When to worry about headache with migraine

Migraine headache may be throbbing or one-sided and can worsen with movement. Nausea and sensitivity to light or sound may accompany it. Some people have temporary visual, sensory, or speech changes called aura. A familiar pattern that responds to an agreed plan is different from a first, abruptly severe, steadily worsening, or otherwise unusual headache.

Use your prescribed migraine treatment as directed, rest in a quiet dark room, drink fluids, and try a small meal if you have not eaten. Record timing, possible triggers, aura, medicines, and response. Arrange a review if attacks are becoming more frequent, treatment is less helpful, or pain medicines are needed repeatedly, because overuse can sustain headaches.

Call emergency services for a thunderclap headache, new weakness, facial drooping, persistent speech trouble, confusion, seizure, fainting, or sudden vision loss. Seek urgent advice for fever with a stiff neck, a new headache after injury, a first neurological episode, or a headache during pregnancy. Get medical review for an attack that is unusually prolonged or unlike your established migraine pattern.

Is this pattern consistent with migraine or does it need another assessment? What should I do during aura? Which preventive options and limits on acute medicines apply to me?