on tasks or making decisions can feel unusually difficult. Some people describe it as trying to think through cotton. Mood swings are also typical during recovery, ranging from a sense of euphoria to feeling low or depressed. The duration varies, with some people bouncing back within a few hours and others feeling off for a full day or more.
Migraine Without Headache
Not every migraine involves head pain. Vestibular migraine, for example, primarily causes balance and dizziness symptoms that can occur with or without a headache. Vertigo episodes can last minutes, hours, or even days. Unsteadiness, loss of balance, and intense sensitivity to motion are hallmarks. People with vestibular migraine almost always have a history of motion sensitivity going back to childhood, like getting carsick easily.
Some people also experience aura symptoms (visual disturbances, tingling, speech difficulty) without ever developing a headache afterward. This is sometimes called “silent migraine.” It’s more common in people who had migraine with aura when they were younger and find that the headache component fades with age.
How Migraines Differ in Children
Migraine in children and teens looks different enough from adult migraine that it’s often missed or misdiagnosed. In younger children, the pain typically affects both sides of the head rather than just one. As teens get older, the pattern gradually shifts toward the one-sided pain that adults experience. Children’s attacks also tend to be shorter than adult episodes.
Kids may have trouble describing their symptoms precisely. Beyond head pain, they commonly report dizziness, lightheadedness, difficulty focusing, nausea, vomiting, and sensitivity to sound and light. During the aura phase, children may see spots or flashing lights and experience confusion or numbness. After an attack, some children feel exhausted while others bounce into an oddly upbeat mood.
Symptoms That Need Immediate Attention
Most migraine symptoms, while miserable, follow a recognizable pattern for each person. Certain headache features, however, can signal something more dangerous than a migraine. Neurologists use a set of red flags to identify headaches that warrant urgent evaluation.
The most critical warning sign is sudden onset. A headache that reaches maximum intensity within seconds, sometimes called a thunderclap headache, can indicate a vascular emergency like a brain aneurysm and needs immediate evaluation. This is fundamentally different from migraine pain, which builds gradually.
Other red flags include new neurological symptoms you’ve never had with previous migraines, such as weakness on one side of your body, new or unusual numbness, or vision changes that don’t fit your typical aura pattern. A headache accompanied by fever, night sweats, or unexplained weight loss suggests something systemic is going on. New onset of headaches after age 50, headaches that steadily worsen over weeks, and headaches that change dramatically with body position (worse when standing or lying down) are also patterns that point away from migraine and toward other causes.
If your headaches have followed the same general pattern for years and a doctor has previously diagnosed you with migraine, a single bad attack isn’t usually cause for alarm. What matters is a break from your established pattern, especially any of the features described above.