Around 10 million individuals across the UK are affected by migraines. They’re far more complex and often more debilitating than regular headaches - they can last anywhere from 4 hours all the way to 72 hours in adults if left untreated, and can occur multiple times a week for some people.
Most people with migraine have episodic attacks, meaning headache occurs on fewer than 15 days per month. Around 2 in 100 people have chronic migraine, where headaches occur on 15 or more days each month, with migraine features on at least 8 of those days.
Migraines can affect the entire nervous system, and their symptoms can present themselves in various ways or types. These range from silent migraines, which are typically painless, to rarer types such as hemiplegic migraines that can cause temporary weakness or paralysis on one side of the body. Additionally, up to 1 in 3 people who get migraines experience ‘aura’ - warning signals that typically occur just before the main migraine attack.
This guide explains the diverse types of migraines, their causes and symptoms, and the available treatments to help relieve them. It’ll also help you understand the different phases of migraines and what to expect at each stage.
Understanding migraine phases and symptoms
Migraines typically progress through several identifiable phases, though their intensity and duration can differ significantly among individuals.
Prodrome phase
The prodrome phase starts up to a day or two before the onset of a migraine.
During this stage, you may begin to experience changes to your body or behaviour. These can be subtle, but specific - for example, you might crave certain foods, need to use the bathroom more often, or experience stiffness in your neck.
Being aware of these early signs can allow you to prepare for an impending migraine attack.
Aura
Aura refers to temporary neurological symptoms that present before or during migraine attacks. They typically develop gradually over several minutes and can last anywhere from 5 to 60 minutes.
Visual symptoms are most common. In a clinical study of 227 participants who experienced migraine with aura, 94.7% had visual disturbances.[1]
These include symptoms such as:
- zig-zagging lines
- flashing lights
- bright spots
- temporary blind spots
Sensory, as well as speech/language symptoms, can also be experienced during the aura stage. For example, these include tingling or numbness as well as difficulty processing speech or language.
Multiple types of aura can also present. Experiencing visual and sensory symptoms was the most common combination of aura in the clinical study cited above.
Not everyone experiences this stage, and the most common type of migraine does not have aura.
Headache
The headache phase can typically last from 4 to 72 hours if left untreated. The discomfort or pain commonly originates above the eye region, affecting one side of the head, with the potential to spread to other areas.
Many people who experience migraines describe the pain as a throbbing or pulsating sensation, which intensifies with physical movement.
During this phase, additional symptoms are common. These include:
- severe nausea
- episodes of vomiting
- heightened sensivity to light, sound, and/or smells
The severity of these symptoms can vary significantly, ranging from mild discomfort to incapacitating pain. Individuals often need to remain in quiet, dark environments to minimise their exposure to stimuli that can make pain or symptoms worse.
Postdrome
The postdrome phase, commonly referred to as the ‘migraine hangover’, is the last stage of a migraine episode and can last anywhere from several hours to a full 48-hour period.
The most severe symptoms have typically passed at this point for most people, but the postdrome phase is still part of a migraine attack.
Some of the symptoms you can experience during the postdrome phase include:
- body aches
- feeling very tired
- brain fog or difficulty concentrating
- mood changes
Occasionally, postdrome symptoms are the opposite of those in the prodrome phase - if you were feeling tired at the beginning of an attack, you might experience sudden bursts of energy or elevated mood during the postdrome.
Types of migraine explained
Each migraine type can present its own unique set of symptoms and have varying underlying causes or triggers.
While different types can be identified and diagnosed, not everyone who gets migraines will experience them the same way, so it is important to consult a medical professional before considering any treatments.
Migraine without aura (common migraine)
As its name suggests, migraine without aura is the most common type of migraine and lacks the warning signs that some people experience before the main stage of the migraine attack.
Nausea (feeling sick), vomiting, and sensitivity to light, sounds, or smells are also commonly reported.
Migraines without aura usually last between 4 and 72 hours and can vary in frequency - you could experience them every few days or only once every few years.
Various factors can cause or trigger a migraine without aura. These include:
- hormonal changes, especially in oestrogen levels
- stress
- dehydration
- poor or insufficient sleep
- diet (skipping meals, alcohol consumption, certain foods and drinks)
Read our Expert Guide to Avoiding Triggers for more information on common triggers.
Menstrual migraine
Menstrual migraines are linked to the menstrual cycle (period), and attacks typically start around 2 to 3 days before you start menstruating, lasting until the 3rd day of the period.
They are very common among people who get migraines. Studies suggest that up to around 60% of women with migraine notice that their attacks are linked to their menstrual cycle.[1]
However, ‘pure’ menstrual migraines, meaning they only occur around your period, are much rarer. The majority of women who get menstrual migraines will also experience migraines at other times of the month - this is known as menstrually-related migraine.
The symptoms of menstrual migraines tend to be more severe than other migraines. Nausea and vomiting can be more common, as well as sensitivity to light and sound.
