Complex Migraine
The 4 Phases

The pain phase is the most familiar to people without complex migraine disease. Pain, no sleep, alcohol, chocolate – pick whatever trigger you like, your migraines will start to spread the chemical electrical charge that causes pain.

Migraines are complicated. Composed of many interconnecting parts in the human brain and body that is so complex and hard to understand, that even scientists and specialists are not exactly sure what happens to cause this dysfunction.

We do know it begins with nerve storms from an over stimulation of nerves from unpredictable triggers and is followed by symptoms and most commonly, though not always, has these four phases.

Complex Migraine 4 Phases

Phase 1 - Prodrome

Symptoms hours or even days before a migraine episode provide an early warning signal that tells me a migraine is on its way.

I am thankful for this now. But it took a while.

This is when I act quickly and take my abortive.

Getting to know my body and its symptoms have made my life more manageable.

Some typical symptoms are:

  • food cravings or immense hunger or thirst
  • constipation or diarrhea
  • mood swings: depression, irritability, anger, anxiety
  • muscle stiffness, especially in the neck
  • fatigue
  • increased frequency of urination

Phase 2 – Aura

The symptoms of the aura phase vary widely between individuals.

Some can be quite terrifying like Serene Branson, the KCBS reporter, who spoke nonsense on her live report at the Grammys.

Initially her co-workers thought she was having a stroke, but was later diagnosed with just Complex Migraine Headache.


On Air Scare For Serene Branson.

Lets face it - Migraines are terrifying! How scary for Serene Branson, this was her first one. Luckily, she has already found a triptan that will work with her migraines.

I have recently been losing my central vision, zig zag lines around the edges, I can see the peripheral and even sometimes I can see all the air particles.

I can see people’s auras! I can still speak, but I don’t recall what I just said, I feel like I am present, but within a minute I forget. Sometimes it remains forgotten for all time!

Some people experience a tingling sensation and have numbness leading to partial paralysis of limbs and face – normally on one side of their body.

This would freak me right out....I am stressed enough with the symptoms I do have already!

Typical migraine aura symptoms are blurry vision, dizziness and confusion.

Some typical aura symptoms are:

  • visual symptoms: flashing lights, wavy lines, spots, blank spots, blurry vision
  • olfactory hallucinations (smelling odors that aren't there)
  • partial paralysis or tingling or numbness of the face or extremities on the side where the headache develops.
  • difficult finding words and/or speaking
  • confusion
  • dizziness or vertigo
  • auditory hallucinations or decrease in hearing
  • reduced sensation
  • hypersensitivity to feel and touch

Some migraine sufferers do not experience all phases nor do they experience the pain. These are called “silent migraines” or “migraine equivalent”.

Phase 3 – Pain

Complex Migraine

This is the most difficult part of the headache phase that is tricky to describe.

I used to get asked “on a scale of one to ten – rate your pain”, and I used to answer 200!

It is hard to comprehend just how intense the pain is if you have never experienced it.

Here are some typical characteristics of the pain phase:

  • pain on one side (hemicranial) or the pain can become bilateral
  • sensitivity to sound (phonophobia)
  • sensitivity to light (photophobia)
  • nausea and vomiting
  • diarrhea or constipation
  • congestion or runny nose
  • depression, severe anxiety
  • hot flashes and chills
  • dizziness
  • confusion
  • dehydration

Phase 4 - Postdrome

Remember I said earlier that Complex Migraine Headache is not just pain. Well, now you know it’s not. It can take hours or sometimes days to fully recover from an attack. The after effect can look like this:

  • melancholy, depression and fatigue
  • poor concentration and poor memory

Sound like a hangover? I would say it’s similar. I used to say a migraine is like your worst hangover EVER!

There is also the chance you may feel euphoria. I used to after long migraines.

I would come out of my ‘meditation’ and go for a slow walk along the beach in awe of the beautiful ocean.

I’d watch the clouds, I felt elated. That doesn’t happen these days because I don’t get the 10 day long episodes. Or those pain levels.

Thank goodness.

Recommended Reading For Complex Migraine

› Complex Migraine: The 4 Phases

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