Stage 1: The Prodrome
- It can start hours or days before the other stages of the attack
- Only 30-40% experience a prodrome
- It can cause repeated yawning
- Food cravings
- Constipation or diarrhea
- Brain fog
- Increased urination
- Neck pain
- Mood changes such as depression and irritation
- Photophobia (sensitivity to light)
- Phonophobia (sensitivity to sound)
- Cold extremities
- Memory changes
We don’t talk about the prodrome often because it isn’t as flashy as the aura or the pain of the headache stage or the fallout of the postrome. We sometimes forget it is there. But other times, it is very there. Sometimes it hits you like a wall of fatigue and stupid. And you could literally drop into a nap anywhere on a seconds notice. Having a conversation becomes a tangled complicated affair. And everything becomes so much more frustrating and complicated than it needs to be.
If we do not have migraine with aura, and have another migraine type like migraine without aura… then the prodrome can indicators can be important to help us to know when to take our tiptan for maximum effectiveness. It can be tricky to pay attention to them though. I, for one, have other chronic conditions so when I start feeling these I tend to wait because it just may be a ‘bad day’ in the other illness department. Yawning though is generally a good one and then, for me, an aura in the next stage obviously the clincher. Here is Research about treating during your prodrome. Basically earlier is better which has always been the suggestion. And our main complication with chronic migraines as well due to the fact we have more migraines than triptans we can take… and our tendency to ‘wait and see’, thus making our treatment less effective.
This tidbit was intriguing “The triptan treatment paradigm is shifting.[15-18] Earlier treatment of the headache phase of the migraine attack itself improves the percentage of patients responding to triptans, reduces the need both for a second dose of triptan and for rescue medication, and reduces recurrence. However, treatment during the aura phase has not been documented to prevent or reduce the headache attack. Prodrome, conversely, appears to offer a unique opportunity for early treatment.” Medscape
I know I am in the prodrome when I get the Yawns. I mean excessive yawning. Over and over again.
Food cravings is an intriguing one due to the fact there is the speculation chocolate is a craving and not a trigger. Because it occurs in this before the migraine area it can be mistaken for a trigger. For me, it is definitely a craving. I get it right in this initial onset stage.
Digestive issues are another common one for me. And one that frequently isn’t known by people. It isn’t all about the migraine nausea for sure!
Aphasia, brain fog, fatigue… I call this the migraine dumification. I feel the sluggish onset of it in the brain and body. And the stupids hit me like a wall.
I do also occasionally get the hyperactivity. It is rather an odd one. I feel all antsy in the pantsy. Not comfortable in my skin. Super chatty, which is quite irregular. Jittery and shaky. Generally, no brain fog or aphasia when I get this though, so that is a bonus. And Hypoactivity, which I find far more common in me.
And of course… the peeing like crazy. Keep in mind, we Also have increased thirst… so this is really just making the Whole cycle worse in this respect. I often feel like I am so parched I need to chug water. And… you know the result of that.
Excessive sleepiness. Drop like a rock sleepy. So sleepy you don’t want to take your triptan because it will make you more sleepy.
The relentless neck pain. God knows that is hellish on its own.
Mood changes. I am prone to the migraine depression drops. I think everyone can be quite thankful I do not get irritated or angry. But I am not too ‘happy’ about the mood drops am I?