Peripheral Nerve Hyperexcitability (PNH) Community
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This patient support community is for discussions relating to Peripheral Nerve Hyperexcitability (PNH) and the various conditions related to it such as neuromyotonia (NMT), cramp fasciculation syndrome (CFS), benign fasciculation syndrome (BFS), Isaacs syndrome and others.

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4 Phases of a Migraine Attack

There are 4 phases of a Migraine attack. They are The Prodrome, The Aura, The Headache, and The Postdrome.


The Prodrome

Migraineurs experience the Prodrome phase hours or perhaps even days before the actual onset of a migraine. For the migraineur, it serves as a warning that a migraine may occur soon. Only 30%-40% of those that suffer from a migraine actually experience this phase, but it is useful in warning to the afflicted person to take steps to counter the migraine attack. Symptoms of prodrome include:


food cravings


mood changes-irritability, depression

muscle stiffness (neck)


an increase in urination frequency




The Aura

In the aura phase, the migraineur may experience exotic or bizarre visual distortions. Auras only occur in 20% of migraineurs. This phase also serves as a warning to the headache phase of the migraine, so it may be a good indication to use medications to curb the attack before it starts. Auras can have symptoms of:


visual auras (flashing lights, wavy lines, spots, partial loss of sight, blurry vision)

olfactory hallucinations (smelling odors that do not exist)

tingling or numbness of the face or extremities

aphasia - difficult finding words or speaking

confusion and dizziness

partial paralysis (only for those suffering from hemiplegic migraines)

auditory hallucinations (hearing things that are not present)

decrease in or loss of hearing

reduced sensation

allodynia - hypersensitivity to touch

phosphenes - brief flashes of light that streak across the visual field



The Headache

This is typically the most excruciating and debilitating phase of a migraine attack. Counterintuitively, they affect the entire body, not just the head with pain that can range from mild to severe, and may be to severe that it cannot be comprehended by those who have never suffered this phase of a migraine attack. The most common time is 6 am, but the headache can occur at anytime, and may last from 1-72 hours. Symptoms of the headache are:


unilateral or bilateral pain

phonophobia - sensitivity to sound

photophobia - sensitivity to light

nausea and vomiting


nasal congestion/runny nose

depression/severe anxiety

hot flashes and chills



dehydration/fluid retention, depends on the individual body's reactions



The Postdrome

Pain may or may not end after the headache phase. The postdrome phase may follow which is similar to feeling like a zombie or hung-over, and it may take hours, or sometimes days, to fully recover. This feeling may be attributed to the migraine itself as it is to the medications taken to treat the migraine. Symptoms of the postdrome may be caused by abnormal cerebral blood flow for up to 24 hours after the end of the headache stage. Symptoms of the postdrome may include:


lowered mood levels, and perhaps depression OR feelings of well-being and euphoria


poor concentration and comprehension

lowered intellect levels

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Jan 15, 2009
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