Migraine and Fever: What’s the Connection?

Fever isn’t typically associated with migraine but can happen at the same time. It’s important to check for unusual symptoms to rule out other potentially life threatening causes.

Migraine is more than just a throbbing headache. It often comes with a litany of equally uncomfortable symptoms, like nausea and sensitivity to light.

Some migraineurs also report experiencing hot flashes or chills. Sometimes, this can feel like a fever.

Are the two connected in some way? And should you be concerned if your migraine coincides with a fever?

Here’s what to know about migraine and fever.

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Can migraine cause fevers?

Fever and migraine can occur at the same time, but it’s almost always a sign of something else going on. Migraine can’t cause fever, but the two can be related.

Why might that be?

Some 2021 research suggests that the hypothalamus, the part of the brain that controls the endocrine system, plays a major role in migraine attacks. The hypothalamus is responsible for several key bodily functions, including body temperature. This could point to a link between migraine and increases in body temperature.

However, there isn’t enough evidence to draw hard conclusions.

Hemiplegic migraine

There is one specific type of migraine that can cause fever, known as hemiplegic migraine.

Hemiplegic migraine is a rare, severe type of migraine with aura. It’s characterized by a migraine attack that occurs with hemiplegia, or motor weakness on one side of the body. Fever is another possible symptom.

Other common symptoms of hemiplegic migraine include:

• vision changes
• difficulty with speech
• fatigue
• numbness
• impaired coordination
• confusion
• lethargy
• fever

Hemiplegic migraine is incredibly rare, occurring in only 0.01% of the general population. Also, fever is not the primary symptom, so if you have a fever and a migraine, it’s more likely caused by something else.

What else could be causing a fever?

A fever is typically defined as a body temperature of 100.4°F (38°C) or higher. Several medical conditions can cause fever, but infection is the most likely culprit.

Infection

Bacterial infections are caused by bacteria and can be treated easily using antibiotics.

Some of the most common bacterial infections include:

• urinary tract infections
• skin infections, like cellulitis and impetigo
• strep throat
• pneumonia
• food poisoning
• STIs, like gonorrhea and chlamydia

Viral infections are caused by viruses and cannot be treated with antibiotics. There are antiviral medications available for some viruses, but not all. Luckily, most viral infections will go away on their own.

Common viral infections include:

• colds
• influenza
• sinusitis
• norovirus (the stomach flu)
• COVID-19
• herpes

Some infections, like pinkeye, can be either viral or bacterial, but fever is a possible symptom of virtually all infectious diseases. Headache is another extremely common symptom of many infections.

Mononucleosis

Often referred to as “the kissing disease,” mononucleosis, or mono, is a viral infection caused by the Epstein-Barr virus. It often causes fever, sore throat, and swollen lymph nodes.

Mono often has a prodrome stage lasting 3 to 5 days. This stage includes symptoms of fatigue, discomfort, and headache.

Sinus infection

Sinusitis, or a sinus infection, is often caused by cold or flu viruses. A person will often develop a sinus infection after getting a cold or flu.

During a sinus infection, the spaces behind the forehead, nose, cheeks, and eyes become inflamed. This can cause pain or tenderness, which can lead to what’s known as a sinus headache.

Sinus headaches can feel similar to migraine attacks, and the two are often misdiagnosed. Both can come with symptoms of congestion, runny nose, facial pain, and a headache that gets worse when you bend over.

However, sinus infections can also cause a low grade fever.

COVID-19

Fever is often the first symptom of COVID-19. While not everyone who has COVID-19 develops a fever, it’s one of the most commonly reported symptoms.

COVID-19 usually features a number of respiratory symptoms.

These include:

• continuous cough
• shortness of breath
• congestion
• sore throat
• headache

Research from 2020 suggests that headache is two times more prevalent with COVID-19 than with other respiratory illnesses.

COVID-19 headaches can also be more severe and persistent. They’re often described as being similar to tension or migraine headaches. They can last for weeks or even months after the illness.

Research from 2023 also found that people with migraine may experience more frequent migraine attacks following infection with COVID-19.

Meningitis

In some cases, a sudden fever combined with a severe headache can indicate a more serious illness.

Meningitis is a rare but potentially life threatening condition that causes inflammation of the membranes surrounding the brain and spinal cord.

Most of the time, meningitis is caused by a viral infection.

It can also be caused by:

• bacteria
• fungus
• parasites
• autoimmune disorder
• traumatic head injury

Typical symptoms of meningitis include fever, headache, and stiff neck.

Other symptoms can include:

• nausea or vomiting
• sensitivity to light
• rapid breathing
• lethargy
• skin rash

Encephalitis is a similar condition that causes inflammation of the brain. It can include many of the same symptoms, like fever and headache, but inflammation can also cause more serious neurological symptoms.

