premonitory Archives - Headache and Migraine News

premonitory

6 August 2019

Watch for these Three Migraine Warning Signs

These are not signs that you may develop migraine later in life, but signs that a migraine is starting – and that a headache is likely to hit within 24 hours.

Why would this be important to know? Well, when a “premonitory” symptom hits, you may still be able to dodge or at least minimize the headache phase of the attack. The early symptoms we’re talking about here are not painful, so if you can use them to lessen the headache pain (by doing some stretching, having a rest, drinking some water, taking some meds – whatever works for you) that’s a big bonus.

Dr. Peter Goadsby explains more about the premonitory phase:

The premonitory phase can occur from hours to days before the canonical attack. The symptoms include: neck discomfort, yawning, tiredness, concentration impairment, mood change, polyuria/polydipsia, or food cravings. The symptoms can be seen in children, as they are in adults. Moreover, there is evidence from functional imaging of activation in the region of the hypothalamus during the premonitory phase.
Understanding the non-pain phases of migraine: premonitory and postdromal

Remember, we’re not talking about warning signs that come 1/2 an hour before a headache, but warnings coming hours and even days early.

Dr. Peter Schmidt and colleagues reported on a study of three particular warning symptoms – mood changes, excessive yawning, and fatigue. The researchers found that many patients experienced at least one of these, and some more than one symptom.

Noticing one of these was by no means a guarantee that a headache would hit within 24 hours, but with every symptom the risk increased. Almost half of the patients in the study had a migraine headache within 24 hours of one of these symptoms (a significant number, considering how individual migraine can be. There are many other possible premonitory symptoms).

Excessive yawning was the most reliable warning, with 25% of patients getting to the headache phase within 1/2 an hour. Again, each symptom raised the likelihood of a headache attack. Read more here: Migraine attack risk increases with each premonitory symptom

Many patients haven’t consciously thought about these warning symptoms because they come so long before the headache hits. It seems likely that if we pay more attention we may be able to better predict (and avoid/partially avoid) attacks.

That being said, patients aren’t always good at predicting attacks. A couple of years ago a study on that very topic found only 9% of migraine patients to be really consistent at predicting attacks (Individual self-prediction of migraine attacks: longitudinal analysis of cohort of migraine patients using a digital platform). But here’s the thing. If we learn to observe, many of us may be able to learn how to predict some attacks. And if we can avoid a few headaches, it’s worth it.

What about you? Have you had success in predicting attacks well in advance?

1 April 2010

1% Thursday: Warning Signs

James Tips 0

Make it a habit to watch for warning signs.

Even for those of us that try to keep track of migraine, cluster headache or whatever-kind-of-headache symptoms from day to day still miss these. It’s usually not hard to miss the main symptoms – headache, dizziness, nausea – whatever it is for you. And quite often we can point to one or two possible triggers in each attack (oh, it was that glass of wine – or I skipped breakfast).

Learning to recognize the warning signs are a little trickier, especially when they’re quickly overshadowed by a wave of incredible pain. But it’s worth paying attention.

In migraine, we call these premonitory symptoms (formerly prodrome). They can arrive right before the major part of the attack, or even a day or more earlier. Some common symptoms? You feel unusually tired. Your neck feels stiff. You have trouble focusing, even trouble speaking. You look pale. Or you start yawning a lot.

What’s the use of noticing these symptoms? First, it may help you correctly recognize your triggers, if you know when the migraine chain-of-events started. Second, it often helps to take medication earlier in the attack. The premonitory phase may be too early, but it will put you on the alert. Talk to your doctor about when to take your medication.

And we’re not just talking about medication – avoiding further triggers, perhaps getting hydrated, or going for a walk, or getting some rest – there may be things you can do to minimize your coming attack.

If you don’t have a migraine or headache diary, print one out and start watching for those early symptoms.

What is 1% Thursday?

Every Thursday at Headache and Migraine News (weather permitting) we’ll talk about one measurable, practical thing we can do to make our lives just 1% better. Usually it will be something very easy, sometimes it will be a challenge. Let us know if you try it, or share an idea of your own – and maybe a year from now we’ll see that things have really changed for the better!