Migraines are a common and debilitating condition that affects millions of people worldwide. While many are familiar with the typical symptoms of a migraine, some of which can be seen in the phase chart below, there are many other symptoms that can also be associated with migraines. In this article, we will discuss 9 surprising migraine symptoms that you may not be aware of.
Aura without headache
Aura is a visual, sensory, or language disturbance that can occur before or during the headache phase. While many people associate aura with headaches, it is possible to experience aura without a headache, which can be confusing and is often misdiagnosed.
It is not uncommon for some people to experience feelings of euphoria or elation after the headache phase of migraine. This phenomenon, known as "postdrome," is the final stage of a migraine and can last hours to days after the headache has ended.
The exact cause of postdrome is not fully understood, but it is thought to be related to changes in brain chemistry- specifically elevated dopamine.
It is important to note that only 80% of migraineurs experience postdrome and some people may feel tired or depressed after a migraine, not euphoric.
Neck pain is another surprising symptom of migraines. The pain can range from a dull ache to a sharp pain and can be felt on one or both sides of the neck. Neck pain can occur before, during, or after a migraine attack and can be a significant source of discomfort. The connection between neck pain and migraines is thought to be related to the trigeminal nerve, which makes sense since the trigeminal nerve is part of the pathophysiology of migraine and stimulation of the trigeminal ganglion results in release of vasoactive neuropeptides, including substance P, calcitonin gene-related peptide (CGRP), and neurokinin A.
Dizziness and vertigo
Dizziness and vertigo are also common symptoms of migraines. Vertigo is a sensation of spinning or tilting, while dizziness is a feeling of unsteadiness. Both symptoms can be particularly disorienting and can last for several hours or even days after a migraine attack.
Sensitivity to light and sound
Many people with migraines experience sensitivity to light and sound, also known as photophobia and phonophobia. This can cause significant discomfort and make it difficult to perform daily activities. Light and sound sensitivity can occur before, during, or after a migraine attack and can be a significant source of distress.
Tingling or numbness in the face and extremities
Tingling or numbness in the face and extremities is another surprising symptom of migraine attacks. Tingling is a positive symptom, while numbness is a negative symptom. See definitions of positive and negative symptoms here:
Tingling or numbness is usually part of the sensory aura phase of a migraine.
Fatigue is a common symptom of migraines and can range from mild to severe. Many people with migraine experience significant fatigue, even after a mild attack, and can take several days to recover. One of the primary reasons for fatigue in migraines is the energy expenditure required to cope with the pain and other symptoms of the headache. The constant pain and discomfort of a migraine can be exhausting, leading to feelings of exhaustion and fatigue. Additionally, the changes in blood flow and neurotransmitter levels that occur during a migraine can disrupt sleep patterns, leading to sleep deprivation and further exacerbation of fatigue. Fatigue can have a significant impact on a person's daily life and can make it difficult to perform daily activities.
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Schramm, E. et al. (2012) "Anxiety, depression, and stress in headache patients: a systematic review". J Headache Pain. 13(1):1-13
Some individuals with migraines may experience cognitive and memory impairment during a headache episode. This can include difficulty concentrating, confusion, and memory lapses.
Migraines can cause memory impairment due to the changes in brain activity that occur during a headache episode. Research has shown that migraines are associated with changes in cerebral blood flow and brain metabolism, leading to alterations in brain function.
Migraine attacks are associated with decreased blood flow to the brain, particularly in the prefrontal cortex, which is involved in higher cognitive functions such as memory and attention.
A study published in the "Journal of Headache and Pain" found that individuals with migraines reported higher levels of memory impairment compared to those without migraines, indicating that this is a common symptom of the condition.
Moreover, the hormonal changes and neurotransmitter alterations that occur during a migraine headache can also contribute to memory impairment. Prostaglandins, which are hormone-like substances produced by the body during a migraine, have been shown to affect cognitive function and lead to memory impairment.
Memory changes can have a significant impact on a person's daily life and can be a significant source of distress.
Journal of Headache and Pain. 2011 Feb;12(1):11-8.
Gastrointestinal symptoms, including nausea, vomiting, and diarrhea, are also common symptoms of migraines and can be a significant source of discomfort.
Migraines can cause diarrhea due to changes in the digestive system that occur during a headache episode. Several studies have investigated the relationship between migraines and digestive symptoms, including diarrhea.
A study published in the "Journal of Neurology, Neurosurgery, and Psychiatry" found that individuals with migraines were more likely to experience digestive symptoms such as diarrhea, nausea, and abdominal pain compared to those without migraines.
Another study investigated the impact of migraines on the digestive system and found that individuals with migraines had increased activity in the enteric nervous system, which is responsible for controlling the muscles and secretions of the digestive tract. This increased activity can result in changes such as increased muscle contractions and fluid secretion, leading to symptoms such as diarrhea.
The release of stress hormones during a migraine headache can also contribute to digestive symptoms, including diarrhea. These hormones can alter the balance of gut bacteria and increase muscle contractions in the intestines, leading to digestive disturbances.
Gastrointestinal symptoms can make it difficult to perform daily activities and can also have a significant impact on a person's daily life.
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