Migraine Symptoms: The 4 Phases, Aura and When to Get Help

What are the main symptoms of migraine?

The main symptoms of a migraine attack are: [1]

• A throbbing headache. It can be severe, is often on one side of the head and can get worse when you move
• Feeling or being sick (nausea and vomiting)
• Being very sensitive to light and sound

The pain can also be on both sides of the head. [2] Some people are sensitive to smell and touch too. [2] Brain fog and dizziness are also common. [5]

Migraine is a neurological disease, not just a bad headache. It affects more than 40 million people in the US, and for more than 90% of them it gets in the way of school, work or social life. [5] Women are three times more likely than men to have it, and you are more likely to have it if a family member does. [2]

What are the 4 phases of a migraine?

A migraine can move through four phases: prodrome, aura, headache and postdrome. Not everyone goes through all of them. [2] The phases can overlap, and the mix can change from one attack to the next. [4]

Early signs can help you plan, but they are not a reliable forecast. In a 2026 diary study of 43 people with migraine, some early symptoms were linked to head pain in the following hours. The links were modest, and the authors say these symptoms should not be used on their own to predict an attack. [10]

The recovery phase is easy to miss. In studies, most people with migraine report symptoms after the head pain stops: 97% in one population study and an average of 86% in four clinic studies. The review’s authors warn that this data is not reliable, so treat those numbers as a rough guide. [8] Sudden head movement can briefly bring the pain back during this phase. [2]

What is migraine aura?

Aura is a set of temporary symptoms from the nervous system. Up to a third of people with migraine get it, and you can have a mix of attacks with and without it. [4] It can affect:

• Sight: zigzag lines, flashing or flickering lights, blind spots or colored spots [1] [4]
• Touch: numbness or pins and needles, such as in the hands or face [1] [3]
• Speech: trouble speaking [1] [3]
• Balance and hearing: dizziness, vertigo or ringing in the ears [4]

Most aura symptoms last 5 to 60 minutes and go away fully. Aura usually comes before the headache, but it can start during or after it. You can also have aura with no headache at all, which is often called silent migraine. [4]

Aura can look like a stroke, so get medical help straight away if you are not sure it is aura. Frequent aura also slightly raises the risk of stroke, so see a doctor if you get it often. [7]

How long does a migraine last?

Migraine attacks usually last between 4 hours and 3 days. Early symptoms can start up to 2 days before the head pain, and some symptoms can carry on after it stops. [1] How often attacks happen varies a lot. Some people have them several times a week, and others much less often. [1]

Most people find their attacks slowly get better as they get older. In women, migraine often improves after menopause and sometimes during pregnancy. [1]

How do you know if it is a migraine or a headache?

Doctors use a set of criteria for the most common type, migraine without aura. You need all of these: [6]

• At least 5 attacks
• Each attack lasts 4 to 72 hours, without treatment or when treatment does not work
• The head pain has at least 2 of these: on one side, throbbing, moderate or severe, or made worse by routine activity such as walking or climbing stairs
• During the headache you have nausea or vomiting, or you are sensitive to both light and sound
• No other diagnosis fits better

These criteria are for doctors to use, so they cannot diagnose you on their own. Our guide to the types of headaches compares migraine with tension, cluster and other headaches.

Migraine can look different in children. Attacks may last 2 to 72 hours, and the pain is more often on both sides of the head. [6] Very young children may not be able to describe their symptoms. They may refuse to watch TV or use a device, or stop playing to lie down in a dark room. [3]

What other types of migraine are there?

Migraine without aura is the most common type. [3] These are some of the others:

Chronic migraine is linked with several other conditions, including fibromyalgia, POTS, Ehlers-Danlos syndrome and MCAS, as well as depression and anxiety. [11]

What triggers a migraine?

It is not known exactly what causes migraine, but it happens when there are changes to nerves and blood vessels in the brain. [1] Triggers differ from person to person. [3] Common ones include:

• Hormone changes, such as your period, pregnancy or menopause [1] [2]
• Stress, anxiety and tiredness [1]
• Too much or not enough sleep [2] [3]
• Skipping meals or not eating regularly [1]
• Alcohol and too much caffeine [1] [2]
• Bright or flashing lights, loud noises and strong smells [2] [3]
• Weather changes [2] [3]
• Physical strain [2] [3]
• Some medicines, including oral contraceptives for some people [2]

Aged cheeses and salty or processed foods might trigger attacks for some people. [2] The free trigger tracker gives you a simple page to compare attacks over time.

How is migraine diagnosed?

No lab test or scan can confirm or rule out migraine. [2] A doctor diagnoses it from your medical history, your symptoms and a physical and neurological exam. [9] They may ask when your headaches start, how long they last, what they feel like and what sets them off. [3] Scans such as an MRI or CT are not usually needed, but a doctor may order one if they suspect another condition. [3]

Migraine is often not diagnosed or treated. If you regularly have symptoms, keep a record of your attacks and how you treated them, then book an appointment. [2] See a doctor if: [1] [2]

• Your attacks are severe, getting worse or lasting longer than usual
• You have attacks more than once a week
• You are finding your migraine hard to control
• You regularly get migraine before or during your period
• Your pattern changes, or your headaches suddenly feel different

If treatment does not help or your symptoms get worse, you may be referred to a specialist. [1] A neurologist is a specialist who can diagnose migraine. [9]

What helps a migraine?

Migraine cannot be cured, but treatment can ease attacks and help prevent them. [1] During an attack:

• Try sleeping or lying down in a darkened room. For some people, an hour or two of sleep can end an attack [1] [4]
• Take painkillers such as ibuprofen or acetaminophen (paracetamol) as soon as the headache starts [1]
• Stay well hydrated [1]

If you are pregnant or breastfeeding, ask a doctor or pharmacist before taking a painkiller. The FDA advises avoiding NSAIDs such as ibuprofen, aspirin and naproxen from about 20 weeks of pregnancy unless a health care professional says you need one. [12]

Try not to take painkillers on more than 2 days a week. Taking them more often can cause more headaches and make migraine harder to treat. [1]

A doctor can offer other medicines. Triptans, gepants and anti-nausea medicines treat attacks. Beta blockers, antidepressants and epilepsy medicines can help prevent them. [1] Triptans might not be safe if you are at risk of a stroke or heart attack. [9]

To help lower the number of attacks, eat at regular times, get plenty of sleep and regular exercise, try to manage stress, and limit caffeine and alcohol. [1]

What should you write down for your doctor?

A migraine diary can help you and your doctor work out your triggers and find the right treatment. [1] [3] Notes made at the time are easier to trust than a story told from memory weeks later.

The appointment one-pager helps you put it all on one sheet. Juno can help too. You tell Juno about an attack by text or voice, and it keeps a dated log you can share with your doctor. Juno does not diagnose migraine. See the migraine tracker page for an example.

When is a migraine an emergency?

Most migraine attacks are not dangerous. But some symptoms can be a sign of something more serious, such as a stroke or meningitis, even if you already get migraine. [1] [2]

If none of those apply, get an urgent appointment the same day, or call NHS 111 in the UK, if you have a migraine attack and: [1]

• it has lasted longer than 72 hours
• aura symptoms last longer than 1 hour at a time
• you are pregnant or have just had a baby

Also see a doctor right away for a long-term headache that gets worse after coughing, exertion, straining or sudden movement, or for new headache pain after age 50. [2]

This article is for general information only and does not replace advice from your own clinician. Juno is a health assistant, not a medical provider.

Last updated 5 November 2026