Migraine is a neurological disease having a characteristically intense and episodic headache, which appears on one or both sides of the head with photophobia, phonophobia and nausea.Migraine commonly exhibits four stages during the episode.
· Prodrome
· Aura
· Headache
· Recovery/ postdrome

Prodrome
     Patient feels irritability and depressed; fatigue, yawning, excessive sleepiness craving for foods like chocolate; occasional hunger (Bulimia) noted; Patient feels as if gained weight due to water retention. These symptoms usually precede the headache phase of migraine attack by several hours or days and experience teaches the patient or observant family that the migraine attack is near.

Aura
     Premonitory sensory, motor or visual disturbances present in 20% cases. The migraine aura is comprised of focal neurological phenomenon that precedes or accompany the attack. They appear gradually over 5 to 20 minutes and usually subside just before the headache begins. Symptoms of migraine aura are usually sensory in nature.

      Visual aura is the best common of the neurological events. There is a disturbance of vision consisting usually of unformed flashes of white or rarely of multicolored lights, which is known as photopsia, or formations of dazzling zigzag lines,arranged like the battlements of a castle, hence the term" fortification spectra or Teichopsia". Some patients complain of blurred or shimmering or cloudy vision, as though they were looking through thick or smoked glass.

      The somato sensory aura of migraine consists of digital lingual or oral paresthesias, a feeling of pin needles experienced in the hand and arm as well as in the ipsilateral nose and mouth area. Paresthesia migrates up the arm and then extends to involve the lips and tongue.

Headache
     The typical migraine headache is unilateral, throbbing and moderate to severe can be aggravated by physical activity. The onset is usually gradual. The pain peaks and then subsides, and usually lasts between 4 and 72 hours in adults and 1 to 48 hours in children. Usually unilateral in 50-70% case.

• Pain starts above one orbit and spread over entire side of head to the occiput and neck or begin in back of head and move forward.
• Pain is worse is recline position, by shaking head, coughing or straining at stool.
• Pain is lessened by sitting or standing, lying down in dark room, vomiting.
  
  Accompaniments
  · Gasrointestinal
            Anorexia,nausea,vomiting,diarrhoea.
  · Special senses
            Photophobia,phonophobia,osmophobia
  · Brainstem features
            Vertigo,ataxia,diplopia,dysarthria
  · Autonomic disturbance
            Hypertension, Hypotension, Tachycardia, Bradycardia, Nasal congestion.
  · Fluid retention
            But rapidly lost by spontaneous diuresis.
  · Psychological upset and confusional state
  
  Postdrome
  Drained out, exhausted and depressed feeling after headache and may have impaired concentration, scalp tenderness or mood changes.
  
  Recovery
  Patient experience a sense of buoyancy and well being. Patients lose several pounds of water from vomiting and Diuresis.