Many people associate a migraine attack with "a headache.” The truth is that a migraine attack is the result of a complex neurological process in and around the brain. Severe head pain may be the most recognizable symptom, but it can affect various body systems before, during, and after the headache phase, resulting in a wide range of possible symptoms.
On this page, you’ll learn about the symptoms of a migraine attack, the phases that can occur, and the symptoms may require medical attention. We’ve also included podcasts and blogs that provide more information about the different symptoms people may experience.
WHAT ARE THE SYMPTOMS OF A MIGRAINE ATTACK?
The typical symptoms that define a migraine attack are:*
- Headache lasting 4-72 hours without treatment
- Headache has at least two of the following characteristics:
- Unilateral—on one side of the head
- Pulsing or throbbing quality
- Moderate to severe intensity
- Aggravated by/causes avoidance of routine physical activity
- During a headache, at least one of the following:
- Nausea and/or vomiting
- Sensitivity to light (photophobia) and sensitivity to sound (phonophobia)
*This is the diagnostic criteria established by the International Classification of Headache Disorders - 3rd Edition (ICHD-3). These criteria describe migraine without aura, but migraine can cause many different symptoms beyond this definition.
There are many other symptoms that can be linked to migraine, such as:
- Aura
- Fatigue
- Brain fog
- Dizziness
- Vertigo
- Feeling off balance
- Neck pain
- Ear pain or pressure
- Sinus pressure or pain
- Runny or stuffy nose
- Upset stomach or diarrhea
- Changes in sleep or mood
- Yawning
- Food cravings
- Frequent urination
- Smell sensitivity
- Ringing in the ears (tinnitus)
Migraine is a complex neurological disease, and symptoms can vary from person to person. Even for the same person, symptoms and their intensity can differ from one attack to the next.
Importance of tracking migraine symptoms in a diary
One of the most helpful steps you can take if you have migraine—or think you might—is to track your symptoms in a headache diary. Some people prefer to use paper diaries (like this one), but others use smartphone apps to keep track. You can find a wide variety of headache tracking apps in your app store and set them up to help you focus on the information and symptoms most important to you.
No matter which format you use, keeping a headache diary can help you track your attacks. It allows you to:
- Track how often you get attacks and what they’re like
- Record how long attacks last, what symptoms you have, and how well treatments work
- Spot possible patterns or triggers over time
- Notice any changes in: frequency, severity, duration, treatment responses, or other symptom changes
- Provide your healthcare practitioner with helpful information, which can support treatment decisions or insurance approval for a new or more effective therapy
A diary doesn’t need to be complicated—just a few notes each day can make a big difference.
Migraine Symptoms by Location
While head pain with nausea or light and noise sensitivity are the hallmark symptoms of migraine, it's important to know that migraine can cause a wide range of symptoms throughout the body.
*Hover over each region on the graphic below to see symptoms associated with that area of the body.
Understanding Migraine Symptoms Throughout an Attack
Migraine attacks typically occur in phases, each with its own set of symptoms. The most commonly recognized phases are the prodrome, aura, headache/acute, postdrome and interictal. Some advocacy groups are beginning to recognize a phase called resolution, which is when the headache ends.
This timeline shows common symptoms based on the phase they usually appear in. While the phases are often described separately, many people notice their symptoms can overlap from one phase to another.
What Symptoms Occur In Each Phase?
Each tab lists the various symptoms that can occur during a migraine attack.
Some people may experience a migraine attack without the headache phase. In these cases, they do not have a headache after the aura phase.
concerning Symptoms that may require medical attention
Healthcare professionals classify migraine as a primary headache disorder, meaning it isn’t caused by an underlying condition. Headaches caused by another medical condition are called secondary headaches. Some secondary headaches are linked to conditions that respond well to routine care, like medication overuse headache, while others may be caused by serious or urgent health problems, such as a stroke or aneurysm.
Because migraine symptoms can sometimes mimic other conditions, it’s important to get an accurate diagnosis from a healthcare professional.
Secondary Headache Red Flags
Some headaches can signal a more serious medical issue. Healthcare professionals may look for “red flags” that could indicate a secondary headache. If you experience any of these warning signs, talk to your healthcare provider.
Adapted from SNNOOP10 mnemonic.
“Thunderclap” Headache
A headache that suddenly reaches full intensity (from 0 to 10) in under a minute and lasts for 5 minutes. It is considered a medical emergency.
Systemic Symptoms with Headache
Headache accompanied by systemic symptoms like fever, neck stiffness, light sensitivity, or chills.
Vision Problems
New vision problems, like double vision or brief episodes where vision becomes blurry or goes dark.
Pulsatile Tinnitus
A pulsing or whooshing sound in one or both ears that matches your heartbeat.
Behavior or Personality Changes
New behavior or personality changes, including seeing, hearing, or smelling things that aren’t there (hallucinations).
New Onset of Headaches
New onset of headaches in children under age 5 or adults over age 65.
Changes in Headache Pattern
Noticeable changes in headache pattern, such as a newly developed aura, fewer headache-free periods, or a change in frequency (such as chronic daily headache in someone who previously had episodic migraine).
Valsalva Maneuver
A headache that appears after exercise or after sneezing, coughing, or straining.
Positional Headache
A headache that worsens or starts when changing positions—like going from lying down to standing—or when you move or turn your head in a certain way.
After Injury
Headache after an injury (even one without obvious head contact, like a "rear-end" car accident).
Frequent Use of Painkillers
Can lead to medication overuse headache, also known as rebound or medication adaptation headache, which is a new type of headache that occurs from taking certain pain-relief or migraine medications too frequently.
New Medications
A severe headache after starting a new medication.
Pregnancy
New onset of headache during pregnancy.
Headache in Immunosuppressed Individuals
Headache in someone with a history of immune disorders, HIV or cancer.
Eye Symptoms
Eye pain, particularly if it's accompanied by tearing, redness, or a droopy eyelid.
The contents of this page are intended for general informational purposes only and do not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. The dosages provided are all stating what is typical for an individual but it is important to always consult with a medical professional to determine what dose is best for you. The list of side effects for each medication is not exhaustive. AMD does not recommend or endorse any specific course of treatment, products, procedures, opinions, or other information that may be mentioned. Reliance on any information provided by this content is solely at your own risk.
