What are typical s/sx of migraines?

• A. A prodrome before the headache, which may include an aura, followed by unilateral headache with nausea, photophobia, or phonophobia.
• B. Headache that is always bilateral and not associated with aura.
• C. Headache with fever and neck stiffness.
• D. There is no prodrome or aura.

Answer: (A)

Migraines typically follow a pattern where a prodrome and sometimes an aura precede the main headache, which is usually unilateral and throbbing, and is accompanied by nausea and sensitivity to light and sound. The prodrome can involve mood changes, yawning, cravings, or fatigue, and the aura consists of reversible neurological symptoms such as visual disturbances or tingling that occur before the headache in some people. The headache itself tends to be unilateral, lasts from several hours to a few days, and worsens with activity, with nausea and photophobia/phonophobia commonly present. This combination—prodrome or aura plus unilateral throbbing pain with nausea and sensitivity to light and sound—best captures the classic migraine presentation.

Other options describe features that aren’t typical for migraines: fever and neck stiffness suggest infection rather than a migraine; a headache that is always bilateral and without aura doesn’t align with the common unilateral, sometimes aura-related pattern; and saying there is no prodrome or aura ignores the common pre-headache symptoms some patients experience, even though not every case has them.