Editing Migraine (section)

===Pain phase===
Classically the headache is unilateral, throbbing, and moderate to severe in intensity.<ref name=Tint2010>{{cite book | vauthors = Tintinalli JE |title=Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)) |publisher=McGraw-Hill Companies |location=New York |year=2010 |pages=1116–1117 |isbn=978-0-07-148480-0 }}</ref> It usually comes on gradually<ref name=Tint2010/> and is aggravated by physical activity during a migraine attack.<ref name=ICHD2004/> However, the effects of physical activity on migraine are complex, and some researchers have concluded that, while exercise can trigger migraine attacks, regular exercise may have a [[prophylactic]] effect and decrease frequency of attacks.<ref name="The association between migraine an">{{cite journal |vauthors=Amin FM, Aristeidou S, Baraldi C, Czapinska-Ciepiela EK, Ariadni DD, Di Lenola D, Fenech C, Kampouris K, Karagiorgis G, Braschinsky M, Linde M |date=September 2018 |title=The association between migraine and physical exercise |journal=The Journal of Headache and Pain |volume=19 |issue=1 |pages=83 |doi=10.1186/s10194-018-0902-y |pmc=6134860 |pmid=30203180 |doi-access=free }}</ref> The feeling of pulsating pain is not in phase with the [[pulse]].<ref name="pathos">{{cite journal | vauthors = Qubty W, Patniyot I | title = Migraine Pathophysiology | journal = Pediatric Neurology | volume = 107 | pages = 1–6 | date = June 2020 | pmid = 32192818 | doi = 10.1016/j.pediatrneurol.2019.12.014 | s2cid = 213191464 }}</ref> In more than 40% of cases, however, the pain may be bilateral (both sides of the head), and neck pain is commonly associated with it.<ref>{{cite book| vauthors = Tepper SJ, Tepper DE |title=The Cleveland Clinic manual of headache therapy|publisher=Springer|location=New York|isbn=9781461401780|page=6|url=https://books.google.com/books?id=uaG08nAKG_wC&pg=PA6|date=1 January 2011|url-status=live|archive-url=https://web.archive.org/web/20161222073613/https://books.google.com/books?id=uaG08nAKG_wC&pg=PA6|archive-date=22 December 2016}}</ref> Bilateral pain is particularly common in those who have migraine without aura.<ref name=Amin2009/> Less commonly pain may occur primarily in the back or top of the head.<ref name=Amin2009/> The pain usually lasts 4 to 72 hours in adults;<ref name=Tint2010/> however, in young children frequently lasts less than 1&nbsp;hour.<ref name=Bigal2010>{{cite journal | vauthors = Bigal ME, Arruda MA | title = Migraine in the pediatric population--evolving concepts | journal = Headache | volume = 50 | issue = 7 | pages = 1130–43 | date = July 2010 | pmid = 20572878 | doi = 10.1111/j.1526-4610.2010.01717.x | s2cid = 23256755 }}</ref> The frequency of attacks is variable, from a few in a lifetime to several a week, with the average being about one a month.<ref name = "Rasmussen_2006">{{cite book| vauthors = Rasmussen BK | chapter = Epidemiology of Migraine | veditors = Olesen J |title=The Headaches|year=2006|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-5400-2|pages=238–240| chapter-url=https://books.google.com/books?id=F5VMlANd9iYC&pg=PA238|edition=3rd|url-status=live|archive-url=https://web.archive.org/web/20170313073938/https://books.google.com/books?id=F5VMlANd9iYC&pg=PA238|archive-date=13 March 2017}}</ref><ref>{{cite book| vauthors = Dalessio DJ |veditors = Silberstein SD, Lipton RB, Dalessio DJ|title=Wolff's headache and other head pain|year=2001|publisher=Oxford University Press|location=Oxford|isbn=9780195135183|page=122|url=https://books.google.com/books?id=aJRV199FZcoC&pg=PA122|edition=7}}</ref>

