I have been suffering since I was 4 years old with migraine attacks – most months I have 14-20 attacks. I have also had a headache that has lasted about 9 years now. It never stops, it never goes away – never goes below a 2 on the pain scale. When that pain reaches about a 6 or 7 – that’s when the other migraine attack symptoms start to come into play.
Most do not know this, but there are 4 stages of a migraine attack:
Prodrome is the premonitory phase. About 80% of Migraineurs experience prodrome, although their friends and family may actually be the first to notice something about the patient doesn’t seem ‘quite right’. Prodrome is not focused on any particular area of the brain. Some symptoms of prodrome may include:
Appetite changes (which may include cravings)
Cognition and concentration difficulties
Diarrhea or other bowel changes
Excitement or irritability
For me – I will get very – VERY cold all of a sudden. Like someone dumped me in a tub of ice. My hands and feet will get extremely cold and sometimes even my finger tips will get bluish in color. My body temp has been recorded as on the lower end of the ‘normal” scale. I get to a point where I can’t form words, cannot express what I want or how I feel. Like there is a short from my brain to my mouth. I will sometimes get false smells, tastes in my mouth, extreme fatigue, sore neck, fidgety like I can’t sit still. Lastly I will sometimes get depressed, like my whole world is going to come crashing down on me. I have been known to have a sobbing fit, like a small child who has misplaced her stuffed teddy bear.
Aura is a very dramatic, focalized result of the brain’s (electrical) wave of spreading cortical depression. Aura is most often visual or hallucinogenic in nature, although it may be sensory or motor as well. Some auras can be so profound as to mimic a stroke. Only a small percentage of Migraineurs experience aura.
Symptoms of migraine with typical aura
Visual aura are the most common kind of typical aura, experienced by more than 90% of patients. The first sign of visual aura is usually a small area of either brightness or blindness in the center of the field of vision, which typically spreads gradually outward from that central spot. This disturbance can take many different forms, such as moving zigzag lines, geometric shapes, blind spots, white or colored dots or stars, and flashes of brightness. The area of disturbance is often described as a crescent or C-shape with a shimmering outer edge, and vision tends to return to normal in the center as the disturbance spreads outward.
Reported by around 50% of patients, sensory aura are often described as a feeling of “pins and needles” or a burning sensation that starts in a particular spot (often the hand) and spreads slowly over that side of the body, face, and mouth. For many people, a feeling of numbness takes over the affected areas as the initial sensation subsides. Sensory aura often follow an experience of visual aura, but they can also occur as the only aura symptom in some cases.
Symptoms of speech and/or language aura can include trouble recalling words (most common), problems understanding language, and difficulties in reading and writing. About 30% of patients report having speech and/or language aura symptoms with migraines, making it the least frequently occurring kind of typical aura.
The ICHD-III states that typical aura symptoms usually last for more than five minutes but for less than an hour. However, a 2013 article reviewed the results of ten migraine studies that reported information about the duration of the participants’ typical aura symptoms. The authors reported that between 12%-37% of patients in those studies actually experienced typical aura that lasted for more than an hour. There are also rare cases in which typical aura have persisted for days or weeks.
For me Aura starts in with phase one – they are hand in hand. I live in a state of prodrome and aura most of the time. I for from attack to attack in a state of visual changes, loss of memory and concentration. I will sometimes get one line for a song or a movie stuck in my head – it will play over and over – just that one line. I will get phantom smells, tastes that are more intense than they were in the beginning of this attack. Dancing lights in my vision that look like the slides of sells from back in my high school science class. I will get dark spots, shadows that move around or even loss of vision in one of more spots.
Headache is the most common phase of a Migraine attack, although not all Migraines are painful. Some physicians include headache resolution as a separate phase of Migraine.
Like I said before, I live in constant pain, so when the attack reaches the “pain” stage it goes from a lower tolerable level – to something that makes me want to hide under the covers. I get to the point where I fear I might pass-out or get sick – sometimes both. I have had to crawl from the bed room all the way to our bathroom across the house on my hands and knees. Dragging my pillow with me so I have something to lay on when I get there. My loving and supportive husband will offer to make my rescue medication for me sometimes, its a powder based medication that you mix with a small about of water and drink. It tastes like a ground up Altoids, I know that doesn’t sound unpleasant – but when you are in a fill blown attack – its one of the last things I wanna drink. I also have one that is a tab that you place on your tongue and it melts – but alas, it also has the same powerful mint flavor.
Postdrome is the last phase of the attack and occurs past the point of headache resolution. Commonly called a ‘Migraine hangover’ these symptoms may persist 1-2 days past the headache phase.
This is the “hangover” part of the attack – I go from this to the start of the next one it seems without any real-time of being “normal.” I feel very tired, my skin, skull and even my hair hurt. I feel as if I was running or fighting for my life – like I was in the boxing ring. My eye muscles feel sore, my legs and arms don’t want to work quite right. I have massive depression and guilt that start to kick in right about this time. If we had to skip an event because of the attack it’s even worse for the guilt.
For many years I felt alone, I felt like my husband resented me – and I felt like no one believed me. My bosses would not understand why I would call in sick, or come in to work and not be that productive. I have had 3 rounds of Botox to try to prevent the attacks – I will do a separate post to go over how that is going.
A Migraine attack without prodrome, aura or postdrome is still called a Migraine. A Migraine without headache pain is called Acephalgic Migraine.
Most facts were found here – http://migraine.com
Some of what I am writing I have never told anyone – its been too hard on me – I usually cry and can’t get the words out.