What to know about episodic migraine

Medical NewsToday\ Medically reviewed by Heidi Moawad, M.D. — Written by Amanda Barrell on August 30, 2021

Migraine is a debilitating neurological condition that commonly causes extremely painful headaches. People can have chronic or episodic migraine.

People with episodic migraine have headaches with migraine symptoms between zero and 14 days per monthTrusted Source. People with chronic migraine have headaches with migraine symptoms on 15 or more days per month, for 3 or more months in a row.

Someone with episodic migraine may not have the episodes every month. Sometimes, doctors will call this low-frequency migraine.

This article will go over migraine, the symptoms of migraine, and its diagnosis and treatment.

Sex and gender exist on spectrums. For the purposes of this article, we use “male” and “female” to refer to a person’s sex assigned at birth. Learn more.

Migraine overview

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Migraine is a debilitating disorder that causes severe headaches. It is a neurological condition, meaning it starts in the brain.

Migraine headaches are different from other types of headaches. They tend to be severe and recurring. In most people, migraine causes multiple symptoms. These may include nausea, weakness, and sensitivity to light, sound, or smell.

In the United States, around 12% of people have migraine. The exact cause of migraine is not known.

Potential risk factors include:

• Sex assigned at birth: Females are three times more likely to have migraine than males.
• Family history: Having family members who have migraine also increases a person’s risk of developing this disease.
• Having another medical condition: People who have depression, anxiety, a sleep disorder, epilepsy, or bipolar disorder are more likely to develop migraine than those who do not. However, most people who have migraine do not have any of these conditions.

Many different things can trigger a migraine attack. It is different for everyone. Some common triggers include:

• stress or anxiety
• bright or flashing lights
• hormonal changes in females
• loud noises or strong smells
• too much or too little sleep
• weather changes
• caffeine
• tobacco
• skipping meals

Phases of migraine

According to the American Migraine Foundation, migraine has four distinct phases. Each of these involves different symptoms that last a different length of time.

Migraine can affect different people a little bit differently.

In general, the four phases are:

• Prodrome: This may last for a few hours or days.
• Aura: This phase may last for between 5–60 minutes and most people do not have aura with their migraine attacks.
• Headache: This may last between 4 hours to 3 days or more.
• Postdrome: This is the last phase. It can last for a few hours and may continue for up to 1–2 days.

Many people do not experience all 4 phases, and may only have one or two of them.

Symptoms of migraine

The symptoms of migraine can vary. They tend to change depending on the phase of the migraine. For example:

Prodrome

During the prodrome phase, people may:

• feel irritable
• feel depressed
• yawn a lot
• need to urinate more than usual
• experience food cravings
• feel sensitive to light, sound, and/or odors
• have difficulty concentrating
• feel fatigued
• have stiff muscles
• find it difficult to speak or read
• feel sick
• have difficulty sleeping

Aura

During the aura phase, people may:

• experience visual disturbances
• feel numbness or tingling on their body

Headache

People describe migraine headache as a:

• throbbing feeling
• feeling of pressure
• pounding sensation
• stabbing sensation

The pain typically affects one side of the head.

They may also have other symptoms during the headache phase, such as:

• feeling nauseous
• vomiting
• feeling dizzy
• not being able to sleep
• fatigue
• stuffy nose
• anxiety
• irritability
• low mood
• sensitivity to light, smell, or sound
• pain or stiffness in the neck

Postdrome

During the postdrome phase, people may:

• find it difficult to concentrate or understand things
• feel extremely tired
• feel depressed
• feel euphoric

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Migraine diagnosis

There is no single test to diagnose migraine. Instead, doctors take several things into account.

First, they will ask about a person’s symptoms, and whether there are any other symptoms that occur with migraine attacks. They will want to know what the migraine episodes feel like, how long they last, how often they happen, and if there are any triggers.

They will also ask about a person’s risk factors. This might include whether any family members have migraine, and whether the person has any other medical conditions.

Doctors will usually carry out a physical exam and may order blood tests. They may also recommend an imaging test, such as an MRI or CT scan.

Migraine treatment

There is no cure for migraine. Doctors usually work with people to help them pinpoint triggers, avoid attacks, and ease the symptoms.

Lifestyle changes can help people avoid episodic migraine, or at least reduce its frequency and severity. These include:

• using exercise and relaxation techniques to manage stress
• eating regular meals and establishing a consistent sleep schedule
• learning personal triggers and avoiding them as much as possible

For some females, hormonal changes linked to the menstrual cycle can trigger migraine. When this is the case, hormone therapy can sometimes help.

Medications that can help with acute migraine attacks include triptans, ergotamine drugs, and pain medications.

During a migraine, there are some things people can do to help ease the symptoms.

These include:

• resting in a quiet, darkened room with their eyes closed
• placing a cool cloth or ice pack on their forehead
• drinking plenty of water

Outlook for episodic migraine

There is no cure for episodic migraine. However, people may be able to manage the condition with lifestyle changes and medications.

In rare cases, episodic migraine will develop into chronic migraine. This happens in about 2.5%Trusted Source of cases.

Summary

Migraine is a neurological condition that causes debilitating headaches.

People with episodic migraine have migraine episodes every so often. People with chronic migraine have migraine attacks more frequently.

There is no cure for migraine. However, with lifestyle changes and medications, people may be able to manage the condition.

Last medically reviewed on August 30, 2021

• Headache / Migraine
• Neurology / Neuroscience
• Pain / Anesthetics