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How do I know when a migraine attack is starting?

Answer

Recognizing the early signs of a migraine attack can help with managing symptoms more effectively. Many people experience warning signs or symptoms in the prodrome phase, which can occur hours or even days before the headache phase begins. These early signs vary widely between individuals but may include:

  • Changes in mood: Feeling unusually irritable, anxious, or even euphoric.
  • Fatigue or low energy: A sense of sluggishness or exhaustion that isn’t typical.
  • Increased sensitivity: Heightened sensitivity to light, sound, or smells.
  • Food cravings: Strong cravings for certain foods, particularly sweet or salty items.
  • Digestive symptoms: Nausea, constipation, or diarrhea may occur before the headache begins.
  • Yawning: Frequent yawning, even when not tired, can be a subtle sign.
  • Neck stiffness or discomfort: A feeling of tightness or tension in the neck and shoulders.

For those who experience migraine aura (a distinct neurological phase that occurs before or during the headache phase), symptoms may include:

  • Visual disturbances, such as flashing lights, zigzag patterns, or blind spots.
  • Tingling or numbness, typically starting in one hand and moving to the face or other areas.
  • Difficulty speaking or finding the right words.

Tracking patterns in these early symptoms can help individuals identify when a migraine attack is starting. Keeping a migraine diary can be particularly helpful in identifying personal warning signs and triggers. Recognizing these early phases allows for timely interventions, such as decreasing stimulus (light and/or sound), using tools such as ice packs, or electrolytes, or using acute treatments (medications), which may help reduce the severity or duration of the attack.

It’s important to note that not everyone experiences all phases of a migraine, and symptoms can vary between attacks.