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Can Feeling Weird Predict a Migraine Attack?

Do you ever feel like you can predict a migraine is coming on because you just feel “off”? You’re not crazy. This is the first phase of a migraine attack, called prodrome, which occurs before the pain — and often visual aura — set in. It can start a day or two before a headache or visual aura.

The long, long list of possible prodrome symptoms:

Visual (aka aura)

  • a bright shape that spreads across the visual field of one eye
    and appears to block some or all of the vision; can be seen whether the
    eye is open or closed
  • flashes of light and color
  • wavy lines
  • geometric patterns
  • blurred vision
  • partial loss of sight

Sensory

  • numbness or tingling on the face or upper extremities
  • a sense that limbs are a distorted shape or size
  • smelling odors that aren’t actually present (like natural gas or something burning)

Motor

  • partial paralysis
  • weakness or heaviness in the limbs on one side of the body

Language

  • difficulty finding words
  • problems understanding spoken or written language

Cognitive

  • mental confusion
  • disorientation
  • transient global amnesia (similar to amnesia that follows a concussion)

Digestive

  • food cravings (particularly for carbohydrates, candy and chocolate)
  • stomach rumblings
  • constipation

Fluid Disturbances

  • increased thirst
  • bloating/fluid retention
  • frequent urination

Mental/Personality

  • mood changes
  • irritability
  • high energy
  • lethargy

These are only part of little-known migraine symptoms. The Many Symptoms of Migraine describes symptom in the active migraine phase and the letdown, or postdrome.

Migraine: The Complete Guide is the source of these lists. It is my very favorite headache book, but is outrageously outdated. Perhaps if we mention it enough, the American Headache Society will consider updating the 14-year-old book.

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Yawning Because Your Brain Needs Oxygen? Think Again

Cooling the brain and making you more attentive is the role of yawning, not increasing oxygen to the brain, according to recent research.

[P]eople do not yawn because they need oxygen, since experiments show that raising or lowering oxygen and carbon dioxide in the blood fails to produce the reaction. Rather, yawning acts as a brain-cooling mechanism. The brain burns up to a third of the calories we consume, and as a consequence generates heat.

Yawning a lot is an indication that I have a migraine on the way. I knew that frequent yawning is a symptom of migraine, but didn’t know its function. I’m not sure if the brain heats up before or during a migraine, but it certainly gets excited. Assuming the increased activity raises the brain’s temperature, yawning to cool it makes sense.

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Advance Warning

About a month ago, I was in a nasty cycle where I’d have a migraine, have three hours off, then have another migraine. On the third day of this, I already had plans to go out for coffee with a friend and thought I was coming out of the cycle, so I went. I expected to be dragging a little, but I had tons of energy. I couldn’t keep a train of thought and I had a terrible time finding words, but I couldn’t stop talking. No more than 10 minutes after I got home, another migraine hit.

Not long after that, I went to my book club meeting and, again, was charged. I felt like energy was practically flowing out of my joints. When I got home that night, a migraine hit.

I’ve since realized these bursts are part of prodrome, the period before a migraine. I’m always fascinated when I learn how migraines affect the body beyond pain, but more importantly, abortants are most effective when taken during prodrome. Figuring out what your prodrome symptoms are is easier said than done. They’re a study of contradictions.

You could be sad, easily annoyed, yawning and tired or hyper, talkative, having trouble finding words and slurring the ones you do find. You might be hungry or have no appetite, have food cravings (especially for carbohydrates) or be disgusted by certain foods. Maybe you’re sensitive to light or sound and your muscles are stiff. You might have constipation, bloating, diarrhea and have to pee all the time. You could have any of these symptoms in any sort of combination and they aren’t necessarily consistent from one event to another.

Tempting as it is to dismiss these as just a funk, a good mood or an upset stomach, being aware of prodrome symptoms might help you get better treatment. If your migraines are close together, something that seems like a hangover from the previous headache (postdrome) could actually be prodrome. Knowing that taking a triptan early may keep your headache bay makes a good case for keeping a headache diary. I definitely know now that when I’m bouncing off the walls, I should have a triptan handy.