What are the stages of a migraine?

The Migraine Research Foundation says that migraine is a neurological disease that affects 39 million people in the U.S. Migraines, which often begin in childhood, adolescence or early adulthood, can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages.

Learn more about each stage of a migraine:

1. Prodrome

One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including constipation, mood changes from depression to euphoria, food cravings, neck stiffness, increased thirst and urination or frequent yawning.

2. Aura

For some people, aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They're usually visual, but they also can include other disturbances. Each symptom usually begins gradually, builds up over several minutes and lasts 20 minutes to one hour.

Examples of auras include:

• Visual phenomena, such as seeing various shapes, bright spots or flashes of light
• Vision loss
• "Pins-and-needles" sensations in an arm or leg
• Weakness or numbness in the face, or one side of the body
• Difficulty speaking
• Hearing noises or music
• Uncontrollable jerking or other movements

3. Attack

A migraine usually lasts from four to 72 hours if untreated, and the frequency varies by the person. Migraines might occur rarely or strike several times a month.

During a migraine, you might have:

• Pain, usually on one side of your head, but often on both sides
• Pain that throbs or pulses
• Sensitivity to light, sound, and sometimes smell and touch
• Nausea and vomiting

4. Post-drome

After a migraine attack, you might feel drained, confused and washed out for up to a day. Some people report feeling elated. Sudden head movement might bring on pain again briefly.

Migraines are often undiagnosed and untreated. If you regularly have signs and symptoms of migraines, keep a record of your attacks and how you treated them. Then make an appointment with your health care provider to discuss your headaches.

Learn more about headaches:

• Get 6 tips for headache relief.
• Get the facts about headache medication.
• Learn about Botox as a chronic migraine treatment.
• Read common questions about headaches and get answers.

Nancy Erickson, M.D., is a Family Medicine physician in Onalaska, Wisconsin.