Why does a migraine attack sometimes fee

Now I'll write the family-facing draft.

Tonight with a migraine attack that feels "high" or detached

First, one look at the red flags: if any one of them is happening right now, call your local emergency number now and do not wait; if none of them are, tonight is a home-care night plus one phone call to book a review.

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1. Why an attack can feel like being "high" or detached

• During a migraine attack the brain handles light, sound, smell and body signals differently, and many people describe the episode as floaty, unreal, sped-up or "high". It is a real, commonly reported experience, and it is worth writing down while it is happening.
• The official public guidance lists aura as: problems with sight such as seeing zigzag lines or flashing lights; numbness or tingling like pins and needles; feeling dizzy; difficulty speaking. Aura usually does not last longer than one hour, and a typical attack runs from four hours up to three days (NHS migraine page, checked 5 November 2026).
• A "high" or detached feeling is not on that list. So it neither confirms migraine nor confirms aura, and it should not be treated as proof of either.
• Other things can produce the same floaty, "not quite real" feeling, and a clinician will want to know about them: skipped meals or low blood sugar, a short or broken night's sleep, dehydration, a sudden change in caffeine or alcohol, a medicine that was started or changed recently, and anxiety or panic.
• So the rule for tonight is check, don't assume. The routine in section 6 is safe whichever of those it turns out to be. Whether this is migraine, whether the feeling is aura, and what to take are a clinician's decisions, not ours — this is not a diagnosis and not a substitute for an examination.

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2. What you have already tried, and the better upgrade for each

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3. Constraints and the avoid-list

Constraints we are working inside: only routines, food already in the kitchen, and what a caregiver can say out loud tonight. No new medicines, no new supplements, no purchases.

Do not, tonight or at the appointment:

• No driving — not the person with the attack, and not you taking them to hospital. Arrange a taxi or ride, a family member to drive, or an ambulance.
• No second painkiller, no "stronger" medicine, no someone else's tablets, and no mixing two boxes that contain the same ingredient.
• No powders, remedies you cannot read the label on, or herbal mixtures from the internet.
• No buying prescription medicine online, and no buying anything "for migraine" that a pharmacist or doctor has not discussed.
• No starting, stopping or changing any prescribed medicine, and no deciding your own monthly limit for pain relief.
• No extra coffee or alcohol to "push through" the strange feeling; and no sudden cut either.
• Nothing from your own cabinet for a child, an older adult, or a pet, and no adjusting anyone's dose yourself.
• Do not use "wait and see" for any item in section 4 — that is exactly where home care stops.

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4. Red flags: when to stop home care

A. Emergency now — call your local emergency number

Any one of these:

• A headache that comes on suddenly and is extremely painful, at full force within seconds
• Problems speaking or remembering things
• Losing vision, or blurred or double vision
• Feeling drowsy or confused, not being themselves
• A seizure or fit
• Weakness or inability to move one arm, one leg, or one side of the face
• Very high temperature with meningitis symptoms (stiff neck, light hurting the eyes)
• A recent head injury

Also go now for repeated vomiting, or a head injury in the last weeks.

B. Same day — do not wait for the weekend

• The attack has lasted longer than 72 hours
• Aura, or this unusual "high" feeling, lasting longer than one hour
• Pregnant, or just had a baby
• The pattern has clearly changed: more frequent, different location, much more severe, or nothing like their usual attacks
• A new headache starting after age 50

C. Home care tonight

None of the above, the person is otherwise well, and this resembles their usual attacks.

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5. Decision tree for tonight

```
Unusual "high"/detached feeling, with or without headache
│
├─ Any A flag? → call your local emergency number now. Do not drive them.
│
├─ Any B flag? → contact your local urgent care service / out-of-hours line
│ today, or go to an emergency department today.
│
└─ No flags, person otherwise well
→ run the 25-minute routine (section 6)
→ write one diary row (section 6, step 5)
→ tomorrow: book the review, take the diary and the medicine boxes (section 9)
```

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6. The 25-minute routine (screenshot-friendly)

0–2 min — Stop and settle. Hand over the car keys. Say out loud: "This is a migraine episode, I'm going to lie down." Lie down, on the side that feels better.

