Migraine is more than a headache. Learn about other symptoms of migraine, including uncommon and surprising signs.

How do you know if your symptoms add up to migraine? A migraine attack typically involves moderate to severe head pain, often on one side of the head. Headache is a general term to describe head pain and is a common symptom of migraine. However, not all headaches are caused by migraine, and not all migraine involves head pain.

For the 39 million people living with migraine in the U.S., attacks usually involve other symptoms besides head pain. Some common symptoms are nausea, vomiting and sensitivity to light, smells and sounds. But other signs are less common or overlooked. Many people who experience these symptoms may not realize they are related to migraine.

Knowing all the symptoms of migraine—even the uncommon ones—is important for getting the proper diagnosis and treatment. We’ve outlined nine surprising symptoms of a migraine attack to help guide you.

#1 Migraine and Neck Pain

While neck pain was previously thought to be a migraine trigger, recent studies show it is a symptom of migraine, not a cause. People with migraine often experience neck pain, including a stiff or tight neck or pain that spreads to or from the neck. Neck pain may be a common migraine symptom, including during the prodrome phase, but it’s often overlooked.

#2 Body Chills

During the hours and days leading up to a migraine attack, some people experience body chills. Changes in the brain and blood vessels that occur during a migraine attack may cause chills, shivering or sweating¹. The areas of the brain often associated with migraine also control body temperature and muscle movement. This means changes in the brain during a migraine attack can lead to changes in body temperature and shivering.

#3 Phantom Smells

Phantom smells (phantosmia) are a rare type of migraine aura. Aura often causes problems with vision and happens before the headache phase of a migraine attack. However, aura can also cause a person to hallucinate scents. Migraine-related phantom smells are usually unpleasant, with the most common being a burning or smoke scent.

#4 Brain Fog

Many people experience migraine and confusion at the same time. This can make a person feel like it’s hard to concentrate and think clearly—symptoms commonly known as brain fog. While it’s difficult to focus and think during head pain, brain fog can also happen during the prodrome and postdrome phases of a migraine attack; that is, in the hours and days before and after the headache phase.

#5 Insomnia

Lack of sleep or trouble sleeping is often considered a migraine trigger or the result of head pain, and it’s true that sleep and migraine affect one another. Insomnia—including difficulty falling or staying asleep, waking up too early and not feeling refreshed after sleep—can also be a migraine symptom in the beginning stages of an attack.

#6 Sinus-like Issues

A stuffy or runny nose and watery eyes may point to a sinus headache, but sinus-related issues are also common migraine symptoms. 45% of people with migraine have at least one symptom of congestion or watery eyes. Sinus headache is rare, and research has found that 90% of self-diagnosed sinus headaches are actually migraine.

#7 Dizziness and Vertigo

People with migraine may have issues with their sense of balance or vision. Feeling dizzy, lightheaded or unsteady can be a symptom of migraine. More specifically, attacks or episodes of dizziness or vertigo can be a sign of vestibular migraine.

#8 Mood Changes

While a migraine attack itself can make a person feel frustrated, sad or irritable, some mood changes—such as anxiety, a depressed mood or giddiness—are actually migraine symptoms. These mood changes may also happen during the prodrome and postdrome phases of a migraine.

#9 Allodynia

While many people with migraine have a heightened sensitivity to light, sound and smell, anywhere from 40% to 70% of people experience pain from things that don’t usually hurt. This often-overlooked side effect of migraine, called allodynia, results from changes in the way your body processes pain. For people with allodynia, a light touch of skin, brushing hair and temperature changes can feel painful.

While researchers understand what happens in the nervous system during a migraine attack, these changes don’t appear on scans or blood tests. Because of this, a migraine diagnosis is based on a specific set of symptoms.

If you experience migraine symptoms—common or uncommon—keep a headache diary and take note of all of your symptoms, whether they seem related to migraine or not. Your doctor can help you identify your set of migraine symptoms and recommend treatments to relieve them and prevent future attacks.

The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.