What are the symptoms of migraine headaches?

James D. Hudson, MD
Family Medicine
Symptoms of migraine headaches include throbbing, sensitivity to light and sound, and nausea and vomiting. A migraine is a one-sided or unilateral headache that is moderate to severe in intensity. Vomiting isn’t required for a headache to be labeled a migraine, but it’s quite common. You don't have to have sensitivity to both light and sound, but one of the two must be present. They're aggravated by physical activity and those with a migraine want to be in a dark, quiet room, lying down.
Migraines can occur with or without what's called an aura. Migraine aura symptoms precede the actual migraine. They're usually visual, involving a kind of bright, squiggly light in the visual field, often on just one side. Black or blind spots within the visual field are also common, along with numbness on the side of the face or difficulty speaking.

Often associated with stroke, these symptoms should go away within an hour, often less than 30 minutes. However, once those symptoms go away, the headaches start.

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There are many variations of migraine so symptoms vary widely. Most commonly, there is headache accompanied by nausea, light, and sound sensitivity and the pain is worse with activity. The pain is commonly pulsatile. Some attacks can be preceded by some visual disturbances or numbness, but most attacks are not. Some people with migraine also complain about pressure like headaches, which they believe are “tension headaches” but are likely variants of their migraines. 

Migraines don't always manifest as headaches, says Mark Green, MD. In this video he explains what other symptoms patients with migraines may experience.

Contrary to common belief, all migraines are not necessarily severe. They may be preceded by a period of neurological impairment, called the aura, which is usually a visual experience, such as flashing lights or holes in the visual experience. The headache itself may be mild or severe. If severe, it can be associated with nausea, vomiting, and sensitivity to loud sounds and bright lights. A severe migraine headache can last several days, but most are relieved by sleep and therefore disappear after a few hours.

The typical migraine headache consists of throbbing pain on either left or right side of the head, and can be quite severe, and associated with sensitivity to sounds and lights and sometimes with nausea and vomiting. About a quarter of all patients who suffer from migraines experience an aura preceding the migraine headache and it can consist of either visual or sensory symptoms. The aura symptoms typically last for 15- 30 minutes, and resolve as the headache starts.

In addition to throbbing pain on one side or both sides of the skull, most people experience loss of appetite, nausea or vomiting and tiredness.

Many people also have problems hearing or speaking, problems spelling, difficulty understanding simple written words and other cognitive problems.

Typically, the early sensations of migraine include a change in mood, appetite, or activity level. These symptoms, known as prodromal symptoms or the prodrome, warn that a migraine headache is on the way.

Some people also experience visual disturbances shortly before the headache begins. These might include seeing sparkling or flashing zigzag lines (scintillations) or blank spots (scotomas). Less often, people will experience tingling on one side of the body, often in the hand, arm, and face. Such visual and sensory disturbances generally last anywhere from 10 to 30 minutes and are known as aura. The presence or absence of aura determines whether an episode is a classic migraine (with aura) or common migraine (without aura).
Migraine headaches may last a few hours up to days, and can be dull, throbbing, constant, and severe. They may happen only occasionally or may repeat within days. They are most often (but not always) on one side of the head and usually felt in the front or side of the head. About 20% of migraine sufferers have warning signs called "auras," visual sensory disturbances that manifest as flashing lights, stars, distorted shapes, or a “blind” spot and inability to see on one side. The aura is caused by a change in brain activity in the visual cortex section of the brain. Many sufferers get nauseated and vomit with a migraine. Lights and a bright room may make the headache much worse. These are all classic warning signs of a migraine and may precede a headache by hours to days.
Michael T. Murray, ND
Naturopathic Medicine

The pain of a migraine is characterized as a throbbing or pounding, sharp pain. It is typically felt on just one side of the head. Although some migraines come on without warning, many migraine sufferers have warning symptoms or "auras" before the onset of pain. Typical auras last a few minutes and include blurring or bright spots in the vision, anxiety, fatigue, disturbed thinking, and numbness or tingling on one side of the body.

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The most common sign of migraine is headache lasting for hours. Symptoms generally include:
  • Pounding pain on one side of your head (or steady pain on both sides of your head);
  • Sensitivity to light and sound;
  • Nausea, vomiting;
  • Visual symptoms (usually in both eyes but often to one side) with some of the following characteristics: a spot of blurring that expands to one side over 10 to 30 minutes; an expanding border often described as zigzag lines, “shimmering” or resembling “heat waves” or “sparklers”; vision loss in one eye only, involving the entire field or only the upper or lower section.
Rare symptoms include double vision, change in lid position (lid droop) or change in pupil size (both smaller and larger).
In very rare cases, the visual problems associated with migraine may not entirely resolve. This may be due to a stroke associated with migraine.
Steven A. Meyers, MD
Diagnostic Radiology
Migraine attacks typically consist of head pain described as throbbing on either side of the head lasting hours to days. Common associated symptoms include nausea and sensitivity to light and sound. 10-15% of people have symptoms such as seeing flashing lights or spots in their vision before the headache begins.
No single symptom is unique to migraine or required for diagnosis. While the headache is most commonly described as throbbing and one sided, many persons with migraine will have headaches on both sides of the head and pain which is not throbbing.
With a severe headache or a type of headache called a migraine, you may:
  • Feel sick to your stomach, and you may even throw up
  • Have throbbing pain that may be worse on one side of your head
  • Be bothered by light or see flashing lights or spots
  • Be bothered by noise
Migraine headaches are defined by the presence of two or more of these four symptoms:
  • moderate-to-severe headache pain
  • pulsating or throbbing pain
  • pain on one side of the head
  • routine physical activity, such as walking up stairs, intensifies pain
The migraine diagnosis also requires one or both of these symptoms:
  • nausea and/or vomiting
  • unusual sensitivity to light and noise

If you have two symptoms from the first category and at least one symptom from the second category, you may be suffering from a migraine headache.

Mosaraf Ali, MD
Integrative Medicine

Throbbing pain is the most familiar sign of a migraine -- but these headaches may bother your stomach, too. To find out more about the far-ranging effects of migraine, watch this video featuring integrative medicine expert and Dr. Oz Show guest Mosaraf Ali.

Angela Lowery
Family Medicine
The most common symptom of migraine headaches is pain. The location of pain can vary. Other symptoms that may occur with migraine headaches are sensitivity to light, blurred vision, nausea and or vomiting, loss of appetite, paleness, fatigue, dizziness, fever, noise sensitivity and auras (flashing lights, dots or blind spots).

Symptoms of migraine headaches usually begin at puberty or early adulthood with throbbing, aching pain in the head. The pain can be moderate, but is often severe, and can get worse with physical activity. Migraine headaches are also often associated with vomiting, sensitivity to light, smell, and sound. People with this disorder commonly have signs to alert them that an attack is oncoming. These signs consist of nausea, loss of appetite or food cravings, and changes in one's mood. In approximately 25 percent of people with this disorder, the migraine occurs shortly after they experience an aura; a short-term interruption in one's balance, sight, speaking ability, coordination, or sensation.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.