Tag: symptoms

Favorites, Symptoms

Migraine Hangover (aka Postdrome)

Kerrie Smyres

The migraines that have been visiting the last couple weeks finally gave way to a 40-hour affair that’s tapering off. I’m now in what’s considered migraine hangover (or postdrome). I was reassured when I first learned that this is a normal event at the end of a migraine:

“The postdrome is a constellation of symptoms that persist beyond the resolution of headache. Many of these symptoms appear initially during the prodrome or with the headache phase. Commonly, patients report anorexia [loss of appetite], nausea, muscle tension, fatigue, and cognitive impairment. This phase has been termed the migraine hangover and can last and produce disability up to 1 to 2 days beyond the headache phase. The pathophysiology of the postdrome is unknown, but likely represents a gradual recovery phase from the extreme neurologic disruption that occurs during migraine.” — Clinical and Pathophysiological Anatomy of a Migraine Attack, Medscape

I particularly like the phrase “extreme neurologic disruption.”

The clinical explanation is helpful, but I’ve been trying to describe what it actually feels like to have a migraine hangover. Here’s my attempt to put it into words:

I’m still shrouded by a bad headache. The pounding doesn’t seem to cover as much of my head as it did, but it hasn’t changed location at all. In a sense its like an echo of what it was, but it feels different while feeling the same.

Instead of having trouble thinking, finding words or making decisions, like I do in the rest of a migraine, I’m lightheaded. Not in an unsteady on my feet kind of way, but that my thoughts are so airy and inconsequential they could just float away.

It’s a weak description, but I have no idea how to truly explain how I feel. Can you help me out? How do you feel when you have a migraine hangover?

To read the Medscape article, use one of the user names and passwords from BugMeNot. The World Headache Alliance summarizes a study that found that the “majority of migraineurs experience disabling post-migraine symptoms.”

News & Research, Symptoms

Cognitive Impairment & Other Strange Migraine Symptoms

Kerrie Smyres

Pain is an obvious symptom of migraine, but there’s so much more to migraine than the headache. Even the well-known symptoms like nausea, vomiting, sensitivity to light and sound, and sometimes aura barely scratch the surface.

Right now I’m in the early stages of a migraine. Although I can feel the pain coming on, more frustrating is that I’m having trouble thinking, concentrating and finding words. I’m fatigued and thirsty. The black circles under my eyes have returned. Eating might make me feel better, but I’m nauseated, have no appetite and the smell of food turns my stomach.

My current symptoms are part of the many different migraine symptoms. I now know what to expect, but I was terrified when I first noticed all these strange feelings I had before and during a migraine. Cognitive impairment was by far the scariest (and it still frustrates me to no end).

My mind is so fuzzy that I can’t make sense of the rest of the post. I’ll return to the topic next week. In the meantime, here are some relevant links that I intend to use as support.

Favorites, Symptoms

The Many Symptoms of Migraine

Kerrie Smyres

Is it just a coincidence that you feel foggy-headed, have to pee a lot and always have dark black circles under your eyes every time you have a migraine? Nope. Throbbing head pain, nausea, sensitivity to light and sound, and weird visual effects are the most discussed symptoms of migraine, but the list is far from comprehensive.

Migraine: The Complete Guide, my very favorite headache book, lists the infrequently discussed symptoms of migraine. I was astonished the first time I saw this list — and relieved to know that I wasn’t a freak of nature. Take a look for yourself:

Prodrome (the period before the pain begins)

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

Headache Phase

Sensory

  • sensitivity to light and noise
  • intolerance of being touched
  • heightened sensitivity to odors

Digestive

  • nausea
  • vomiting
  • intolerance of food odors
  • loss of appetite
  • diarrhea
  • constipation

Skin

  • paleness
  • cold, clammy hands and feet
  • facial swelling
  • goose bumps
  • bloodshot eyes
  • black circles around eyes
  • sweating

Fluid disturbances

  • water retention
  • frequent urination

Respiratory

  • frequent yawning
  • sighing
  • hyperventilating
  • nasal congestion
  • runny nose

Mental/Personality

  • irritability
  • depression
  • anxiety
  • nervousness
  • difficulty concentrating

Circulatory

  • changes in blood chemistry
  • changes in blood pressure
  • blood vessel dilation
  • difficulty regulating temperature
  • changes in heart rhythms

Postdrome (24 hour following headache)

Cognitive

  • inability to concentrate

Respiratory

  • frequent yawning

Mood/Personality

  • fatigue
  • depression
  • euphoria
  • feeling of intense well-being
  • lethargy

So you’re not crazy, losing your mind or faking it!

This information is much like that in Not Just a Headache: Migraine’s Other Symptoms, which I posted last December. It’s such an important topic and receives so little attention that I wanted to revisit it.

By the way, Migraine: The Complete Guide is published by the American Council for Headache Education and is a terrific resource for anyone who wants to learn about migraine. It was published in 1994, but the information is so good that its worth getting. And if you buy it through the links in this post, a portion of what you spend will help support this blog.

Books & Products, Symptoms

Not Just a Headache: Migraine’s Other Symptoms

Kerrie Smyres

The usual description of migraine includes visual aura, one-sided throbbing pain, nausea, and sensitivity to light and sound. There’s a lot more to it than that. The following information, which comes from my very favorite migraine book, Migraine: The Complete Guide, is a list of the other symptoms of migraine. It’s organized by the phase that the symptoms they occur in and by which part of the body is involved. I’ve made a few changes to the information from the book; most noticable is that I’ve collapsed the book’s sections on aura and prodrome into one.*

Prodrome (the period before the pain begins)

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

Headache Phase

Sensory

  • sensitivity to light and noise
  • intolerance of being touched
  • heightened sensitivity to odors

Digestive

  • nausea
  • vomiting
  • intolerance of food odors
  • loss of appetite
  • diarrhea
  • constipation

Skin

  • paleness
  • cold, clammy hands and feet
  • facial swelling
  • goose bumps
  • bloodshot eyes
  • black circles around eyes
  • sweating

Fluid disturbances

  • water retention
  • frequent urination

Respiratory

  • frequent yawning
  • sighing
  • hyperventilating
  • nasal congestion
  • runny nose

Mental/Personality

  • irritability
  • depression
  • anxiety
  • nervousness
  • difficulty concentrating

Circulatory

  • changes in blood chemistry
  • changes in blood pressure
  • blood vessel dilation
  • difficulty regulating temperature
  • changes in heart rhythms

Postdrome (24 hour following headache)

Cognitive

  • inability to concentrate

Respiratory

  • frequent yawning

Mood/Personality

  • fatigue
  • depression
  • euphoria
  • feeling of intense well-being
  • lethargy

Having the variety of chronic daily headache that is caused my migraine, I’m not convinced that these symptoms only occur in their respective phases. I certainly have different symptoms that don’t seem to be connected to severe headache pain. It could be that people with CDH have trouble knowing when they are in a particular stage or that we experience the symptoms more frequently than in these rigidly defined phases. I also wonder if people who have been diagnosed with tension-type headache experience similar additional symptoms, particularly the cognitive ones. (Don’t take anything in this paragraph as fact — these are my vaguely informed, non-medical musings.)

So you’re not crazy, losing your mind or faking it. Perhaps it’s a link to send to those who question your illness.

*Some sources maintain that an aura only encompasses the visual changes that can happen before a migraine. Others, like this book, include sensory, motor, language and cognitive difficulties as part of aura. The more common approach is that aura is only visual, but one of many symptoms of prodrome.

Symptoms

Advance Warning

Kerrie Smyres

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.