9 Clinical Signs and Symptoms of Migraine Prodrome: At-a-Glance for Primary Care

Migraine remains one of the most prevalent and debilitating neurological disorders globally, affecting approximately 15% of the worldwide population and roughly 1 in 7 Americans annually.¹ Despite its high prevalence, the prodromal phase of migraine, occurring in approximately 60% of migraineurs,² remains underrecognized in clinical practice, representing a critical missed opportunity for therapeutic intervention.³

The prodrome, or premonitory phase, manifests 24 to 48 hours before the headache phase and can persist for 4 to 72 hours if untreated.³ This phase is characterized by a constellation of neurological, autonomic, and behavioral symptoms that are increasingly understood to represent the earliest manifestations of migraine pathophysiology rather than mere precipitating factors.⁴ Recent evidence has challenged traditional concepts of migraine "triggers," suggesting that symptoms such as food cravings, mood alterations, and sleep disturbances may be early migraine phenomena rather than causative agents.¹

The short slide show above summarizes the primary signs and symptoms comprising the migraine prodrome, with the caveat that not all people who experience the premonitory phase report all or all of the same symptoms.