The Migraine Symptom Index, From A to Z

Migraine symptoms range far beyond head pain. An attack can cause a wide spectrum of symptoms that are neurologic, constitutional, autonomic, physical, and psychological. As a sensory processing disorder, it can also affect any of your senses. Migraine symptoms present in so many ways — affecting multiple parts of the body — that many people with migraine don’t even realize the connections themselves.

Being able to know and recognize your symptoms is empowering. It gives you the information you need to share with your doctor, so you can strategize the best multidisciplinary treatment plan for you. Understanding your symptoms also enhances your ability to manage migraine attacks when they occur, allowing you to see the telltale signs of a looming attack and take early action. Which of these migraine symptoms affect you?

Migraine Symptom Index 

Anxiety: Though anxiety can also exist outside of a migraine attack, it often occurs or worsens just prior to migraine headache (a period known as the prodrome phase). 

Appetite loss: Decreased appetite can occur anytime during the migraine cycle.

Aura: Migraine aura is a sensory disturbance that can occur before or during a headache, and is experienced by 25 to 30 percent of people with migraine. Disturbances in vision are the most common: 

• • Flashes of light
  • Geometric forms
  • Floaters
  • Rotating, oscillating, or shimmering objects
  • Image distortions
  • Temporary blind spots

Others develop perceptual distortions, as with “Alice in Wonderland” syndrome, where objects may seem smaller or larger — or nearer or farther away — than in real life. Other symptoms of aura include:

• • Tingling or numbness in the limbs
  • Perceiving unpleasant (though nonexistent) smells 
  • Weakness and difficulty walking
  • Difficulty with language 
  • Confusion
  • A sense of deja vu

Autonomic symptoms: These include nasal congestion, eyelid swelling, nasal secretions, eye redness, and teary eyes. 

Brain fog: The feeling of having trouble concentrating and having difficulty accessing your thoughts is common in migraine.

Cold feeling: Experiencing difficulty warming up is typically felt in the prodrome phase. Cold hands and feet can be symptoms as well.

Concentration difficulty: Cognitive impairment can occur anytime during the migraine cycle. 

Cutaneous allodynia: This is when an ordinarily non-painful stimulation can feel painful. This can happen at any time during the migraine cycle. You might experience discomfort from wearing tight clothing, glasses, a ponytail, headband, or hat. Activities like combing your hair or being hugged could also create a painful sensation. 

Depression: Feeling sad, bleak, or in a low mood may occur prior to migraine headache and at any time in the migraine cycle. 

Diarrhea/constipation: You may experience either diarrhea or constipation, or they may alternate during a migraine attack.

Double vision: This symptom is often experienced along with dizziness or a partial loss of vision.

Drowsiness: In some patients, drowsiness can significantly disrupt activities. This is commonly seen in the prodrome and postdrome phases, which are before and after the headache itself.

Euphoria: The feeling of intense happiness and excitement typically occurs during the prodrome or postdrome phases. 

Eye pain: It’s common to feel pain behind the eye(s) during an attack.

Fatigue: This can occur at any time during the migraine attack, though most typically during the prodrome and postdrome phases.

Fluid retention: Retaining fluid, called edema, typically happens in the extremities during prodrome. You might notice that your ring or watch feels tight. 

Food cravings: Cravings are common during prodrome — for chocolate, for example. Because eating these foods is often followed by a migraine attack, we often think of these foods as triggers. But one theory posits that in fact, the food cravings are simply one of the body’s signals that a migraine attack is already on its way.

Gastroparesis: Delayed gastric emptying can cause early satiety, nausea, and stomach pain and is often seen during migraine headache. It makes pills less effective.

General/constitutional: Prodrome symptoms can include a loss of appetite, feeling cold, diarrhea, constipation, fluid retention, food cravings, sluggishness, stiff neck, thirst, increased urinary frequency, and fatigue.

