Women account for more than 2/3 of the cases, with 25%, 55%, and 90% of the cases occurring before the age of 10, 20, and 40 years, respectively. The majority of patients have a family history of migraine, with prodromal symptoms such as vomiting, photophobia, phonophobia, depression or lethargy hours to days before the attack. 10% of patients have visual or other aura. The frequency of attacks varies from once a week to several times a year, with occasional cases of persistent attacks. Saper describes migraine attacks in five phases. It is important to note that these five phases are not necessary for every attack, and some patients may present with only a few of them, with most presenting with two or more phases, and some with only one. On the other hand, the characteristics of each phase can be very different, and the seizures can be different for the same individual. 1. Anterior somatic phase: 60% of migraine patients have anterior somatic symptoms a few hours to a few days before the headache starts. Anterior symptoms are not aura, and they can occur in both migraine with and without aura. They can manifest as mental and psychological changes, such as depression, fatigue, lethargy, drowsiness, or emotional agitation. Irritability, anxiety, irritability or euphoria. It may also manifest as autonomic symptoms, such as pallor, chills, anorexia or obvious hunger, thirst, scanty urination, frequent urination, straining to urinate, yawning, stiff neck, nausea, increased bowel movements, abdominal pain, diarrhea, panic, shortness of breath, accelerated heart rate, and hypersensitivity to odors. The anterior somatic symptoms vary greatly from patient to patient, but each patient has a relative stability of anterior somatic symptoms per episode. These anterior symptoms may appear in the anterior phase, or they may occur during the headache attack, or even last until after the headache attack and become subsequent symptoms. 2. Aura: About 20% of migraine patients have aura symptoms. The aura is mostly focal neurological symptoms, and occasionally it is a generalized neurological dysfunction. A typical aura should meet three of the following four characteristics, namely: recurrence, gradual development, duration of no more than lh, and following headache. In most cases, the aura lasts 5 to 20 min. In rare cases, the aura may come on suddenly, and in some cases, the aura may appear during the headache. There are also migraines with migratory aura, where the aura not only starts before the headache, but also lasts for several hours to 7 days after the headache. The aura may be visual, motor, sensory, or may manifest as brainstem or cerebellar dysfunction. The most common aura is visual, accounting for about 90% of the aura. Such as flashes, dark spots, monocular blackness, binocular blackness, visual distortion, and blankness outside the visual field. The flashes can be jagged or lightning-like flashes or citadel-like flashes. Retinal edema and occasionally a cherry-red macula are seen in the fundus of patients with retinal artery-type migraine. A common aura second only to the visual phenomenon is paresthesia. Typically, it affects one side of the hand and face, and hemiparesis may also occur. If the dominant hemisphere is involved, aphasia may occur. A contralateral or ipsilateral headache develops after several minutes, mostly in childhood. This is called hemiplegic migraine. Patients with hemiplegic migraine may have focal signs that last for more than 7 days, even when cerebral infarction is detected on imaging. Migraine with migraine aura and migrainous hemiplegia were previously classified as “complex migraine”. Oculomotor disorders following recurrent migraine attacks are called oculomotor paralysis migraine. It is mostly caused by paralysis of the motoneurotic nerve, followed by paralysis of the talocrural nerve and the spider nerve. Most of them have a history of migraine without aura, and the palsy may persist for a long time with recurrent attacks. If the aura involves the brainstem or cerebellum, the condition is known as basilar migraine, also known as basilar artery migraine. Dizziness, vertigo, tinnitus, hearing impairment, ataxia, diplopia, and visual symptoms including flashes, dark spots, blackness, visual field defects, and visual distortion may occur. Bilateral damage may result in depression of consciousness, the latter especially in children. Sensory dullness and hemianesthesia may also be present. Migraine aura may not be accompanied by headache, which is called migraine isotropia. It is most often seen in children with migraine. Sometimes it is seen after middle age, and the aura may be the main clinical manifestation of a migraine attack with a mild or no headache. It may alternate with headache attacks and may manifest as flashes of light, dark spots, abdominal pain, diarrhea, nausea, vomiting, recurrent vertigo, hemiparesis, hemianesthesia, and psychosomatic changes. Examples include benign episodic vertigo in children, vestibular Meniere’s disease, and benign recurrent vertigo in adults. Some follow-up studies have shown that a significant number of patients with a previous diagnosis of Ménière’s disease have symptoms mostly related to migraine. One report described a group of adult patients with benign recurrent vertigo, aged 7 to 55 years, with morning onset symptoms of recurrent dizziness, nausea, vomiting and profuse sweating, lasting from a few minutes to 3 to 4 days. The onset and end of the attacks are positional vertigo, without auditory symptoms during the attacks. Almost all patients are asymptomatic during the interictal period. These patients have several features in common with migraine, including alcohol, sleep deprivation, emotional stress and aggravation, and are more frequent in women, often during menstruation. 3. Headache phase: Headache can appear in any part around the head or neck, and can be located temporal, frontal, orbital. The nature of the headache is often pulsating pain, but some patients describe it as drilling pain. The pain level is often moderate or severe, or even unbearable. It tends to develop gradually after rising in the morning, and then gradually relieves after reaching its peak. Some patients also have an afternoon or evening onset. Most headaches in adults last 4h to 3 days, while most headaches in children last 2h to 2 days. There are cases of longer duration, which can last for several weeks. Some people refer to migraine attacks that last more than 3 days as migraine persistence. During the headache, many patients experience nausea, vomiting, blurred vision, photophobia and phonophobia, and prefer to live alone. Nausea is the most common accompanying symptom, reaching more than half of the patients, and it is often moderate or severe. Nausea may precede the onset of headache, or may occur during or after the onset of headache. Vomiting is present in nearly half of patients, and some patients experience significant relief of the attack after vomiting. Other autonomic dysfunctions may occur, such as frequent urination, dysuria, nasal congestion, panic attacks, hypertension, hypotension, and even cardiac arrhythmias. Vertigo, ataxia, diplopia, hearing loss, tinnitus, and impaired consciousness may occur if the attack involves the brainstem or cerebellum. 4.End stage of headache: This is the stage when the headache starts to reduce and finally stops. 5.Following symptoms period: A series of following symptoms may appear after the headache is relieved in a large number of patients. They may feel drowsy, sleepy and drowsy. Some patients feel exhaustion, hunger or anorexia, polyuria, scalp pressure and muscle pain. Mental and psychological changes may also occur, such as irritability, irritability, high mood or low mood, little speech, little movement, etc.