Classic migraine is diagnosed when the prodrome is followed by an aura. Auras vary greatly and include visual, sensory, motor, or speech symptoms. A typical visual aura follows the prodrome and precedes the headache by 20 to 30 minutes. The common auras are scotoma (a blind spot in vision) or an arc of scintillating flashing lights. The scotoma may begin as a circle of flashing light that increases in size gradually.

Sensory auras usually contain a paresthesia (burning or prickly feeling), especially a sensation of numbness. Because migraine headaches are one-sided, auras are often one-sided. The paresthesia may produce, for example, numbness on the whole hand on one side. A person can also have motor auras. Motor auras may be due to weakness, which develops focally and spreads to involve one or more muscle groups. The weakness may vary from a feeling of heaviness to a massive hemiparesis (paralysis on one side).

If there is no prodromal period or aura then a person is said to be suffering from common migraines. The name is not indicative of the disorder.

The migraine headache is pulsatile, or throbbing, which distinguishes it from other types of headaches. It is often one-sided and typically resides behind the eye. For some, the best treatment is to be alone in a room and hope the migraine headache goes away in a short time. Normally this is not the case and the headaches last for several hours.

Research into migraine headache is more and more pointing to an abnormality in the autonomic nervous system as the cause of the migraine headache.(7,8) Some studies show that the parasympathetic system is not working, while others show the deficiency is in the sympathetic nervous system.

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