What are the four phases of migraine progression?

Prepare for the Pharmacology IV – Headache Therapeutics Test. Review the therapeutic approaches, tackle multiple-choice questions with explanations, and boost your test-taking confidence. Ace your exam with precision!

Migraine typically progresses through four distinct phases, with prodrome signaling the impending attack, followed by aura if present, then the main headache, and finally a postdrome phase. The prodrome can occur hours to a day before the headache and includes subtle symptoms like mood changes, yawning, food cravings, or neck stiffness. If an aura occurs, it usually develops within minutes to an hour before the headache and consists of focal neurological symptoms such as visual disturbances (zigzag lines, scotomas) or sensory changes, and some people may have aura without a subsequent headache. The headache phase is the hallmark, often unilateral and throbbing, moderate to severe in intensity, worsened by movement and accompanied by photophobia, phonophobia, and nausea. After the pain fades, the postdrome follows, bringing fatigue, scalp tenderness, and a sense of cognitive or physical exhaustion that can last hours to a day. Not everyone experiences all phases, and some may have aura without headache, but this sequence reflects the common progression of a migraine attack.