migraine is a chronic condition of recurrent attacks. most (but not all) migraine attacks are associated with headaches. migraine headaches usually are described as an intense throbbing or pounding pain that involves one temple. (sometimes the pain is located in the forehead around the eye or in the back of the head). the pain usually is unilateral (on one side of the head) although about a third of the time the pain is bilateral. the unilateral headaches typically change sides from one attack to the next. (in fact unilateral headaches that always occur on the same side should alert the doctor to consider a secondary headache for example one caused by a brain tumor). a migraine headache usually is aggravated by daily activities such as walking upstairs. nausea vomiting diarrhea paleness cold hands cold feet and sensitivity to light and sound commonly accompany migraine headaches. as a result of this sensitivity to light and sound migraine sufferers usually prefer to lie in a quiet dark room during an attack. a typical attack lasts between four and 72 hours. an estimated 40% to 60% of migraine attacks are preceded by premonitory (warning) symptoms lasting hours to days. the symptoms may include sleepiness irritability fatigue depression or euphoria yawning and cravings for sweet or salty foods. patients and their family members usually know that when they observe these warning symptoms that a migraine attack is beginning. an estimated 20% of migraine headaches are associated with an aura. usually the aura precedes the headache although occasionally it may occur simultaneously with the headache. the most common auras are 1) flashing brightly colored lights in a zigzag pattern (fortification spectra) usually starting in the middle of the visual field and progressing outward and 2) a hole (scotoma) in the visual field also known as a blind spot. some elderly migraine sufferers may experience only the visual aura without the headache. a less common aura consists of pins-and-needles sensations in the hand and the arm on one side or pins-and-needles sensations around the mouth and the nose on the same side. other auras include auditory (hearing) hallucinations and abnormal tastes and smells. complicated migraines are migraines that are accompanied by neurological dysfunction. the part of the body that is affected by the dysfunction is determined by the part of the brain that is responsible for the headache. vertebrobasilar migraines are characterized by dysfunction of the brain stem (the lower part of the brain that is responsible for automatic activities like consciousness and balance). the symptoms of vertebrobasilar migraines include fainting as an aura vertigo (dizziness in which the environment seems to be spinning) and double vision. hemiplegic migraines are characterized by paralysis or weakness of one side of the body or mimicking a stroke. the paralysis or weakness is usually temporary but sometimes it can last for days. retinal or ocular migraines are rare attacks characterized by repeated instances of scotomata (blind spots) or blindness on one side lasting less than an hour that can be associated with headache. irreversible vision loss can be a complication of this rare form of migraine. for approximately 24 hours after a migraine attack the migraine sufferer may feel drained of energy and may experience a low-grade headache along with sensitivity to light and sound. unfortunately some sufferers may have recurrences of the headache during this period.
what are the symptoms of migraine headaches?