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Migraine Attacks: Recognizing the Phases and Triggers

In the second video of the series, PA Christina Lindemann walks through the phases of a migraine attack and the symptoms that can point to migraine. She highlights how migraine can extend well beyond headache, with distinct symptoms across the prodrome, aura, headache, and postdrome phases.

PA Lindemann also explores common triggers, practical screening tools, and key features that help differentiate migraine from other primary headache disorders. With a focus on recognition and evaluation, this video helps PAs better identify migraine and take the next step toward accurate diagnosis.

Key Takeaways:

  1. There are 4 phases of a migraine attack, and patients may experience all or some of them each time.
  2. Photophobia, impairment in functioning, and nausea in a patient with moderate-to-severe headaches should prompt consideration of migraine as a diagnosis.
  3. Migraine can be suspected and differentiated from other primary headache disorders based on the duration of the headache, intensity of symptoms, and associated features.

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Speaker

Click on the photo below to learn more about the speaker.

Christina Lindemann, MSPAS, PA-C

References and Additional Resources:

The timeline of a migraine attack. American Migraine Foundation. Published January 18, 2018. Accessed June 1, 2026. https://americanmigrainefoundation.org/resource-library/timeline-migraine-attack/

Ferrari, Goadsby PJ, Burstein R, et al. Migraine. Nat Rev Dis Primers. 2022;8(1):2. https://pubmed.ncbi.nlm.nih.gov/35027572/

Dodick DW. Migraine. Lancet. 2018;391(10127):1315-1330. https://pubmed.ncbi.nlm.nih.gov/29523342/

Andreou AP, Edvinsson L. Mechanisms of migraine as a chronic evolutive condition. J Headache Pain. 2019;20(1):117. https://pubmed.ncbi.nlm.nih.gov/31870279/

Lipton RB, Scher AI, Kolodner K, Liberman J, Steiner TJ, Stewart WF. Migraine in the United States: epidemiology and patterns of health care use. Neurology. 2002;58(6):885-894. https://pubmed.ncbi.nlm.nih.gov/11914403/

Martin VT, Fassler CS, Brunst KJ, et al. Migraine and its association with pubertal maturation and behavioral traits among adolescent girls. Acta Neurol Belg. 2023;123(4):1279-1289. https://pubmed.ncbi.nlm.nih.gov/36631631/

Waliszewska-Prosół M, Grandi G, Ornello R, et al. Menopause, perimenopause, and migraine: Understanding the intersections and implications for treatment. Neurol Ther. 2025;14(3):665-680. https://pmc.ncbi.nlm.nih.gov/articles/PMC12089631/

Lucas S. Migraine and other headache disorders: ACOG clinical updates in women’s health care primary and preventive care review summary volume XVIII, number 4: ACOG clinical updates in women’s health care primary and preventive care review summary volume XVIII, number 4. Obstet Gynecol. 2019;134(1):211. https://pubmed.ncbi.nlm.nih.gov/31241597/

Martin VT, Behbehani MM. Toward a rational understanding of migraine trigger factors. Med Clin North Am. 2001;85(4):911-941. https://pubmed.ncbi.nlm.nih.gov/11480265/

Hoffmann J, Schirra T, Lo H, Neeb L, Reuter U, Martus P. The influence of weather on migraine – are migraine attacks predictable?. Ann Clin Transl Neurol. 2015;2(1):22-28. https://pubmed.ncbi.nlm.nih.gov/25642431/

Eigenbrodt AK, Ashina H, Khan S, et al. Diagnosis and management of migraine in ten steps. Nat Rev Neurol. 2021;17(8):501-514. https://pubmed.ncbi.nlm.nih.gov/34145431/

Onan D, Younis S, Wellsgatnik WD, et al. Debate: differences and similarities between tension-type headache and migraine. J Headache Pain. 2023;24(1):92. https://pubmed.ncbi.nlm.nih.gov/37474899/

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