Classical migraine

Alternative names:

Migraine (classical); migraine headache, migraine with aura

Symptoms:

Migraine headaches are often described as a 'pounding' discomfort that frequently starts on one side of the head and then spreads to involve both sides or may remain localized. For many affected patients, headaches have a tendency to start on the same side each time. Many patients describe pain behind the eye or in the back of the head and neck. The headache typically begins as a dull ache that progressively worsens over several minutes to hours to the point of disabling pain. The headache may last several hours to days, during which patients may be intolerant to light (photophobia) or sound (sonophobia). Patients will frequently have the urge to rest in a quiet, dark room.

Aura (preliminary or prodromal symptoms)

• may occur a few minutes to 24 hours before headache
• visual changes, one or both eyes (common, may occur in any combination)
  • seeing zigzag lines
  • seeing flashing lights
  • other visual hallucinations
  • temporary blind spots
  • photophobia (discomfort when in bright light)
  • blurred vision
• abnormal tastes or odors
• eye pain

Symptoms that may precede or accompany classic migraine headache

• loss of appetite
• nausea
• vomiting
• chills
• increased urination
• increased sweating
• swelling of the face
• irritability
• fatigue

Headaches associated with abnormal neurological functions (such as speech, vision, balance, movement, sensation, among others) necessitate immediate evaluation by a qualified health care provider, particularly if the person has not had similar headaches before. Other symptoms that may herald a more serious diagnosis include loss of consciousness, a change in headache pattern, the presence of the worst headache in one's life, headaches that are more severe when lying down, or a headache that starts extremely abruptly. Such headaches may be the result of stroke, intracranial hemorrhage, aneurysm, or other serious condition and require the immediate attention of a physician. Also contact your healthcare provider if previously effective treatments are no longer helpful, or if symptoms indicating side effects of medications occur, including irregular heartbeat, changes in skin color (pale or blue), extreme sleepiness or sedation, persistent cough, depression, fatigue, nausea, vomiting, diarrhea, constipation, stomach pain or cramps, dry mouth, extreme thirst, among others.

Signs and tests:

Headaches associated with abnormal neurological functions (such as speech, vision, balance, movement, sensation, among others) necessitate immediate evaluation by a qualified health care provider, particularly if the person has not had similar headaches before. Other symptoms that may herald a more serious diagnosis include loss of consciousness, a change in headache pattern, the presence of the worst headache in one's life, headaches that are more severe when lying down, or a headache that starts extremely abruptly. Such headaches may be the result of stroke, intracranial hemorrhage, aneurysm, or other serious condition and require the immediate attention of a physician. Also contact your healthcare provider if previously effective treatments are no longer helpful, or if symptoms indicating side effects of medications occur, including irregular heartbeat, changes in skin color (pale or blue), extreme sleepiness or sedation, persistent cough, depression, fatigue, nausea, vomiting, diarrhea, constipation, stomach pain or cramps, dry mouth, extreme thirst, among others.

Update Date: 05/08/00
Joseph Campellone, M.D., Assistant Professor of Neurology (Department of Medicine) Robert Wood Johnson Medical School, New Jersey. Director, Neurophysiology Laboratory, Cooper Hospital.VeriMed Healthcare Network