The mention of migraine is a headache for many patients who suffer from it all year round. Migraine may sound like a small disease, but it really kills people when it hurts, so what are the symptoms of migraine? Migraine with aura, also called typical migraine, accounts for 15% to 18% of migraine, and most of them have family history. Typical cases are divided into three phases: 1. Aura phase: Brief aura appears before the attack, such as visual aura: flashing light, flickering jagged lines, dark spots, black blindness and hemianopia, etc.; there may also be visual distortion and object color change, etc. Next are somatosensory aura, such as numbness and abnormal sensation in one limb or face, and motor aura, such as mild hemiparesis and aphasia, but they are relatively rare. The aura can last for several minutes to one hour. 2. Headache phase: Temporal or retro-orbital throbbing headache on one side appears at the same time as or after the aura. It is unilateral in about 2/3 of patients and bilateral or alternating on both sides in 1/3. It may also present as a full headache, unilateral or bilateral frontal headache and uncommon occipital headache. The headache often starts in the frontal, temporal and retro-orbital regions and spreads to the hemilateral or whole head. The headache is typically associated with a distinct pulsation of the superficial temporal artery and is often accompanied by nausea, vomiting, photophobia or phonophobia, irritability, odor terror and fatigue. The patient prefers to lie still in a dark room and is relieved after sleep. The headache lasts from 2 to 10 hours, a few can last from 1 to 2 days, and in children it lasts from 2 to 8 hours. The frequency of attacks can be weekly, monthly or several months, and the number of attacks varies. The intervals between attacks are mostly asymptomatic. 3.Late stage of headache: after the headache subsides, patients often show fatigue, tiredness, weakness and poor appetite, etc., and improve in 1 to 2 days. Migraine without aura, also called common migraine, is the most common type of migraine, accounting for about 80% of migraine. Compared with migraine with aura, it lacks typical aura and is often bilateral temporal and periorbital pain, which may be pulsating, with recurrent headache and vomiting. The headache lasts for a long time, up to several days, and the symptoms can be complicated by cervical muscle contractions when the pain persists. There is often scalp tenderness during the attacks, and vomiting may occasionally end the headache. This type of migraine is often significantly associated with menstruation. Compared with migraine with aura, migraine without aura has a higher frequency of attacks, which can seriously affect the patient’s work and life and often requires frequent pain medication. Differential diagnosis of migraine There are many causes of migraine, which can be broadly classified into primary and secondary. The former can not be attributed to a specific cause and can be called idiopathic headache, such as migraine and tension-type headache; the latter can involve various intracranial lesions such as cerebrovascular disease, intracranial infection, cranial trauma, systemic diseases such as fever, internal environmental disorders and abuse of psychoactive drugs. So, how to distinguish different types of headache? I. Migraine has the highest incidence rate, especially in middle-aged and young people, and most of the typical migraine patients have the onset of migraine in adolescence, and most of them have family history. 20% of migraine patients have aura when they have an attack, such as depression and “gold stars in front of the eyes”. It starts at the back of one orbital area and gradually worsens and extends to half of the head or even the whole head. The pain is usually pulsating and throbbing. It is particularly triggered by mood swings, alcohol consumption or menstrual flow. It usually lasts no longer than 3 days. II. Tension headache is usually triggered by emotional anxiety or depression, tension, and improper positioning of the head, neck and scapula. The pain location is mostly in the back of the occipital region and neck, sometimes it is a frontal headache with persistent dull pain, and the head may also be accompanied by a tightening and heavy pressure feeling, and the head discomfort usually starts after waking up, and the headache gradually worsens or maintains the pain for a long time. Trigeminal neuralgia often occurs suddenly when brushing teeth, washing face, blowing hair, talking or yawning, and each pain attack is relatively short, ranging from seconds to minutes, and stops abruptly. Experts remind that different types of headaches are treated differently. Therefore, it is very important to learn to diagnose various kinds of headaches differently. If the headache is only primary, you can try to relieve it at home, while if it is secondary, you should go to the hospital to find out the cause and receive regular treatment.