It’s well-studied that hormone levels have a significant effect on migraines. Oestrogen has a particularly close link with migraines and is thought to affect the processes that communicate pain in your body. This is most likely what leads to menstrual migraines as oestrogen levels drop in the days before your period starts.
Migraine with aura (classic migraine)
Up to 1 in 3 people who get migraines experience migraine with aura. Aura has multiple symptoms, ranging from visual and auditory effects to sensory issues. Seeing visuals like flashing lights and bright spots is most common.
The aura stage typically lasts anywhere from 5 minutes to 60 minutes, gradually intensifying until the main headache stage of the migraine attack.
The causes or triggers of migraine with aura are similar to those of migraine without aura.
Retinal migraine (ocular migraine)
Retinal migraines are a subtype of migraine with aura. They are typically rare and cause visual disturbances in a single eye only. These include:
- flashes of light
- blind spots
- sudden loss of vision that comes and goes
- temporary blindness
These visual symptoms tend to last 5 to 60 minutes and are usually followed by or experienced alongside a headache.
Any new or sudden loss of vision in one eye could also be an indicator of eye disease or stroke, so you should see your GP as soon as possible to rule out these conditions.
It’s thought that the causes of retinal migraines are linked to the disruption of blood vessels and blood flow to the eye or visual pathways in the brain, as well as nerve activity. Potential triggers include:
- stress
- smoking
- high blood pressure
- intensive execise
- dehydration
- low blood sugar
- use of oral contraceptives
Silent migraine (migraine aura without headache)
Silent migraines present typical aura symptoms (visual disturbances, sensory changes, dizziness and vertigo, etc.) without head pain. Despite the lack of pain, silent migraines can still be debilitating as the visual and sensory effects can significantly affect day-to-day life.
Silent migraines are relatively rare and often occur more frequently in older people.
Hemiplegic migraine
Hemiplegic migraines are another subtype of migraine with aura. They’re uncommon and are characterised by temporary weakness or paralysis that affects one side of the body (hemiplegia). They typically start in the hand and spread to the arms and the face.
They’re accompanied by typical aura symptoms such as tingling, difficulties with speech, and sensory changes, which are similar to symptoms of a stroke. The majority of hemiplegic migraine cases experience headaches, either during aura symptoms or after.
Symptoms usually last a few hours, but very rarely can last for up to 4 weeks in a small number of cases.
Hemiplegic migraines may be inherited due to mutations in genes such as CACNA1A, ATP1A2, or SCN1A. They follow an autosomal dominant pattern, meaning a person with one of these mutations has a 50% chance of passing it on. However, in some people, no specific genetic change is found, and hemiplegic migraine occurs sporadically.
Chronic migraine
A chronic migraine is diagnosed when headaches occur on 15 or more days per month for over 3 months, with migraine symptoms present on at least 8 of those days.
It’s estimated that 1 in 50 people globally are affected by chronic migraine, and it is considered a debilitating and disabling condition because of its frequency and the significant negative impact on quality of life and both mental and physical health.
Vestibular migraine
Vestibular migraines are characterised by dizziness, vertigo, or other balance issues alongside other typical migraine symptoms.
A diagnosis of vestibular migraine is based on recurring, moderate to severe episodes of vertigo, dizziness, or imbalance that occur around or at the same time as migraine symptoms.
These episodes can last anywhere from 5 minutes to 72 hours and have to be accompanied by headache, aura, or sensitivity to light or sound to qualify as a vestibular migraine.
People experiencing vestibular migraines will likely be referred to ear, nose, and throat (ENT) specialists to rule out any related balance disorders. Their vestibular (the system responsible for balance) function should be within regular limits to be diagnosed with vestibular migraine.
Vestibular migraine is not fully understood yet, but it’s believed to result from a crossover between vestibular pathways in the brain and those responsible for controlling pain.
Abdominal migraine
Abdominal migraines are defined by regular episodes of moderate to severe stomach pain, accompanied by nausea and vomiting, but no headache during the attacks.
They’re mainly experienced by children and may affect up to around 1 in 25 of them. They usually stop getting them once they grow older, but they often go on to develop migraine with headache later in life.
The causes of abdominal migraine are not fully known. There is also little knowledge about abdominal migraines in adults. It’s believed that there’s some connection to the gut-brain connection - the two-way link between your brain and your digestive system.
Managing migraine symptoms
The symptoms of migraines can be managed with practical coping strategies, clinically proven treatments, and lifestyle adjustments. What helps can differ between people and the types of migraines they experience - finding the right combination that works for you is important.
These strategies and medications can help relieve symptoms during an attack. Some treatments and lifestyle changes can also reduce how often migraines occur, although they cannot cure migraine completely.
Practical coping strategies
Sensitivity to light, sound, and smells is a commonly experienced symptom of migraines. Exposure to these stimuli can make other migraine symptoms worse or cause further discomfort.
Sleep/eye masks and dark-tinted sunglasses can help reduce exposure to light, especially during the daytime. Migraine glasses, which are specially designed to block out the majority of red and blue light, can be helpful for some people. The clinical evidence on their effectiveness is limited, however.
