Migraine is much more than a severe headache.
It is a neurological disorder that can cause a combination of head pain, nausea, visual disturbances, sensitivity to light and sound, fatigue and other neurological symptoms.
Some symptoms may even begin hours or days before the headache itself.
This can make migraine confusing—particularly for someone experiencing their first attacks.
Understanding the typical signs can help you recognise a possible migraine pattern and discuss it more effectively with a healthcare professional.
But there is another reason recognition matters.
Some symptoms that can occur with migraine can also occur with serious medical conditions such as stroke.
Knowing when not to assume that your symptoms are migraine is therefore just as important.
Here are 14 symptoms and signs associated with migraine, followed by the warning signs that need urgent medical attention.
What Does a Migraine Attack Feel Like?
Migraine attacks vary considerably between people.
According to the World Health Organization, migraine attacks typically last around 4 to 72 hours when untreated or unsuccessfully treated.
Migraine headache is often:
- moderate to severe
- pulsating or throbbing
- aggravated by ordinary physical activity
- associated with nausea
- associated with sensitivity to light and sound.
Although migraine pain frequently affects one side of the head, it does not have to be one-sided.
Some people experience pain on both sides.
And not everyone experiences every migraine symptom.
The Four Possible Phases of a Migraine Attack
It can help to understand migraine as a process rather than simply the moment when your head starts hurting.
A migraine attack may involve four phases:
- Prodrome
- Aura
- Headache
- Postdrome
Not everyone experiences all four.
For example, only a minority of people with migraine experience aura.
Symptoms can also overlap between phases.
Let's look at the signs you may experience.
1. Throbbing or Pulsating Head Pain
One of the best-known migraine symptoms is moderate to severe head pain.
People often describe the pain as:
- throbbing
- pounding
- pulsating
- intense.
Pain frequently occurs on one side of the head but can occur on both sides.
It may also be felt around the forehead, temple or behind an eye.
Headache location alone cannot diagnose migraine because other headache disorders and medical conditions can cause pain in similar areas.
The combination and pattern of symptoms provide more useful information.
2. Pain That Gets Worse With Normal Activity
Migraine pain commonly becomes worse with ordinary physical activity.
Things as simple as:
- walking
- climbing stairs
- bending down
- moving around the house
may intensify the headache.
This helps distinguish migraine from some other types of headache.
Someone having an attack may therefore prefer to lie or sit still rather than continue normal activities.
This is different from saying that exercise necessarily caused the migraine.
Physical activity can aggravate the pain of an attack that is already underway.
3. Sensitivity to Light
Bright light may become extremely uncomfortable during migraine.
This is known as photophobia.
Someone experiencing an attack may want to:
- close the curtains
- turn off bright lights
- lower screen brightness
- rest in a darkened room.
Ordinary daylight or indoor lighting may suddenly feel unusually intense.
Photophobia can occur during the headache phase and sometimes at other stages of migraine.
4. Sensitivity to Sound
Sound can also become difficult to tolerate.
This is called phonophobia.
Normal noises that would not ordinarily bother you may suddenly seem painfully loud.
Examples include:
- television
- music
- conversation
- traffic
- household appliances.
The combination of headache plus sensitivity to both light and sound is characteristic of migraine in many people.
5. Nausea or Vomiting
Migraine frequently affects the digestive system.
You may experience:
- nausea
- loss of appetite
- vomiting.
For some people, nausea can be almost as disabling as the head pain itself.
This is one reason migraine should not be thought of simply as a headache.
Severe vomiting can also make it difficult to keep fluids or oral medicines down.
If you repeatedly experience vomiting during attacks, discuss this with your healthcare professional because different treatment formulations and anti-nausea medicines may be considered.
6. Neck Pain or Stiffness
Neck discomfort is common in people with migraine.
It can occur before or during an attack.
Importantly, neck pain was historically described as a migraine trigger, but research increasingly suggests that it is often actually part of the migraine attack itself.
Someone might think:
“My stiff neck caused my migraine.”
But the neck stiffness may have been an early symptom that the attack had already begun.
Persistent or unusual neck pain still deserves appropriate medical assessment.
And a severe headache accompanied by fever and marked neck stiffness can indicate a medical emergency rather than ordinary migraine.
7. Unusual Tiredness
Fatigue can occur before, during and after migraine.