The pain is frequently accompanied by nausea, vomiting, [[photophobia|sensitivity to light]], [[Hyperacusis|sensitivity to sound]], [[osmophobia|sensitivity to smells]], fatigue, and irritability.<ref name=Amin2009/> Many thus seek a dark and quiet room.<ref name=Walton2009/> In a [[basilar artery|basilar migraine]], a migraine with neurological symptoms related to the [[brain stem]] or with neurological symptoms on both sides of the body,<ref name=Basil2009>{{cite journal | vauthors = Kaniecki RG | title = Basilar-type migraine | journal = Current Pain and Headache Reports | volume = 13 | issue = 3 | pages = 217–20 | date = June 2009 | pmid = 19457282 | doi = 10.1007/s11916-009-0036-7 | s2cid = 22242504 }}</ref> common effects include [[vertigo (medical)|a sense of the world spinning]], light-headedness, and confusion.<ref name=Amin2009/> [[Nausea]] occurs in almost 90% of people, and vomiting occurs in about one-third.<ref name=Walton2009>{{cite book| vauthors = Lisak RP, Truong DD, Carroll W, Bhidayasiri R |title=International neurology: a clinical approach|year=2009|publisher=Wiley-Blackwell|location=Chichester, UK|isbn=9781405157384|page=670|url=https://books.google.com/books?id=L6_L75yvaPQC&pg=PA670}}</ref> Other symptoms may include [[blurred vision]], nasal stuffiness, diarrhea, frequent urination, [[pallor]], or sweating.<ref name=Joel1999>{{cite book| vauthors = Glaser JS |title=Neuro-ophthalmology|year=1999|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780781717298|page=555|url=https://books.google.com/books?id=eVU2CODGj98C&pg=PA555|edition=3rd|url-status=live|archive-url=https://web.archive.org/web/20170313073802/https://books.google.com/books?id=eVU2CODGj98C&pg=PA555|archive-date=13 March 2017}}</ref> Swelling or tenderness of the scalp may occur as can neck stiffness.<ref name=Joel1999/> Associated symptoms are less common in the elderly.<ref name=ElderlyBook2008/>

====Silent migraine====
Sometimes, aura occurs without a subsequent headache.<ref name = "Cutrer_2006">{{cite book | vauthors = Cutrer FM, Olesen J | chapter = Migraines with Aura and Their Subforms | veditors = Olesen J |title=The Headaches|year=2006|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-5400-2|pages=238–240| chapter-url=https://books.google.com/books?id=F5VMlANd9iYC&pg=PA238 |edition=3rd |url-status=live |archive-url= https://web.archive.org/web/20170313073938/https://books.google.com/books?id=F5VMlANd9iYC&pg=238|archive-date=13 March 2017 }}</ref> This is known in modern classification as a [[acephalgic migraine|typical aura without headache]], or acephalgic migraine in previous classification, or commonly as a silent migraine.<ref name="americanmigrainefoundation.org-Robblee-2019-Silent-Guide">{{cite web |vauthors=Robblee J |title=Silent Migraine: A Guide |url=https://americanmigrainefoundation.org/resource-library/silent-migraine/ |website=American Migraine Foundation |access-date=22 January 2021 |date=21 August 2019 |archive-date=28 January 2021 |archive-url=https://web.archive.org/web/20210128132026/https://americanmigrainefoundation.org/resource-library/silent-migraine/ |url-status=live }}</ref><ref name="jmedicalcaserep-Yusheng-2015-aura-w/o-headache">{{cite journal | vauthors = He Y, Li Y, Nie Z | title = Typical aura without headache: a case report and review of the literature | journal = Journal of Medical Case Reports | volume = 9 | issue = 1 | pages = 40 | date = February 2015 | pmid = 25884682 | pmc = 4344793 | doi = 10.1186/s13256-014-0510-7 | doi-access = free | title-link = doi }}</ref> However, silent migraine can still produce debilitating symptoms, with visual disturbance, vision loss in half of both eyes, alterations in color perception, and other sensory problems, like sensitivity to light, sound, and odors.<ref name="medicalnewstoday-Leonard-2018-Silent-migraine">{{cite web |vauthors=Leonard J |veditors=Han S |title=Silent migraine: Symptoms, causes, treatment, prevention |url=https://www.medicalnewstoday.com/articles/323011 |work=Medical News Today |access-date=22 January 2021 |date=7 September 2018 |archive-date=19 January 2021 |archive-url=https://web.archive.org/web/20210119184614/https://www.medicalnewstoday.com/articles/323011 |url-status=live }}</ref> It can last from 15 to 30 minutes, usually no longer than 60 minutes, and it can recur or appear as an isolated event.<ref name="jmedicalcaserep-Yusheng-2015-aura-w/o-headache"/>