Earplugs and hearing protection, such as ear defenders, help block out background noise and loud sounds that can intensify migraine symptoms for some people.
Migraine treatments
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help relieve migraine pain and may ease other symptoms as the headache improves. For significant nausea or vomiting, an anti-sickness medicine is often needed alongside pain relief.
Triptans are a class of medicines specifically used to treat migraines. They can be effective for people who find that painkillers are not providing enough relief from their symptoms. Sumatriptan, zolmitriptan, and rizatriptan are popular examples of triptans.
While they are generally well-tolerated, they may not be suitable for people with conditions such as heart disease. Complete our online consultation to see if you are suitable for treatment with triptans, or you can contact our clinical team for further advice.
There are also non-medical treatments that can be considered. There’s evidence that suggests behavioural therapies can help reduce the frequency of migraine attacks.[3] Taking a vitamin B2 (also called riboflavin) and magnesium supplement can also help reduce the frequency and severity of migraine attacks.
Find more information on migraine treatments, including triptans, in our Everything You Need to Know guide.
Lifestyle adjustments
Making small, but meaningful changes to your lifestyle can help reduce the frequency and severity of migraine attacks.
The ‘SEEDS’ methodology is a commonly recommended set of lifestyle modifications that can help manage symptoms:
- Sleep: maintain a regular sleep schedule, aiming for 7 to 8 hours of quality sleep every night
- Exercise: do 30 to 50 minutes of moderate aerobic activity 3 to 5 days every week
- Eat: have regular, balanced meals and avoid long periods without food to keep blood sugar levels stable
- Diary: keep a record of migraine attacks, when they occurred, and the symptoms experienced
- Stress management: try to reduce stressors with relaxation techniques, mindfulness, and breathing exercises
FAQs about migraine types
What are the main phases of a migraine attack?
A migraine attack goes through four distinct phases: prodrome, aura (not everyone gets this), headache, and postdrome.
The prodrome phase can start up to 24 hours before head pain, while the postdrome phase, also known as the ‘migraine hangover’, can last for up to 48 hours after the headache phase has passed.
What does migraine aura look like?
Migraine aura typically presents as temporary visual or sensory symptoms that appear before or during an attack. Many people describe flashing lights, zig-zag or wavy lines, blind spots, or areas of blurred vision.
Some individuals also experience sensory changes, such as tingling in the face or hands, or difficulty speaking. Aura usually develops gradually over several minutes and lasts less than an hour.
What causes ocular migraine?
Ocular migraines are thought to occur when nerve activity and blood flow to the eye or visual pathways in the brain are reduced or disrupted. This can be triggered by factors such as stress, dehydration, bright lights, hormonal fluctuations, smoking, or a lack of sleep.
You should see your GP as soon as possible if you experience any sudden loss or change in vision to rule out other potential conditions.
Can you have a migraine without a headache?
Yes, it is possible to have a migraine without a headache. This type is known as a ‘silent migraine’. People may experience symptoms such as visual disturbances, sensitivity to light, nausea, or aura without the headache stage that’s typical in other migraine types.
Silent migraines are managed in similar ways to other migraine types. This often involves lifestyle modification, avoiding triggers, and appropriate treatment where needed.
What causes hemiplegic migraine?
Hemiplegic migraine is a rare type of migraine thought to be caused by a genetic mutation that affects nerve signalling in the brain.
This can disrupt nervous system function, leading to symptoms such as weakness or temporary paralysis on one side of the body, visual phenomena, and difficulties with speech. While a hemiplegic migraine attack can be triggered by external factors such as stress or bright lights, genetics are understood as the primary cause.
What is a vestibular migraine?
A vestibular migraine is a form of migraine that primarily affects balance and spatial awareness. Symptoms often include episodes of vertigo, dizziness, motion sensitivity, unsteadiness, or nausea.
Although the exact cause is not completely understood, vestibular migraines are believed to involve a miscommunication between the brain’s pain and balance centres.
What is a silent migraine?
A silent migraine, also called migraine aura without headache, involves experiencing typical aura symptoms such as visual disturbances and sensory issues without the following headache stage and pain.
While they’re not painful, silent migraine attacks can be equally debilitating as painful migraines, and their symptoms can typically last for up to an hour.
What is a chronic migraine?
The diagnosis of chronic migraine requires someone to experience headaches on 15 or more days monthly for a minimum of three consecutive months. Migraine symptoms must be present for at least 8 of these headache episodes.
Clinical sources
- Thomsen, A.V., Ashina, H., Al-Khazali, H.M. et al. Clinical features of migraine with aura: a REFORM study. Journal of Headache and Pain (2024). [Accessed 18/11/2025]
- Seo JG. Menstrual Migraine: A Review of Current Research and Clinical Challenges. Headache and Pain Research (2024). [Accessed 18/11/2025]
- Bae, J. Y., Sung, H. K., Kwon, N. Y. et al. Cognitive Behavioral Therapy for Migraine Headache: A Systematic Review and Meta-Analysis. Medicina (Kaunas, Lithuania) (2021).