Migraine: A Care Staff Guide to Symptoms, Aura and Treatment

It is mid-morning in a care home. One of the residents has stopped joining in, is squinting at the window and asks for the curtains to be closed. She says her head is thumping and she feels sick. A colleague says it is "just a headache". For someone with migraine, it is often far more than that, and sometimes a headache like this needs urgent attention.

This guide sets out what the NHS says about migraine symptoms, aura and treatment, when to get urgent help, and how care staff can support someone who has migraine. It draws on the NHS pages on migraine symptoms and treatment, both last reviewed on 10 March 2026.

What migraine looks like

The NHS describes the main symptoms of a migraine attack as a throbbing headache, often on one side of the head, which gets worse with movement. The person may feel or be sick, and may be sensitive to light and sound.

Some people have warning symptoms before the headache starts. The NHS lists feeling very tired and yawning, cravings or thirst, mood changes, a stiff neck and needing to pass urine more often. These early symptoms can begin hours, or up to two days, before the head pain. The NHS also says they can carry on after the headache has gone, so a person may not feel back to normal straight away.

Attacks usually last between 4 hours and 3 days. Some people have them several times a week and others less often. The NHS says migraines linked to periods are often longer and more severe.

Aura

Some people get warning signs called aura. The NHS gives these examples:

• vision problems, such as zigzag lines or flashing lights
• numbness or pins and needles
• dizziness
• difficulty speaking

The NHS says aura symptoms should not last longer than an hour. Some of these signs, such as difficulty speaking, can also be signs of a stroke, which is why the next section matters.

When to get urgent help

The NHS says to get an urgent GP appointment or contact NHS 111 if:

• an attack has lasted longer than 72 hours
• aura lasts longer than an hour at a time
• the person is pregnant or has just had a baby

The NHS lists these as reasons to call 999:

• a sudden, extremely painful headache
• trouble speaking or remembering things
• loss of vision, or blurred or double vision
• feeling drowsy or confused
• a seizure or fit
• a very high temperature along with signs of meningitis
• being unable to move, or weakness on one side of the body or face
• a recent head injury

The NHS adds that people should not drive themselves to A&E. In a care setting, call 999 and follow your organisation's emergency procedure. If you are unsure whether someone is having a stroke, use the FAST test described in our guide to recognising stroke with the FAST test, and call 999 if any sign is present.

Treatment

According to the NHS, migraine treatment has two parts: treating an attack, and preventing attacks.

Treating an attack

The NHS names painkillers such as ibuprofen and paracetamol, and advises taking them as soon as the headache starts. It also lists medicines called triptans and gepants, and medicines that stop a person feeling or being sick. Prescribing decisions belong to the GP or other prescriber. Care staff should give medicines as prescribed and recorded on the person's medication administration record, and ask a pharmacist or GP if they are unsure.

The NHS also advises lying down in a darkened room during an attack.

Preventing attacks

For people who have frequent attacks, the NHS lists preventive medicines such as beta blockers, antidepressants and epilepsy medicines, along with acupuncture, relaxation techniques, cognitive behavioural therapy (CBT) and vitamin B2.

Too many painkillers can make things worse

The NHS advises trying not to take painkillers on more than two days a week, because taking them too often can lead to more headaches and make migraine harder to treat. Our guide to medication overuse headache explains this risk in detail. Another type of severe headache is covered in our cluster headache guide.

Everyday self-care the NHS suggests

• Avoid known triggers.
• Stay hydrated and limit caffeine and alcohol.
• Eat at regular times, exercise regularly and sleep well.
• Keep a healthy weight and manage stress.
• Keep a migraine diary to help identify triggers.

The NHS says to see a GP, though not urgently, if attacks are severe, getting worse or lasting longer than usual, happen more than once a week, are hard to control, or regularly come before or during a period.

Practical points for care staff

The NHS pages are written for the person with migraine and do not cover care settings, so these points are suggestions rather than NHS guidance.

• Offer a quiet, darkened room and a drink, and ask what usually helps the person.
• Note when the attack started, what the person says, any aura, and any medicine given and when.
• Help the person keep a migraine diary if they want to, so the GP can see patterns.
• Do not assume a new or different headache is "just a migraine". Compare it with what is normal for that person and escalate if it is not.
• For someone who cannot say how they feel, look for changes such as withdrawal, covering the eyes or refusing food.

Training and CPD

Recognising when a headache is a red flag is part of safe care. Keep a record of what you learn for your own development, and browse professional development options on our CPD pages.

Key points to remember

• Migraine is more than a headache and can include nausea, light and sound sensitivity and aura.
• Attacks usually last 4 hours to 3 days.
• Call 999 for the NHS red-flag signs, including sudden severe headache, speech or vision problems, weakness, seizure or confusion.
• Take painkillers early, but try not to use them on more than two days a week.
• A diary helps to identify triggers.

Frequently asked questions

How long does a migraine last?

The NHS says attacks usually last between 4 hours and 3 days.

Is aura dangerous?

Aura is a common warning sign of migraine, but the NHS says it should not last longer than an hour. If it does, get urgent advice from a GP or NHS 111, and call 999 if there is speech trouble, weakness or loss of vision.

Can painkillers cause headaches?

Yes. The NHS says taking painkillers too often can lead to more headaches, so it advises trying not to take them on more than two days a week.

This guide is for general information and is not a substitute for clinical advice or your organisation's policies.