Understand Migraine
Migraine is more than a headache. It is a neurological condition that can affect pain, vision, balance, thinking, digestion, sensory processing, energy and everyday function.
What is migraine?
Migraine is a neurological disorder involving changes in how the brain and nervous system process information and respond to internal and external signals.
Head pain can be an important part of migraine, but it is only one possible symptom.
An attack can involve combinations of sensory, gastrointestinal, cognitive, autonomic, emotional, visual and balance-related symptoms.
You can have migraine without having a headache.
This is one reason migraine can sometimes be difficult to recognise.
What can migraine feel like?
Symptoms vary considerably between people and may also vary from one attack to another.
Pain
Headache may be throbbing, pulsating, pressing or otherwise painful. It may affect one side or both sides of the head.
Sensory changes
Light, sound, smell, touch or movement may become unusually uncomfortable or overwhelming.
Nausea & digestion
Nausea, vomiting, appetite changes and other gastrointestinal symptoms can accompany migraine.
Thinking & language
Brain fog, slowed thinking, difficulty concentrating or problems finding words can occur.
Balance & dizziness
Some people experience vertigo, dizziness, motion sensitivity or unsteadiness.
Energy & body changes
Fatigue, yawning, neck discomfort, changes in mood, food cravings or a general sense that something is changing may occur around an attack.
The phases of migraine
Migraine is often described as having four possible phases. Not everyone experiences every phase, and they do not always occur in a neat sequence.
Prodrome
Changes can begin hours or sometimes longer before the main attack.
Fatigue, yawning, mood changes, concentration difficulties, neck symptoms, food cravings or sensory changes may occur.
Aura
Some people experience temporary neurological symptoms before or during migraine.
These can include visual, sensory, language or other neurological changes.
Attack
This may involve headache, nausea, sensory sensitivity, dizziness and other migraine symptoms.
Importantly, headache does not have to be present.
Postdrome
Symptoms may continue after the main attack settles.
Fatigue, cognitive difficulty, sensory sensitivity or feeling generally depleted can continue during recovery.
Different types and presentations of migraine
Tap a box for a brief explanation.
Migraine without aura
Migraine without aura is a common form of migraine. Attacks may involve headache together with symptoms such as nausea and sensitivity to light or sound.
Learn More — Coming SoonMigraine with aura
Aura involves temporary neurological symptoms that may occur before or during a migraine attack.
Visual aura is common, but aura can also involve sensation, speech or language and other neurological changes.
Learn More — Coming SoonMigraine without headache / silent migraine
Some people experience migraine phenomena without significant head pain.
For example, a person may experience aura, sensory changes, nausea, dizziness or other migraine symptoms without developing the headache they associate with migraine.
Learn More — Coming SoonVestibular migraine
Vestibular migraine prominently affects the systems involved in balance and motion.
Symptoms may include vertigo, dizziness, motion sensitivity, unsteadiness and visual-motion sensitivity.
Headache may or may not accompany vestibular symptoms.
Learn More — Coming SoonChronic migraine
Chronic migraine describes migraine occurring within a pattern of very frequent headache days.
Some days may have obvious migraine features while other days may feel more like another type of headache.
Learn More — Coming SoonMenstrual migraine
Some people experience migraine attacks that have a close relationship with menstruation and hormonal change.
Hormonal patterns can also change during perimenopause and menopause.
Learn More — Coming SoonHemiplegic migraine
Hemiplegic migraine is a rare form of migraine with aura in which temporary motor weakness occurs as part of the aura.
Because new weakness can also be a sign of serious neurological conditions, new or unexplained symptoms require appropriate medical assessment.
Learn More — Coming SoonMigraine with brainstem aura
This is a less common form of migraine aura involving neurological symptoms associated with brainstem function.
Because some symptoms can overlap with other neurological conditions, appropriate medical assessment is important.
Learn More — Coming SoonAbdominal migraine
Abdominal migraine is seen particularly in children and involves recurrent episodes of abdominal pain with migraine-related features.
Some children later develop more typical migraine.
Learn More — Coming SoonMigraine doesn’t always mean headache
This can be particularly important when trying to understand unexplained episodes of visual disturbance, sensory sensitivity, dizziness, nausea or other neurological symptoms.
A person may have migraine-related symptoms with little or no head pain.
However, new neurological symptoms should not simply be assumed to be migraine. Appropriate medical assessment may be needed to exclude other causes.
It may not be one trigger
Migraine can be influenced by many interacting factors.
Sometimes one factor is obvious. At other times several smaller demands may accumulate.
Sleep
Too little, disrupted or changing sleep can influence migraine for some people.
Food & hydration
Long gaps without eating or inadequate fluid intake may contribute for some people.
Hormonal change
Menstruation, perimenopause and other hormonal changes can influence migraine patterns.
Sensory load
Light, noise, smell, motion and visually busy environments may add load.
Illness & body load
Pain, infection, poor sleep or another health condition may affect the overall picture.
Stress & change
Stress, excitement, major changes and even the let-down after a demanding period may influence migraine in some people.
Not every symptom before migraine is necessarily a trigger.
Sometimes something interpreted as a trigger — such as tiredness, food cravings, mood change or neck discomfort — may actually be an early part of the migraine attack.
Why does ALPIMS look beyond the migraine?
Migraine frequently occurs alongside other symptoms, conditions and differences.
ALPIMS uses its domains to help organise that wider picture without assuming that everything has one cause.
Is it definitely migraine?
Many migraine symptoms overlap with other conditions. A healthcare professional can help determine whether the pattern fits migraine and whether further assessment is needed.
My symptoms have changed
A substantial or unexplained change from your usual migraine pattern is worth discussing with an appropriate healthcare professional.
This is my first severe or unusual headache
A new, sudden or unusually severe headache should not automatically be assumed to be migraine.
Sudden severe headache, new neurological deficits, significant confusion, loss of consciousness or other concerning acute symptoms may require urgent medical assessment.
I have neurological symptoms without much headache
Migraine can occur without headache, but other neurological conditions can produce similar symptoms.
New or unexplained neurological symptoms should be medically assessed rather than being self-diagnosed as silent migraine.
Now look at what may help
Once you understand migraine a little better, you can explore treatment, everyday management and how other ALPIMS conditions may change what is useful for you.
General information only. This page is intended to help people understand migraine and does not diagnose migraine or replace individual medical advice. New, severe, rapidly changing or unusual neurological symptoms should be appropriately medically assessed.