What are the common prodrome and aura associated with migraine headaches?

From the Guidelines

Migraine Prodrome and Aura

The common prodrome symptoms of migraine include mood changes, fatigue, and cravings for specific foods, which can occur hours to days prior to the onset of headache 1.

• These symptoms can also include depressed mood, yawning, and can be experienced by individuals with migraine without aura. Aura symptoms, experienced by approximately 30% of migraine sufferers, typically involve visual disturbances such as zigzag patterns or blind spots, and can also include sensory or motor symptoms, lasting 5-60 minutes 1.
• The aura symptoms can manifest as fortification spectra, unilateral paresthesia, or numbness that spreads gradually in the face or arm 1.
• The aura is usually accompanied by or followed by headache within 60 minutes 1.
• It is worth noting that while these symptoms are common, not all individuals with migraine will experience them, and the specific characteristics of the prodrome and aura can vary widely from person to person 1.

From the Research

Common Prodrome Symptoms

• The most common prodromal symptoms identified in people with migraine include:
  • Sensitivity to light (57.2%) 2
  • Fatigue (50.1%) 2
  • Neck pain (41.9%) 2
  • Sensitivity to sound (33.9%) 2
  • Difficulty thinking or concentrating (30.0%) 2
  • Dizziness (27.8%) 2
• Other prodromal symptoms reported in pediatric patients include face changes, fatigue, irritability, mood change, and neck stiffness 3
• Premonitory symptoms can start hours to days before the onset of a migraine headache and can predict its onset in some individuals, including lethargy, yawning, light and sound sensitivity, thirst, and cravings 4

Aura Symptoms

• Aura is a fully reversible focal neurological phenomenon involving visual, sensory, speech, and/or motor symptoms that develops gradually and usually precedes the headache phase 5
• Visual aura is the most common type of aura, occurring in over 90% of patients 5
• Aura symptoms can include positive and negative features, such as visual disturbances, sensory changes, and speech difficulties 5
• The duration of each aura symptom is usually no longer than one hour, but motor symptoms can be longer lasting 5

Relationship Between Prodrome and Aura

• Some prodromal symptoms are also encountered during the aura phase or accompany the headache phase 3
• Brain activity and network connectivity changes occur during the prodromal phase, which can give rise to prodromal symptoms and aura 6
• Differentiating migraine triggers and prodromal symptoms is crucial for shedding light on migraine pathophysiology and improving migraine management 6