Migraine can cause severe, recurrent, and potentially disabling headaches that typically last from 4–72 hours. Many people associate migraine episodes with feelings of nausea, heightened sensitivity to light and sound, and occasionally skin and muscle sensitivity. Migraine is surprisingly common. Around 39 million people in the United States experience this neurological disease’s incapacitating symptoms.
How long do migraine attacks last?
The length and frequency of migraine varies from person to person. There is an especially intense form of migraine called status migraines (SM). These long-lasting migraine headaches can cause symptoms for more than 72 hours, even with treatment. Although exact epidemiological data is lacking, an 11-year SM affects around 3% of people with migraine.
Migraine progresses through different phases that lead on from each other. Not everyone will experience each phase with every migraine attack they have. The four stages are:
prodrome
aura
headache
postdrome
Each stage lasts a different length of time, varying between people and between each migraine attack.
Migraine stages
Understanding the distinct phases of a migraine attack can help people manage the condition. When someone recognizes the earliest symptoms of a migraine episode, they can take measures to prevent the situation from progressing. Here is an outline of the stages, including duration and the most common symptoms someone may experience:
Prodrome
This stage is also called the premonitory or warning stage. It may begin several days or just a couple of hours before the onset of the aura stage. During this stage, an individual may notice subtle changes that are not necessarily headache-related. The symptoms serve as a warning of an upcoming migraine attack.
Prodrome symptoms include:
anxiety
constipation
fatigue
food cravings
increased thirst and urination
mood changes
neck stiffness
Aura
Not everyone who has migraine also experiences the aura stage with each attack. It only occurs in around 25% of individuals with migraine. The aura stage typically occurs shortly before the main migraine attack and lasts around 20–60 minutes. Auras are sensory disturbances that range from flashes of bright light to the inability to speak normally.
Aura symptoms include:
dizziness
hearing noises
impaired vision, or hearing
numbness or pins and needles in the limbs
seeing bright or flashing lights, sparkles, colored spots, or zigzag lines
slurred speech
weakness in the face or body
The aura stage usually happens before the primary headache. However, in some adults, and commonly in children, the aura symptoms
Headache
The symptoms during the headache stage are usually the same, no matter if someone experienced the aura stage or not. Headache symptoms include:
blurred vision
dizziness and lightheadedness
extreme sensitivity to light and noises
irritability
possible sensitivity to odors, touch, and movement
stiffness in the shoulders and neck
throbbing pain on one or both sides of the head that worsens with movement or activity
upset stomach, nausea, or vomiting
This stage is the most acute, with more than 90% of people experiencing symptoms severe enough to prevent them from functioning normally.
Postdrome
Postdrome happens at the end of the primary headache stage for around 80% of people. It can last for 24–48 hours and may include the following symptoms:
aching body
confusion
difficulty concentrating
dizziness
elation or depression
feeling drained
weakness
Some people find that sudden head movement or a return to strenuous activity may cause the headache to return, but only briefly.
Causes and common triggers
Identifying migraine causes and triggers can help people avoid them and prevent a migraine attack from occurring.
Triggers are different for everyone, but some common ones include:
alcohol and caffeine
bright lights
changes in the weather
dehydration
diet
hormonal changes
odors
overuse of medication
stress
Migraine treatments
Migraine treatments can involve using medications and home remedies to reduce the severity of symptoms.
Home remedies include:
increasing water intake
napping
resting in a dark and quiet room
using a cold compress
taking an over-the-counter pain reliever such as aspirin, ibuprofen, or naproxen
If home remedies do not relieve symptoms, an individual can ask their doctor for prescription medication.
A doctor may recommend the following
antiepileptics
antidepressants
beta-blockers
serotonin antagonists
botulinum neurotoxin (Botox)
CGRP antagonists
.
When to seek medical help
The American Migraine Foundation estimate that less than 50% of people with migraine seek help from a doctor. If a migraine episode lasts for longer than is typical for an individual, they should seek a doctor’s advice. They should visit the emergency room if a migraine episode becomes too severe and at-home treatments do not alleviate symptoms.
An individual should seek immediate medical attention if they have the following symptoms
an extremely severe headache
a headache that starts abruptly like a thunderclap, especially if the individual is aged over 50 years
a migraine headache accompanied by a stiff neck, or fever, confusion, slurred speech, or seizures
speech, vision, movement, or balance problems that differ from the regular migraine pattern
Always seek medical attention if someone has a headache following a head injury.
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