During the prodrome phase, some people feel unusually:
- tired
- sleepy
- sluggish
- low in energy.
This may happen before significant head pain appears.
After the headache resolves, fatigue can continue during the postdrome phase.
Some people describe this period as a “migraine hangover.”
8. Frequent Yawning
Repeated yawning can be an overlooked early symptom of migraine.
It may occur during the prodrome phase before the headache develops.
Of course, yawning usually means nothing more serious than tiredness.
One episode of yawning does not indicate migraine.
But if repeated yawning consistently appears alongside other symptoms before your attacks, it may form part of your personal migraine pattern.
9. Mood or Concentration Changes
Some people notice changes in how they feel or think before an attack.
Possible prodrome symptoms include:
- irritability
- difficulty concentrating
- mood changes
- feeling unusually energetic
- feeling unusually low.
These changes do not mean that emotional problems are “causing” the migraine.
They may sometimes be neurological symptoms of the attack itself.
This is another example of why migraine is much more than head pain.
10. Food Cravings
Food cravings can occur during migraine prodrome.
Chocolate is a particularly interesting example.
For many years, chocolate was commonly blamed as a migraine trigger.
But suppose someone develops an intense chocolate craving as part of migraine prodrome.
They eat chocolate.
Several hours later, the headache begins.
It would be easy to conclude:
“Chocolate caused my migraine.”
But the craving may actually have been evidence that the migraine attack had already started.
This does not mean food never contributes to attacks.
It means that distinguishing cause from early symptom can be difficult.
11. Visual Aura
Some people experience migraine with aura.
Aura consists of temporary neurological symptoms that commonly develop gradually and usually resolve.
Visual aura can include:
- flashing lights
- shimmering spots
- zigzag lines
- blind spots
- unusual visual patterns.
Aura generally lasts between approximately 5 and 60 minutes.
Visual aura often affects part of the visual field and is related to activity in the brain rather than simply a problem with the eye itself.
Only about 25–30% of people with migraine experience aura, so you do not need aura to have migraine.
12. Tingling or Numbness
Aura can sometimes cause temporary sensory changes.
Someone may experience tingling or numbness that gradually travels through:
- a hand
- an arm
- part of the face
- the tongue.
These symptoms can be frightening.
Typical sensory aura generally develops gradually and is reversible.
However, new numbness should not automatically be assumed to be migraine, particularly if it appears suddenly or is accompanied by weakness, speech problems, facial drooping or other possible stroke symptoms.
Seek urgent medical assessment when appropriate.
13. Speech or Language Changes
Migraine aura can sometimes affect language.
A person might temporarily have difficulty:
- finding the correct word
- producing words
- understanding language.
But this requires particular caution.
Sudden difficulty speaking is also a major warning sign of stroke.
If you suddenly develop a new speech or language problem—especially if you have never experienced it as part of a medically assessed migraine pattern—seek emergency medical care.
Do not wait at home to see whether it turns into your usual headache.
14. Symptoms After the Headache Ends
Migraine does not necessarily end when the pain stops.
The postdrome phase can continue after the headache has improved.
People may experience:
- fatigue
- difficulty concentrating
- brain fog
- mood changes
- weakness or low energy.
Recovery may take time.
This helps explain why someone may still feel unwell or unable to work normally even though the severe head pain has ended.
What About Watery Eyes and a Blocked or Runny Nose?
Autonomic symptoms such as tearing or nasal symptoms can occur with migraine.
However, prominent watering of one eye, nasal congestion, eyelid changes and extremely severe pain around one eye can also occur with another neurological headache disorder called cluster headache.
Cluster headache requires different diagnosis and treatment.
This is one reason self-diagnosing every recurring headache as migraine can be problematic.
What About Frequent Urination?
Some people report increased urination during migraine prodrome.
However, frequent urination has many other possible causes and is not specific enough to diagnose migraine.
For example, urinary frequency can be associated with:
- increased fluid intake
- caffeine
- urinary conditions
- diabetes
- medications
- pregnancy
- other health conditions.
Persistent unexplained urinary frequency deserves appropriate medical assessment rather than automatically being attributed to migraine.
Migraine Without Aura
Most people with migraine do not experience aura.
A typical migraine without aura may involve recurring headaches lasting hours to several days, with features such as:
- moderate or severe pain
- throbbing or pulsating quality
- worsening with ordinary physical activity
- nausea or vomiting
- sensitivity to light and sound.
