Migraine and cluster headache are both primary headaches and share several features. They are usually characterised by intense pain on one side of the head, and are often accompanied by non-pain symptoms.13,14

Migraine has well-recognised phases:6,8,14

·       non-pain premonitory symptoms in the prodrome phase, from possibly 72 hours before the attack, with changes in mood, energy levels, behaviour or appetite;

·       aura (experienced by a third of migraineurs) with visual disturbances such as flashing lights or blind spots lasting 5-60 minutes – these may overlap with the headache or appear after the headache phase has started;

·       a pulsating, throbbing unilateral headache, often with nausea, vomiting, photophobia and/or phonophobia lasting for a few hours to a whole day – someone with migraine will want to remain still or lie down as movement worsens the pain.

·       the postdrome phase or resolution as symptoms subside, but sometimes causing tiredness for a few days.

It is possible that what a migraineur perceives as a trigger, eg insufficient sleep, hunger or bright lights, could actually be premonitory symptoms of the oncoming migraine attack.6