Prodrome to migraine headaches
Prodrome refers to symptoms that precede an actual attack of migraine. Migraine aura also precedes an attack, but it occurs 20 to 60 minutes before the headache and typically consists of visual disturbances or partial visual loss. Prodrome typically is a period of 24 to 48 hours before a migraine attack and it can consist of a wide variety of symptoms. Many people are aware that these symptoms indicate an impending migraine attack, but some are not. Some people tell me that when they feel unusually full of energy, very happy, and creative they realize that they will get a headache the next day. And some realize that what was happening to them was a prodrome only in retrospect, even after having all of the same symptoms repeat themselves many times. Not many people experience prodrome and its features are varied. Here are some of the symptoms reported in the prodrome period:
Depression
Euphoria
Irritability
Restlessness
Hyperactivity
Fatigue
Drowsiness
Difficulty concentrating
Neck or other muscle stiffness
Feeling hot or cold
Increased thirst
Increased urination
Food cravings
Loss of appetite
Yawning
Tearing
Constipation
Diarrhea
Fluid retention
Sensitivity to light and/or sound
If you do experience a prodrome and are aware of it while it is happening, taking an anti-inflammatory medication (Advil, Aleve, Migralex) or, if that does not work, a triptan may prevent an attack or at least make it milder.
I don’t see a problem with taking anti-inflammatory drugs or triptans as often as necessary (see my blog post)since they do not cause rebound or medication overuse headaches. Only caffeine, opiate (narcotics) drugs and short acting barbiturates (as in Fiorinal, Fioricet, Esgic) have been proven to cause worsening of headaches if taken more than once or twice a week. The only reason not to take anti-inflammatory drugs is a history of peptic ulcer, gastro-intestinal or other side effects. Migralex contains magnesium which reduced gastro-intestinal side effects of aspirin, which is the main ingredient in Migralex. Aspirin may in fact have a preventive effect and can reduce the possibility of worsening of headaches.
Feeling cold is a sign of magnesium deficiency, which is present in 50% of migraine sufferers. Taking magnesium daily could alleviate many symptoms, including headaches.
Great article on this poorly appreciated migraine phase. If you can learn to recognize your prodrome it can serve as a powerful weapon in the battle to control your migraines. Remember, only a small % of migraines start with an aura, but every migraine starts with a prodrome.
Be cautious with anti-inflammatories and triptans; don’t use them on more then 12 days each month. If you are able to recognize your prodrome, it would be better to focus on the basics like hydration, nutrition, posture, sleep and especially making sure your neck and jaw muscles are as relaxed as possible.
I frequently have several symptoms for my prodrome, but they vary for each migraine. The most common symptoms I get are irritability, and that is to say, little things that normally would be somewhat annoying suddenly become intolerable and make me snap. Also, I become extremely intolerant to cold. If I become cold, I have to take a hot shower or a bath to warm up, I can’t just cover up with a blanket. I also have Raynaud’s Syndrome, so if my hands and finger nails turn blue and dusky, I’m going to get a migraine. And, I also have expressive aphasia, so when I have problems finding a certain word when I’m talking or if I’m talking and suddenly what I’m saying doesn’t at all match what I’m thinking about, I’m definitely going to have a migraine. I have learned over time that with each of these symptoms, there is a certain window of time before the migraine will come. Sometimes, knowing ahead of time is a good thing, sometimes, not so much.