5 Early Warning Signs of a Migraine Attack You Might Be Missing

Recognizing the symptoms of the prodrome stage of a migraine episode can help you start treating the attack earlier.

When we think of migraine we often think about the attack stage, when symptoms tend to make themselves the most obvious. Throbbing head pain, nausea, and sensitivity to light and noise are common symptoms during the attack stage.

However, the attack stage is just one of four stages of a migraine episode. It’s important to know that not everyone experiences all four stages, and different people experience different symptoms during each range. The first stage of an attack is the prodrome, or premonitory, stage. Then comes the aura stage which approximately 25% to 30% of people with migraine experience.

Then, after the aura, comes the third stage, the main attack. Often this stage is referred to as the “headache stage,” though not everyone will actually experience head pain during a migraine episode.

After the attack stage, many people experience the postdrome stage, also referred to as a “migraine hangover.”

It’s important to be aware of the different stages of an attack. The better we understand how attacks typically present for us, the faster we can treat attacks and find relief.

Many people with migraine are unaware that the prodrome stage even exists or that the prodrome stage can start 1 to 3 days before the aura or attack phase. One study found that 79% of people with migraine reported experiencing prodrome symptoms at least during some attacks.

Recognizing that a migraine attack is starting during the prodrome stage can help you treat the attack earlier. Here are five early warning signs that you might be missing.

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Excessive yawning

One sign that may indicate an attack is underway, is yawning. This can be a tricky symptom to notice, especially if you’re already feeling tired or sluggish. Pay close attention next time you get a sudden bout of repetitive yawning, especially if it’s not associated with feeling tired, or not getting enough sleep.

Frequent urination

Another peculiar prodrome symptom is suddenly needing to have several trips to the bathroom. It’s unclear what the connection between frequent urination and migraine is but it’s a commonly reported symptom of an impending attack.

Neck pain

Neck pain and stiffness are common premonitory symptoms of migraine. Sometimes people think that a stiff neck can trigger a migraine attack, but neck discomfort can also be a symptom indicating that an attack has already started.

It can be difficult to determine if neck stiffness is a symptom or a migraine trigger. Tracking occurrences of neck pain and stiffness in a migraine diary may be able to help you identify patterns in the hours and days before an episode.

Mood changes

Have you ever noticed you turn into a grizzly bear right before an attack? You’re not alone.

So many of us experience mood changes during the prodrome stage of a migraine episode. As frustrating as it is to be told by a loved one that you’re being snappy or grumpy, it’s often the people around us that are able to spot changes to our mood first.

Of course, nobody wants to feel irritable but if you notice this mood change happening frequently before attacks you can use this information to your advantage. Try to take note of your emotional and mental symptoms before and during attacks. This may be able to help you identify and treat an attack earlier.

While irritability is the most common mood change reported in the prodrome stage, other emotional changes may happen as well. Some people with migraine experience sudden low mood or gloominess before an attack, while others experience the opposite and feel euphoric during the prodrome.

Food cravings

If you suddenly get a craving for a specific snack, it could be your body’s way of telling you a migraine is underway.

Similar to neck pain, it can be hard to unravel migraine food triggers from cravings that are actually prodrome symptoms.

For example, if you have a craving for chocolate, then eat some chocolate and soon find yourself in the attack stage of a migraine, it can be easy to assume that it was the chocolate that triggered your head pain.

This could be the case, but it’s very possible that an attack was already underway and that the craving for chocolate was actually a symptom of the prodrome phase. If you can eat chocolate happily at other times, without an attack, it’s likely it was a craving and not a trigger for you.

Writing down the foods you crave at the start of a migraine attack can be helpful when trying to decipher what is or isn’t a trigger or migraine symptom.

The takeaway

Do any of these signs sound familiar? If so, you may already be starting to connect the dots between your migraine attacks and these early premonitory symptoms.

Migraine is a complex condition and you might not always experience the same premonitory symptoms at the start of every attack. This can make it tricky to determine if a migraine attack is actually starting.