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In most cases, migraines progress through four stages:
Pro-drome - One or two days before a migraine attack, a patient experiences mild changes that warn them of an upcoming migraine. The changes include the following:
Aura - An aura may occur before or during migraines, though many people experience migraine pains without the aura. Auras are symptoms of the nervous system. They are usually disturbances related to the vision, such as flashes of light or wavy, zigzag vision. Sometimes auras can also be related to disturbances in the sense of touch, movement or speech. The patient’s muscles may get weak or they may feel as though someone is touching them. Each of these symptoms begins gradually, builds up over several minutes and lasts for 20 to 60 minutes. Examples of migraine auras are as follows:
Main headache attack - A migraine usually lasts for 4 to 72 hours if untreated. The frequency with which headaches occur vary from person to person. During a migraine, one may experience the following:
Post-drome - The final phase, known as post-drome, occurs after a migraine attack. Some patients feel drained and washed out, while some feel elated. For the next 24 hours, the patient may also experience the following:
A diagnosis of migraine is usually arrived from a careful study of the patient’s medical history, migraine symptoms, the patient’s family history of migraines as well as a number of physical and other advanced examinations. The doctor usually rules out other common possibilities of headache before arriving at diagnosing migraine.
The doctor will ask the patient the exact manner in which they experience the headache, the region where they experience the headaches, time when the headaches start as well as the frequency and duration of the headaches. Other useful information would include knowing how long the patient has been having these headaches and whether the related migraine symptoms are experienced before, during or after the attacks.
Headaches caused by poor eyesight, cervical spondylosis and sinusitis will all be ruled out after the medical tests.
Status migrainosus: This rare and severe migraine with aura lasts for longer than 72 hours.
Migrainous infarction: This is when a migraine is associated with brain stroke. Typically, this is a migraine headache with an aura that lasts more than an hour. An aura that lasts longer than an hour can be a sign of bleeding in the brain.
Persistent aura without infarction: This complication arises if an aura lasts for more than a week after a migraine has ended. This complication has similar symptoms to migrainous infarction, but there is no bleeding in the brain.
Migralepsy: This is a condition where an attack of fits is triggered by a migraine.
Stroke: A brain stroke occurs when blood supply to the brain is cut off or blocked by a blood clot or fatty material in the arteries.
Mental health issues: According to the Anxiety and Depression Association of America, migraines have been associated with a small increased risk of depression and anxiety.
Other complications: Migraines can also bring on symptoms like motion sickness, sleepwalking, sleep talking, night terrors and teeth grinding. Additionally, migraines can bring on abdominal pain, cyclical vomiting and vertigo.
Complications due to medications: It is frequently observed that because migraines recur, people frequently overuse pain medications. Frequent and unguided use of pain medicines lead to abdominal complaints such as gas and acidity to more severe conditions like bleeding.
Medication overuse headache (rebound headache): Continual, long-term use of medications used to treat migraines can cause a rebound headache also known as a medication overuse headache. This can lead to a cycle where taking too much medication causes a rebound headache, which then necessitates taking more medication, which causes worse headaches and so on.
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