Triggers, premonitory symptoms and aura in migraine

Abstract

In migraine patients, trigger factors include sleep loss, oversleeping, stress and climate changes. During the phase of migraine attacks, patients experience various premonitory symptoms, such as neck stiffness, fatigue, decreased concentration, nausea, appetite changes, photophobia and phonophobia, and auras, such as visual, sensory and language symptoms. Involvement of the dopaminergic system and activation of the hypothalamus are likely involved in the premonitory phase. In the aura phase, cortical spreading depression, changes in cortical metabolism, cerebral blood flow and neurovascular coupling have been implicated. In this review, we would like to discuss the role of trigger factors, premonitory symptoms and aura symptoms in the course of migraine attacks and the correlation between these factors and clinical signs of migraine.