Prodrome is the first phase of migraine and can signal that a headache is about to start. Treatment in this phase may stop or lessen the severity of a migraine attack.
When most people think of migraine attacks, symptoms like head pain, vomiting and sensitivity to light and sound come to mind. However, these symptoms are only one part of migraine, as there are multiple phases of a migraine attack: prodrome, aura, headache and postdrome.
Prodrome is the first phase of a migraine and is also known as the premonitory phase or “preheadache.” It can signal that a headache is about to start. Being aware of this phase of migraine can help you quickly react to oncoming migraine attacks—and, in some cases, stop the pain before it starts.
Migraine Prodrome Symptoms
Prodrome can begin several hours or days before the aura or headache phases of a migraine attack. It’s important to note that people will often misattribute their prodromal symptoms to something that caused their migraine attack. Not everyone experiences it or in the same way, but common symptoms can include:
- Depressed mood or changes in mood
- Difficulty sleeping
- Increased need to urinate
- Food cravings
- Sensitivity to light or sound
- Trouble concentrating
- Difficulty speaking or reading
- Neck pain or muscle stiffness
How to Detect Migraine Prodrome
Everyone experiences migraine in their own way. Not all people living with migraine will experience all four phases with every attack. Keeping a headache diary can help you better understand your migraine and recognize your unique prodrome warning signs. Learn more about keeping a headache diary here.
Prodrome vs. Aura
Prodrome and aura are the two phases that can come before the headache phase. Depending on your symptoms for each phase, there can be some overlap between the two experiences. If you are unsure if you’re experiencing prodrome or aura, learning about the timeline and symptoms of each phase can help you distinguish between the two.
- Occurs over the course of a few hours or days.
- Involves symptoms such as mood changes, muscle stiffness, food cravings and fatigue.
In contrast, aura:
- Typically lasts five minutes to one hour.
- Is characterized by symptoms that can affect the senses.
- Visual disturbances (such as “stars” or “lightning”)
- Temporary loss of sight
- Numbness and tingling in the body
Treatment During Prodrome
Once the prodrome phase starts, follow your treatment plan that you and your provider developed as soon as possible to help prevent or reduce the severity of the headache phase. If you are prescribed acute medication for migraine, taking it during prodrome may help stop a migraine attack. The earlier you take your acute medications, the more likely they are to be effective. If you do not have a treatment plan, talk with your doctor and make a prodrome plan of action together.
It’s also important to avoid any known food or environmental triggers during this phase. Be sure to stay hydrated, and do not skip meals. If possible, take a nap or relax in a quiet, dark room to help you de-stress and avoid environmental triggers such as light or sound. If these options aren’t available, wearing earplugs or using a heating pad or ice pack on your head, neck or shoulders may reduce pain or tension.
Prodrome indicates that a migraine attack is starting. Knowing your triggers and symptoms and beginning treatment as soon as possible is critical for stopping or reducing the severity of the attack. Whether you’ve been living with a migraine diagnosis or are in the process of receiving one, it’s important to know how to tell the difference between migraine and other more serious conditions. If you experience sudden, intense headache pain, significant vision changes, weakness, numbness or unusually severe trouble speaking or concentrating, it’s best to seek medical attention.
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.
Reviewed for accuracy by the American Migraine Foundation’s subject matter experts, headache specialists and medical advisers with deep knowledge and training in headache medicine. Click here to read about our editorial board members.