These include:

• seizure
• muscle weakness
• partial paralysis of arms and legs
• problems with speech
• altered mental state

Both meningitis and encephalitis can be extremely serious and need to be treated right away.

Autoimmune disorders

A healthy immune system works to protect against infection and illness by attacking foreign cells like viruses and bacteria. In the case of an autoimmune disorder, the immune system mistakenly attacks healthy cells and tissues.

Autoimmune disorders are classified into two distinct categories: localized and systemic.

Localized autoimmune disorders affect only one organ or body tissue.

Systemic disorders can affect multiple body systems.

Specific features vary by disease, but most autoimmune disorders share a few common symptoms, including fatigue, inflammation, and headache.

Research from 2022 suggests that migraine is linked to immune dysfunction. In fact, migraine is more common among people with certain autoimmune disorders, including multiple sclerosis, celiac disease, and psoriasis.

Many autoimmune disorders can also cause low grade fevers. Some disorders that commonly feature both low grade fever and headache include:

• rheumatoid arthritis
• Crohn’s disease
• lupus
• multiple sclerosis

Autoinflammatory diseases

Another category of immune-related conditions is autoinflammatory disease. Although they sound similar to autoimmune disorders, they are not the same thing.

Autoinflammatory diseases, sometimes referred to as periodic fever syndromes, are incredibly rare. The most common symptom is a recurring, unexplained fever. Some autoinflammatory diseases, such as cryopyrin-associated periodic syndromes (CAPS), also present with migraine-like headaches.

Heat-related illness

Fever and headache can happen due to external factors, like extremely hot weather.

Heat-related illnesses occur when the body becomes severely overheated. While some heat-related conditions are relatively mild, such as heat rash, others can be more serious.

Heat exhaustion occurs when the body loses excessive water and salt. People with heat exhaustion often feel dizzy, weak, tired, and nauseous. They may also have a headache and elevated body temperature.

If not treated, heat exhaustion can turn into heatstroke.

Heatstroke is a medical emergency that occurs when the body can no longer control its temperature. With heatstroke, body temperature rises quickly and dangerously — it can reach 106°F (41°C) or more within 15 minutes.

Other common symptoms include:

• altered mental state
• confusion
• slurred speech
• loss of consciousness

How to manage migraine with fever-like symptoms

Here’s how to manage migraine combined with fever.

Confirm whether it’s a fever with a thermometer

Migraine can cause nausea, body aches, chills, and excessive sweating, which can make you feel like you have a fever. Before doing anything else, it’s a good idea to double-check with a thermometer.

If you do have a fever, it’s time to look for other symptoms.

Check other symptoms

If your temperature is 100.4°F (38°C) or higher, check for other symptoms, such as a runny nose or trouble breathing. This will give you more information on the possible cause.

Since COVID-19 can come with both headache and fever, taking an at-home test is a good idea.

Seek medical attention if necessary

Depending on your symptoms, you may want to see a doctor. Certain illnesses, such as strep throat, require prescription treatments. In other cases, a severe headache and fever could signal something more serious.

Consider whether or not your migraine is unusual in any way.

Some things to look for include:

• symptoms that are new or worse than usual
• head pain that comes on suddenly and severely
• migraine that lasts longer than 72 hours
• pain that doesn’t improve with medication

If you have a fever of 103°F (39.4°C) or higher, it’s best to call a healthcare professional. You should also seek medical attention if your fever lasts longer than 3 days or does not respond to medication like Tylenol or Advil.

A fever of 105°F (40.5°C) is an emergency and requires immediate attention.

Additionally, if you have a fever and headache along with any of the following symptoms, seek medical attention right away:

• stiff neck
• rash
• trouble breathing
• chest pain
• seizure
• loss of consciousness
• mental confusion
• strange behavior or altered speech
• persistent vomiting
• abdominal pain

Rest and fluids

Several different home remedies, most notably rest and fluids, can also help soothe headache and fever symptoms.

If you have a cold or flu, it’s crucial to let your body rest and stay hydrated. A fever alone can dehydrate you, and dehydration can worsen an existing headache.

An ice-cold drink may seem refreshing when you have a fever, but drinking a warm beverage can be more beneficial if you have nasal congestion.

Of course, chicken noodle soup is a common favorite.

If you have a fever, it’s important to stay cool. Wear light clothing, keep the room temperature slightly lowered, and use a cool, damp washcloth on your forehead and the back of your neck.

Takeaway

Migraine doesn’t cause fever, but several different illnesses can cause headache and fever together.

These symptoms are usually caused by common infections, like a cold or the flu. For people with migraine, any illness can trigger a migraine attack.

However, in some cases, having a fever and severe headache together can indicate a more serious medical condition, such as meningitis.

It’s important to see a doctor if your headache is worse than usual, your fever is higher than 103°F (39.4°C), or you’re experiencing other serious symptoms such as stiff neck or chest pain.