Migraine: Symptoms, Causes, Triggers, Diagnosis and Treatment

Migraine is a type of severe headache that can happen repeatedly. Migraine attacks can affect daily activities and may include throbbing head pain, nausea, vomiting, and sensitivity to light, sound or smells. Effective treatments can help reduce symptoms, shorten attacks and prevent future migraines.

Migraine is a recurring headache disorder. An attack may progress through as many as four stages: prodrome, aura, headache and postdrome. Not everyone with migraine experiences every stage, and symptoms can vary from person to person.

Migraine attacks may happen rarely or several times a month. In adults, the headache stage typically lasts 4 to 72 hours. In children, it may last 2 to 72 hours.

Migraine symptoms depend in part on the stage of an attack.

Prodrome

Prodrome can begin one or two days before a migraine. Subtle changes may signal that an attack is coming.

Possible symptoms include:

• Increased sensitivity to light and sound.
• Fatigue.
• Neck pain.
• Trouble concentrating.
• Dizziness.
• Mood changes.
• Food cravings.
• Increased urination.
• Frequent yawning.

Migraine aura

Some people have an aura before or during a migraine attack. Aura develops gradually and may last from a few minutes to 60 minutes. About 1 in 4 people with migraine has aura. Some people also can have aura without a migraine headache.

Aura symptoms result from changes in brain activity and may affect vision, sensation or language.

Visual aura symptoms may include:

• Flashing or flickering lights.
• Spots of light.
• Shiny geometric patterns, zigzag lines or stars.
• Blind spots that slowly spread.
• Blurred areas of vision.

Sensory aura symptoms may include:

• Numbness or tingling in the face or arms that slowly spreads from one area to another.

Language aura symptoms may include:

• Trouble finding words.
• Trouble speaking the words you want to say.

Headache

During the headache stage, migraine symptoms may include:

• Severe, throbbing pain on one or both sides of the head.
• Nausea, vomiting or both.
• Sensitivity to light, sound and smells.

Physical activity, including walking or bending over, may make the pain worse.

Postdrome

After a migraine attack, you may feel drained, confused or worn out for as long as a day. Some people instead report a burst of energy.

The exact cause of migraine attacks isn't known. Migraine is thought to involve changes in nervous system activity that trigger pain.

Research suggests that changes involving neurotransmitters and neuropeptides in the brain may play a role. One of these neuropeptides is calcitonin gene-related peptide, or CGRP. Some newer migraine treatments target CGRP or its receptor.

Hormone changes also may trigger migraine. Changes during the menstrual cycle can contribute to attacks. Birth control pills and hormone replacement therapy may make migraine attacks worse for some people.

Migraine can affect people of any age, but it often first appears during the teenage years. Attacks tend to peak between the late teenage years and age 50 and often become less frequent over time.

Other risk factors include:

• Family history. Having a family member with migraine increases your chance of having migraine.
• Sex assigned at birth. People assigned female at birth are more likely to have migraine. Migraine often becomes less frequent and less severe after menopause.

Migraine diagnosis typically includes a physical exam and a discussion of your medical history.

Your care team may recommend additional tests to rule out other causes if you have unusual migraine-type headaches, other medical conditions or unexpected neurological symptoms. Testing may include a CT scan or an MRI. Your care team also may recommend evaluation by another specialist when needed.

There are two main types of migraine based on how often headaches occur:

• Episodic migraine means having headaches fewer than 15 days a month.
• Chronic migraine means having headaches 15 or more days a month for more than three months in a row.

Keeping a migraine record can help you and your care team recognize possible triggers, develop a treatment plan and measure how well treatment works.

Consider recording:

• When each migraine begins and how long it lasts.
• Pain level on a scale of 1 to 10.
• How much the migraine interferes with usual activities.
• Symptoms before, during and after the attack.
• What provides relief.
• Possible triggers during the previous 24 hours.
• Your stress level before the attack.

Migraine treatment generally has two goals: stopping or limiting symptoms once an attack begins and preventing future attacks.

Acute migraine treatment

Acute treatment is used after a migraine attack begins. These treatments tend to work best when taken early. The goal is to stop or reduce symptoms.

Taking acute medicine as soon as possible after symptoms begin may improve its effectiveness. Rest and hot or cold packs also may help.

Using some acute medicines too often can lead to medicine overuse headaches. The source material advises limiting pain reliever use to no more than two to three days a week and telling your care team if you use acute migraine medicine more than nine days a month.

