Unlike common headaches, migraine attacks are episodes of complex neurological symptoms that unfold in as many as four phases. You may not experience all four, and the combination of symptoms you experience may vary, but one thing you have in common with all people who suffer a migraine attack — you want to know when it’s going to end.
As a pain management specialist and a triple-board-certified physiatrist, Dr. Stanley Mathew at the American Rehabilitation Center in Dubuque, Cedar Rapids, and Anamosa, Iowa, understands the complexities of migraine disease and offers information, treatments, and hope. Here, he explains how to recognize the onset of postdrome — the final phase of your migraine attack.
The migraine timeline
What triggers your migraine attacks? Are you sensitive to certain foods? Do strong smells or bright lights set it off? Maybe poor sleep quality starts you on the road to an attack. Just as your triggers are unique to you, so is your migraine experience.
Keeping a migraine diary can help you identify your triggers and learn to recognize the onset of an attack. Familiarity with your personal patterns enables you to treat your migraine attack early, reducing the intensity and potentially stopping it.
In addition to finding your triggers, it’s helpful to note what happens before and after a migraine attack. There are four distinct phases in the migraine attack timeline:
Think of the prodrome phase as a preheadache. It may begin a few hours before your migraine attack or up to a few days. You may experience mood changes, such as depression and irritability. You might yawn a lot, crave certain foods, have trouble sleeping, and develop a stiff neck.
Write down any physical, mental, or emotional oddities — they can serve as warning signs in the future.
About 30% of people experience the aura phase, which includes unsettling disturbances in vision, speech, and/or motor skills. This stage can last 5-60 minutes or longer and is the precursor to the pain phase.
The pain phase is when the migraine headache hits. Intense pain, usually on one side of your head, is common, as are nausea and vomiting. You may feel depressed, anxious, or giddy during your attack. Neck pain and stiffness often accompany migraine attacks, as do sensitivities to smells, sounds, and lights.
The attack phase can last 4-72 hours.
Once the migraine headache subsides, you may experience the prodrome phase. Although the pain is gone, your migraine experience isn’t over yet — but it will be soon.
Postdrome — The migraine hangover
Postdrome is often called the “migraine hangover” because it occurs after the attack and produces some symptoms that resemble an alcohol hangover. Five of the most common are:
- Light sensitivity
These are signs that you’re on the downhill side of your migraine attack, and it’s almost over.
About 80% of people with migraine disease experience the postdrome phase. If you’re one of them, you gain some valuable insight into your disease that can help you and Dr. Mathew better manage your attacks.
The postdrome phase of a migraine attack isn’t a reaction to the attack; it’s part of it. You can ease your symptoms — or at least avoid exacerbating them — by remaining calm, restful, and hydrated. Turn off the lights and rest.
For some people, the symptoms at the end of the migraine attack are opposite those at the beginning. For example, if you feel energetic prior to an attack, you may feel depressed during the postdrome phase and vice versa.
The postdrome phase can last up to 24 hours, so be kind to yourself. Sleep if you can, do some light stretches, and eat comforting food (as long as it’s not one of your triggers).
Preventing and treating migraine attacks
Migraine disease is complicated and involves multiple variables. Although much research has been conducted, the best intel is in your personal migraine diary. That information, coupled with Dr. Mathew’s expansive knowledge and skill, can help you spot the signs of an attack early and treat it quickly.
In addition to avoiding your migraine triggers, Dr. Mathew may recommend medications, such as prochlorperazine, metoclopramide, or subcutaneous sumatriptan, that address acute migraine attacks.
He also offers Botox® as a preventive measure to lessen the frequency and severity of migraine attacks.
Call us today, or book an appointment online to discover how Dr. Mathew can help you manage your migraine attacks.