The intensity of a migraine attack can drain you both physically and mentally. Many migraineurs liken the postdromal phase, or aftereffects, of migraine to a hangover. Lingering mental cloudiness, low-grade headache, fatigue, lack of appetite, dizziness, and other symptoms can continue to affect you for several days following a migraine attack. You may also feel on edge, unsure whether or not this attack has truly finished, and on guard against a possible recurrence.
There has been limited study on the postdromal phase of migraine, and not all migraineurs experience the phenomenon. For those who do, the migraine postdrome typically lasts a day or less, although it can last longer for some people. Women report postdromal symptoms more frequently than men, and fatigue and a lowgrade headache are the most commonly reported symptoms.
After a migraine, you may feel as if your brain has taken a permanent vacation. Perhaps you can't find your car keys, are struggling to follow the plot line of a movie, or are unable to grasp the right word in conversation. Described by some migraineurs as “brain fog,” changes in thinking and cognition during and following a migraine attack can trigger memory problems, difficulty with concentration, shortened attention span, slowed reaction time, and problems with visual/spatial processing.
Migraineurs with aura seem to experience a greater degree of cognitive problems during and following attacks. White matter lesions (WML), visible on MRI as white spots, are also more common in migraine with aura. Further study of WMLs in migraine is needed to fully understand their significance.
The good news is that these cognitive problems are not long lasting. A number of studies have explored whether migraineurs are more likely to have long-term cognitive impairment than the general population, and no evidence of a substantial difference in brain function has been uncovered.
In fact, a 2007 study published in the journal Neurology suggests that migraine with aura may actually be protective against cognitive decline. The study, which followed more than 1,400 subjects over the age of 50 for a 12-year period, found those who had migraine with aura scored better on word recall tests than those without migraine.
Getting Back to Normal
Peppermint oil has been used as a medical treatment for centuries, and recent research has shown that the smell of peppermint oil may be effective in relieving tension headache. If you have a lingering postdromal headache, a sniff of peppermint oil may be a safer way to soothe the pain without risk of rebound headache.
The best thing you can do for yourself in the wake of a migraine is to rest and free yourself from as much stress as is practical and possible. If you're still experiencing some non-migraine head pain, be careful not to overtreat it or a rebound headache could result. Try rest and compresses instead, and call your doctor for guidance if you can't get relief.
In a day or so you should be back to normal functioning. Once you are, take a few minutes to sit down with your headache diary and note any triggers or circumstances surrounding this migraine attack, in addition to treatment notes, before they fade from memory. Look for similarities between this attack and past episodes to see if there are any patterns you and your doctor can learn from.