Over-the-counter medicines used by some people include:

• Aspirin.
• Acetaminophen.
• Ibuprofen.
• Naproxen.

Ask your care team which medicine is appropriate for you. If over-the-counter medicine doesn't provide enough relief, prescription treatment may be considered.

Prescription options may include:

• Nonsteroidal anti-inflammatory drugs, or NSAIDs.
• Triptans.
• Dihydroergotamine.
• Antinausea medicines.
• Gepants, which inhibit CGRP.
• Nerve blocks.
• Neuromodulation.

Tell your care team if you are pregnant or breastfeeding prior to taking any medication. For children with migraine, talk with a healthcare professional about treatment options.

Preventive treatments may include:

• Tricyclic antidepressants such as amitriptyline or nortriptyline.
• Blood pressure medicines, including beta blockers and calcium channel blockers.
• Antiseizure medicines such as topiramate.
• CGRP monoclonal antibodies.
• Gepants.
• OnabotulinumtoxinA (Botox) injections.

For some people, magnesium, coenzyme Q10 or riboflavin, also called vitamin B-2, may help lessen the frequency, duration or severity of migraine attacks. Talk with your care team before taking these substances, particularly if you use other medicines.

Non-medicine approaches may include:

• Biofeedback.
• Cognitive behavioral therapy, or CBT.
• Muscle relaxation, breathing exercises or guided imagery.
• Transcutaneous nerve stimulation devices.
• Counseling or support groups.

Healthy routines may help reduce the number or severity of migraine attacks.

Consider these approaches:

• Manage stress. Identify stressful situations and use strategies that help you manage your response.
• Maintain a regular routine. Consistent sleep and meal schedules may help reduce triggers.
• Exercise regularly. With your healthcare professional's approval, consider aerobic activities such as walking, swimming or cycling.
• Drink enough fluids. Ask your care team how much fluid is appropriate for you.
• Avoid overusing pain relievers. Frequent use over time can contribute to medicine overuse headaches and, with some medicines, other side effects.

How long does a migraine last?

In adults, the headache stage typically lasts between 4 and 72 hours. In children, it may last between 2 and 72 hours. Other stages, including prodrome and postdrome, can extend the overall experience beyond the headache itself.

Can you have migraine without aura?

Yes. Most people with migraine don't experience aura. Even among people who have migraine with aura, attacks without aura also may occur.

Can you have aura without a migraine headache?

Yes. Some people may experience an aura without a migraine headache.

What is the difference between episodic and chronic migraine?

Episodic migraine involves headaches fewer than 15 days a month. Chronic migraine involves headaches 15 or more days a month for more than three consecutive months.

What should you do when a migraine starts?

Acting early is important. Acute medicines generally work best when taken soon after an attack starts. Resting in a quiet, dark room and using hot or cold packs also may help.

Can migraine be prevented?

Preventive medicine, behavioral therapies and healthy routines may help reduce how often migraine occurs and how severe attacks become. Your care team can help determine which approach fits your needs.

Migraine can be severe and interfere with daily life. But treatment can help many people have fewer attacks and reduce their severity. Because migraine patterns and responses to treatment vary, work with your care team to develop a care plan that fits your needs.

*This article is intended for informational purposes only and should not be substituted for medical advice. For medical questions and advice, it is always best to consult with your trained physician.

Related Articles: 

Migraines: An Overview

Understanding Stress: Causes, Effects, and Management Tips

Sources: 

Arnold, M. J. (2026, February 15). Acute migraine treatment: Guidelines from the International Headache Society. AFP. https://www.aafp.org/afp/2026/0200/practice-guidelines-acute-migraine-treatment 

Headaches and pregnancy. ACOG. (n.d.-b). https://www.acog.org/womens-health/faqs/headaches-and-pregnancy 

Mayo Clinic. (2026a). Migraine A Type of Headache. Rochester, Minnesota; Mayo Clinic. 

Mayo Foundation for Medical Education and Research. (2025a, July 8). Migraine. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/migraine-headache/diagnosis-treatment/drc-20360207 

Mayo Foundation for Medical Education and Research. (2025, July 8). Migraine. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201 

Moreland, P., Gaffney, B., & Lanham, J. S. (2025, May 15). Migraine headache prophylaxis. AFP. https://www.aafp.org/afp/2025/0500/migraine-headache-prophylaxis 

Migraine | National Institute of Neurological Disorders and Stroke. (n.d.-k). https://www.ninds.nih.gov/health-information/disorders/migraine