You do not need flashing lights, tingling or speech changes to have migraine.
Can You Have Migraine Aura Without Headache?
Yes.
Some people experience typical migraine aura without subsequently developing significant head pain.
This has historically been called “silent migraine,” although migraine aura without headache is a more accurate description.
Because new visual or neurological symptoms can have causes other than migraine, a first episode should be appropriately medically assessed rather than self-diagnosed.
How Is Migraine Diagnosed?
There is no single blood test, brain scan or eye test that proves someone has migraine.
Diagnosis is generally based on:
- your symptoms
- attack pattern
- medical history
- family history
- physical and neurological examination.
A healthcare professional may sometimes recommend additional testing or brain imaging if your symptoms are unusual or there is concern about another cause.
But many people with a typical migraine history do not require repeated scans.
Keep a Migraine Diary
If you experience recurring headaches, keeping a diary can provide valuable information.
Record:
- when the headache started
- how long it lasted
- where the pain occurred
- severity
- nausea or vomiting
- light and sound sensitivity
- aura symptoms
- possible prodrome symptoms
- medicines taken
- response to treatment
- menstrual cycle where relevant.
Over several weeks or months, patterns may become clearer.
Take this information to your healthcare appointment.
When Should You Arrange a Medical Appointment?
Seek professional assessment if:
- you experience recurrent headaches and have never been diagnosed
- headaches are becoming more frequent
- attacks are becoming more severe
- headaches regularly interfere with work, school, sleep or daily activities
- your usual headache pattern changes
- treatment that previously worked stops helping
- you are taking acute headache medicines frequently.
Effective migraine treatments are available.
You do not have to simply tolerate repeated disabling attacks.
When Is a Headache an Emergency?
Not every neurological symptom should be assumed to be migraine.
Seek urgent or emergency medical care for symptoms such as:
- a sudden extremely severe headache that reaches maximum intensity rapidly
- new weakness or paralysis, particularly on one side
- new facial drooping
- new difficulty speaking or understanding speech
- loss of consciousness
- seizure
- severe confusion
- sudden significant vision loss
- severe headache following a significant head injury
- severe headache with fever and marked neck stiffness
- a severe new headache during pregnancy or shortly after childbirth.
Also seek urgent assessment for a new or dramatically different neurological aura, particularly if symptoms appear suddenly rather than gradually, persist unusually long or do not completely resolve.
Stroke and migraine can sometimes produce overlapping neurological symptoms.
When stroke is possible, rapid assessment matters.
Contact your local emergency medical service rather than assuming the symptoms will pass because you have experienced headaches before.
The Bottom Line
Migraine is a neurological disorder—not simply a severe headache.
A migraine attack can involve throbbing pain, nausea, vomiting, sensitivity to light and sound, neck discomfort, fatigue, yawning, concentration changes and food cravings.
Some people also experience aura involving temporary visual, sensory or language symptoms.
Migraine can progress through several phases, and symptoms may begin well before head pain and continue after it disappears.
Recognising your personal pattern can help you seek appropriate diagnosis and treatment.
But never assume that every new neurological symptom is migraine.
Sudden weakness, facial drooping, speech difficulty, significant vision loss or an abrupt severe headache can indicate a medical emergency and require urgent assessment.
Medical Disclaimer
This article provides general educational information and is not a substitute for personalised medical diagnosis or treatment. Migraine symptoms can overlap with other neurological and medical conditions. Seek urgent medical care for sudden severe headache, new weakness, speech difficulty, loss of consciousness, significant vision changes or other serious new neurological symptoms.
Sources and Further Reading
World Health Organization — Migraine and Other Headache Disorders
https://www.who.int/news-room/fact-sheets/detail/headache-disorders
American Migraine Foundation — Migraine Symptoms FAQ
https://americanmigrainefoundation.org/resource-library/migraine-symptoms-faq/
American Migraine Foundation — Migraine Prodrome: Symptoms and Prevention
https://americanmigrainefoundation.org/resource-library/migraine-prodrome-symptoms-prevention/
American Migraine Foundation — Migraine and Aura
https://americanmigrainefoundation.org/resource-library/migraine-and-aura/
American Migraine Foundation — Diagnosis and Treatment
https://americanmigrainefoundation.org/migraine-diagnosis-treatment/
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