Headache or pain phase: Commonly experienced symptoms in this phase include: 

• • Nausea
  • Vomiting 
  • Sensitivity to light, sound, and smell
  • Visual disturbance (aura symptoms described above) and 
  • Dizziness

Gastrointestinal symptoms are common during the headache phase and can include: 

• • Nausea
  • Appetite loss
  • Food cravings
  • Delayed gastric emptying 
  • Diarrhea
  • Constipation

You might also experience continued symptoms from the prodrome phase, such as:

• • Mood changes 
  • Agitation 
  • Fatigue and lethargy
  • A sense of disorientation
  • Anger and rage 
  • Depression
  • Urinary frequency

Additional symptoms may include: 

• • Blurry vision
  • Nasal stuffiness
  • Pallor or redness
  • Sensations of heat, cold and sweating
  • Neck pain and discomfort
  • Sinus pain and pressure
  • Vertigo 
  • Cutaneous allodynia (described above). 

Heat and sweating: These sensations occur during the headache phase.

Hyperactivity: This active state, in which you feel unable to stay still, typically occurs during prodrome. 

Irritability: This feeling is common before the migraine headache or afterwards. 

Language symptoms: Some people have difficulty with speech and language, word recall, or replacing the word you mean to say with another one. This is a symptom of cognitive impairment that can appear at any phase of a migraine attack, but most often during prodrome.

Mood changes: Common in prodrome, people can feel depressed, irritable, or revved up. After the headache has subsided, people may feel tired, washed out, irritable, and listless. Alternatively, some people report feeling refreshed or euphoric in postdrome.

Motor symptoms: People may feel weakness or difficulty walking. Sometimes, the weakness affects just one side of the body, making it look like a stroke.

Nausea/vomiting/abdominal pain: This is one of the most frequently cited symptoms by people with migraine. It can be experienced in all phases of an attack.

Neurological prodrome symptoms: Symptoms can include difficulty concentrating, inability to generate speech, feeling overly sleepy, yawning, and experiencing light or sound sensitivity.

Numbness/tingling: Often associated with sensory aura, numbness can move from the fingertips up to (and across) the face.

Olfactory hallucinations: This is when you smell imaginary unpleasant things or foul odors. 

Osmophobia: A heightened sensitivity to smells and a negative perception of smells can occur at any time during the migraine cycle.

Perception symptoms: People can experience memory problems or a sense of deja vu, in which you feel as though you’ve experienced something before.

Phonophobia: A heightened sensitivity to sound (with accompanying discomfort) can occur at any time during the migraine cycle.

Photosensitivity: A heightened sensitivity to light can occur at any time in the migraine cycle. The discomfort of this enhanced perception prompts many people to wear sunglasses or seek a dark room. 

Restlessness: This symptom can occur during prodrome and migraine headache. 

Sensory symptoms: This may include a tingling sensation in limbs or numbness. Oftentimes this sensation migrates, starting at the tips of fingers and moving up the arm to the face. 

Sinus pain/pressure: Sinus pain, as well as a stuffy or runny nose, can be a part of the migraine headache. People with migraine may be misdiagnosed with sinus infections.

Somnolence: Feeling overly sleepy is common in prodrome and postdrome.

Stiff neck: This can occur during prodrome and/or the headache phase. Some patients know that a migraine is near when they feel their neck become stiff or tight. 

Talkativeness: This commonly occurs in the prodrome phase. 

Thirst: Frequently occurring in prodrome, thirst is thought to be due to the involvement of the hypothalamus.

Throbbing head pain: A classic symptom of migraine headache, throbbing head pain is often experienced on one side of the head but can be felt bilaterally as well. 

Urinary frequency: An increase in urination, also known as diuresis, can be a prodrome warning sign of a migraine attack. It may also occur toward the end of the attack. Diuresis is caused by the kidneys as they filter too much bodily fluid.

Vertigo: The sensation of the room or yourself spinning is often accompanied by nausea/vomiting. Vertigo can happen before or during headache. 

Visual symptoms: See Aura.

Watery eyes: This can be a signal of an impending headache. It can be confused with a symptom of allergies or a sinus infection.

Weakness: Gradual weakness on one side of the body, as when an arm goes limp, is typically felt during prodrome. Sudden muscle weakness could be due to a stroke, so it’s important to consult a doctor immediately if you experience this symptom.

Yawning: Excessive yawning is often a signal that a migraine attack is coming.

Managing The Symptoms Of Migraine

Were you surprised by any of the symptoms listed above? Migraine is more complex than many of us realize at first, which is why it’s so important to track your own unique symptoms. Self-knowledge is crucial for managing your life with headache and migraine. By increasing your understanding of your unique migraine, you’re taking an important step toward putting control within reach.