2–5 min — Make the room quiet. Curtains closed, lights dim, TV and music off, phone face-down and on silent. Earplugs or ear defenders if the house has them.

5–10 min — Water and food. Water within reach, small sips. Eat something already in the kitchen: bread and cheese, rice, a banana, crackers, eggs, soup, toast, porridge. No new food, no special "migraine" products.

10–15 min — Your medicine, exactly as prescribed. If a medicine was already agreed with the prescriber for the first sign of an attack, take it as prescribed and write the name and the time on the diary row. Add nothing else to it.

15–20 min — Comfort. Warm compress on the neck and shoulders for 15–20 minutes over a towel, or a cool cloth on the forehead. Keep the room dim.

20–25 min — One diary row, then stop working. Start time · one side or both · throbbing or dull · nausea? light? noise? · what the unusual feeling was and how many minutes it lasted · what you ate · how long you slept · medicine name and time.

Then: set one alarm for a few hours' time, keep the room quiet, and let the person sleep. No second round of checking every ten minutes.

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7. Scripts you can say out loud

To the person having the attack:
> "You're safe. This room is dark and quiet, water is here, food is here. I'm not going to quiz you. If anything changes in your speech, vision or strength, say the word 'call' and I will."

To whoever would have driven:
> "I'm having an attack and I can't drive. Can you take me, or book me a ride and stay on the phone with me?"

To a family member at home:
> "If I get confused, sleepy, or my speech or vision changes, call the emergency number and tell them: migraine attack, and these are the symptoms."

To the clinic or answering service (say it in this order):
> "Adult with a migraine attack. It started at [time]. One-sided? throbbing? nausea? Any aura or visual change, and for how long? Any red flags — no. Medicines used so far, name only, and how many days this month. I'd like a review and a written plan."

At the appointment — the sentence your own plan card already uses:
> "We've been to the emergency department more than once and each time we leave without a plan. Can we agree today on those four things?"

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8. Success in the next 24 hours (no promise of a cure)

Tick these off — the goal is a shorter, less frightening, better-documented episode, not a guarantee that the pain stops:

• [ ] No driving at all while the symptoms are on
• [ ] One diary row written, including what the unusual feeling was and how long it lasted
• [ ] Meals eaten at the usual times, water sipped steadily, caffeine and alcohol unchanged
• [ ] Bedtime at the usual hour, no late night and no sleeping in to catch up
• [ ] Nothing added to the medicine box — no second painkiller, no powders, no online purchases
• [ ] If any red flag appeared, help was called first instead of being managed at home
• [ ] The review appointment booked or requested, with the diary and the medicine boxes in the bag

If a migraine still comes despite all of this, that is not a failure of the routine — prevention reduces attacks; it never guarantees them.

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9. The review that actually changes things

One appointment, four things agreed in writing:

1. Which medicine to take at the first sign of an attack, and the earliest moment it is worth taking (name only — the dose is the prescriber's)
2. Whether a preventive medicine is worth trying, if attacks are frequent
3. A written list of the signs that mean go to emergency now
4. What to do if the attack is still here after a few hours, and after half a day

Bring: the diary; every medicine, supplement and remedy in the house with the name and strength on the box; the allergy list; and the number of days this month that pain relief was used — the official guidance warns that using painkillers on more than two days a week can itself lead to more headaches, so bring the real number of days rather than setting your own cutoff.

One question that changes tonight's care: is this the first time this has felt this way, or is it different from attacks they have had before?

If you tell me your country or city, I can point you to the right local emergency and urgent-care services and the language to use when you call.

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I cannot diagnose this and I am not a physician; everything above is home care and documentation while you get a clinician to look at it.

Source: nhs-conditions https://www.nhs.uk/conditions/migraine/