What are the symptoms of migraine headaches?

The Migraine Symptom Picture

A migraine is a neurological event, not just a bad headache. The classic attack brings throbbing or pulsing pain, usually on one side of the head, moderate to severe, and typically worse with movement, coughing, or physical activity. Along with the pain, most people experience:

• Nausea and vomiting, sometimes bad enough that you cannot keep food or fluids down.
• Sensitivity to light and sound (and sometimes smell), which is why people retreat to a dark, quiet room.
• Disabling intensity that makes it hard to work or function, lasting anywhere from 4 hours to 3 days if untreated.

The Phases: Warning Signs and Aura

Migraines often unfold in stages. In the hours before the pain, some people notice prodrome symptoms: mood changes, food cravings, neck stiffness, yawning, or fatigue. About a quarter of people then experience an aura just before or during the headache, most often visual: flashing lights, shimmering zigzag lines, or blind spots. Aura can also cause tingling or numbness that spreads over minutes. A key feature of true migraine aura is that it builds up gradually over minutes and then fades, rather than appearing all at once.

What the Symptoms Mean

For someone with a migraine history, these symptoms following your familiar pattern point to a migraine, not a dangerous cause. The reassuring signs are that the attack resembles your previous ones, the aura develops slowly and resolves, and your usual treatment helps.

Which Symptoms Are Dangerous

Some symptoms are not part of an ordinary migraine and should never be written off as one:

• Pain that peaks in seconds (a thunderclap), or the worst headache of your life.
• Sudden weakness, numbness, facial drooping, slurred speech, or vision loss that comes on abruptly rather than building slowly like aura.
• Confusion, a seizure, or loss of consciousness.
• Fever with a stiff neck or a new rash.
• A headache that is simply new or different from your usual migraines, particularly if you are over 50, pregnant, or immunocompromised.

Symptoms like these can signal a stroke, brain bleed, or meningitis and need emergency evaluation.

For a complete guide, see our migraine headaches page. Bellaire ER is open 24/7 at 5302 Bellaire Blvd with board-certified emergency physicians on site. Walk in any time or call (713) 660-0001.