How common is headache in migraine?

Migraine headache may be throbbing or pulsing, affect one or both sides, and worsen with ordinary movement. Nausea, vomiting, sensitivity to light or sound, and a need to rest in a quiet place can occur alongside it. Some people experience an aura, such as flashing lights, blind spots, tingling or speech difficulty, before or during an attack.

Not every headache is migraine, and migraine does not always include prominent head pain. Triggers and patterns vary between people; missed meals, disrupted sleep, stress, hormonal changes, bright light or certain foods may be relevant for some people. A diary can help distinguish a recurring pattern from a new problem.

At the first sign of a familiar attack, rest in a dark, quiet room, drink fluids and try a small meal if you have missed one. Follow an agreed treatment plan and take medicines exactly as directed. Record timing, symptoms, possible triggers and treatment response. Repeated use of acute pain medicines can itself contribute to frequent headaches, so discuss regular use with a clinician.

Arrange a review if attacks are frequent, changing, difficult to control, or interfering with work, school or sleep. Seek urgent help for a sudden severe headache, new weakness, confusion, fainting, seizure, persistent vision loss, fever with a stiff neck, or a new neurological symptom that does not follow your usual aura pattern.

Does my symptom pattern fit migraine with or without aura? Which treatment should I use early in an attack? How can I identify triggers, and would preventive treatment or a review of my current medicines be useful?