Saturday, August 21, 2010

Premonitory Symptoms

As I finally ended one horrible week-long migraine, had a day of "relief" (still bad headache, just not debilitating), and began to have another migraine attack... I got to thinking. Around the times that I have my worst migraines (both before and after), I tend to get extremely irritable, snappy, and on edge. And, sometimes I get a burst of energy before...and then a migraine hits and stops me in my tracks.

So, I did some research online to see if other migraine sufferers experience extreme mood changes around the time of a migraine attack. I came across an article in the New York Times (August 4, 2010), where Dr. Dodick responds to this very question:

"Migraine is too often “bookmarked” by the start and stop of the headache, but migraine is frequently associated with symptoms other than headache before, during and after the onset of head pain. About 75 percent of migraine sufferers will experience non-headache premonitory symptoms prior to the headache pain. Patients experience a range of cognitive, emotional and physical symptoms in this phase; the most common include feeling tired and weary, difficulty concentrating, stiff neck, dizziness, light and noise sensitivity, yawning, and depression or irritability.

These non-headache symptoms usually occur within six hours before and resolve within six hours after the headache. But in a sizable minority of people, the symptoms can start within 24 hours of the pain and take more than 24 hours to resolve.

This range is important to recognize for a few reasons. First, it reflects the fact that the changes associated with a migraine attack are occurring in the brain up to three days before and one day after the headache pain begins, and therefore, the disability associated with attacks cannot be measured by the duration of the pain alone..."

You can read the entire article in Consults.

It is unfortunate that many of these premonitory symptoms are so subtle that we may not notice until the migraine has already struck. Even those that have migraine with aura (as I do) cannot always count on the "warning." I don't always get an aura, or at least not the same type of aura (usually visual or auditory, though there are many different experiences that fall under the term "aura").


  1. I know that my mood is effected by them. Often I feel energetic, like I've had too much caffeine, but slightly different before one. Sometimes I feel that way and don't get a migraine but usually I do which stinks because then I get depressed and in "I'm about to get a migraine" mode. And I love it when I see the sun's reflection on it leaves a little light blind spot and I start to worry I may be getting one. But, back to the subject; my mood is slightly energetic/shaky before..almost like the energy overloads my brain or something... and then after I'm usually a little off. I haven't ever been too irritable beyond grumpy about the pain but I have noticed that sometimes my memory will be a little off and I'll mix up words sometimes.

    1. BHern, that's interesting about your mood changes. I know that I can get extremely agitated / irritable leading up to a migraine. But, other migraines are preceded by a huge energy spike (before migraine), and then a complete crash (with migraine).

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