Recognizing Migraine prodrome isn’t terribly difficult, but it does require us to be more aware of our bodies and what they’re telling us.
A Migraine attack can consist of up to four phases:
- the prodrome phase, sometimes called the premonitory phase.
- the aura phase,
- the headache phase, and
- the postdrome phase, sometimes referred to as the “Migraine hangover.”
During the prodrome phase, Migraine patients experience symptoms that can warn us that a Migraine attack is beginning. These symptoms can precede the aura phase for Migraine with Aura or headache phase for Migraine without Aura by two to 48 hours.
The Migraine prodrome is often overlooked. Many patients haven’t been told about it and don’t know it’s even possible. According to Dr. Peter Goadsby, the prodrome is
“common if you ask about it, but patients often don’t think to tell about those symptoms.”
Several studies have shown that some Migraine patients are able to very accurately tell that a Migraine attack is beginning from their prodrome symptoms. In one study of patients who were aware of having prodrome symptoms (Giffen et al.), participants correctly predicted a full Migraine attack following prodrome symptoms 93% of the time.
Migraine prodrome symptoms can vary from one Migraine to the next and definitely from one Migraine patient to another. Some Migraine patients have even found that which prodrome symptoms they experience is a good indicator or how severe their Migraine attack is going to be because they have different prodrome symptoms with mild, moderate, and severe Migraine atracks. Possible Migraine prodrome symptoms include:
- concentration problems,
- difficulty reading (aphasia),
- difficulty speaking (aphasia),
- food cravings,
- increased thirst,
- increased urination,
- repetitive yawning,
- sleep problems, and
- stiff neck.
How long before the aura or headache phases the prodrome symptoms begin varies from one person to the next. For most Migraineurs, they begin one to two hours before the aura or headache, but for some, they can precede the aura or headache phase by 24 hours or more.
The Migraine prodrome can be beneficial for us. Knowing a Migraine attack is beginning can allow us to be better prepared. If we’re out and know a Migraine attack is beginning, it can give us a chance to get home or someplace else safe and comfortable. For a lucky few, recognizing prodrome may give us the opportunity to treat early and avoid the headache phase completely.
Do you know if you experience Migraine prodrome symptoms? Many doctors believe that most Migraine patients do, but that they aren’t aware of them because they’ve never been asked about them. I’ve prepared a prodrome tracker to help determine if you have prodrome symptoms. To use it, mark any potential prodrome symptoms you experience. Then, after a Migraine attack, refer back to your prodrome tracker to see if you had prodrome symptoms. Using the tracker can help you become more aware of your body and any prodrome symptoms you may experience.Migraine ProdromeTracker
- Goadsby, Peter J., MD PhD. “Premonitory Phase of Migraine – Biology and Clinical Characteristics.” Platform Presentation. 53rd Annual Scientific Meeting of the American Headache Society. Washington, DC. June 4, 2011.
- Sprenger, Till, MD. “Premonitory Phase of Migraine – Insights into Primary Headaches from Functional Imaging.” Platform Presentation. 53rd Annual Scientific Meeting of the American Headache Society. Washington, DC. June 4, 2011.
- Becker, Werner J., MD PhD. “Premonitory Phase of Migraine – Treatment of premonitory Phase of Migraine: What is the Evidence?” Platform Presentation. 53rd Annual Scientific Meeting of the American Headache Society. Washington, DC. June 4, 2011.