Migraines do not always cause fever. Fever is not a classic or typical feature of migraine. Migraine commonly causes symptoms beyond headache, including nausea, vomiting, and sensitivity to light and sound. Some people may feel unusually hot, cold, sweaty, or chilled during an attack, but these sensations don’t necessarily represent a true fever.
A measured fever occurring with headache deserves separate consideration, particularly when it is new, persistent, or accompanied by other concerning symptoms. This guide covers the real migraine and fever connection, why the two sometimes overlap, and when a fever with headache signals something more serious.
Migraine and Fever Connection
The migraine and fever connection comes down to a shared brain structure, the hypothalamus, which controls both migraine activity and body temperature regulation. This overlap explains why so many people describe feeling feverish during an attack without an actual temperature spike.
Changes in the Nervous System
The hypothalamus plays a role in the early stages of a migraine attack, triggering symptoms like fatigue, yawning, and appetite changes. Since this same brain region controls temperature, some crossover in sensation makes sense.
Autonomic Symptoms During Migraine
The autonomic nervous system controls sweating, blood flow, and skin temperature. During a migraine, this system can misfire, causing sweating, flushing, or chills that feel like fever without raising core body temperature.
Feeling Flushed or Chilled
Some studies note mild temperature shifts of half a degree to one degree Celsius during severe attacks. This stays well below the medical definition of fever, which starts at 100.4°F (38°C).
Rare Migraine Variants
A small number of rare migraine types involve more pronounced autonomic symptoms, including significant sweating or flushing. Even in these cases, a true measured fever remains uncommon and warrants separate evaluation.
Can a Migraine Directly Raise Your Body Temperature?
A migraine attack itself does not directly cause a true fever in the medical sense. What people often describe as “migraine fever” is a subjective feeling of heat, chills, or sweating tied to nervous system activity, not an actual rise in core temperature confirmed by a thermometer. Migraines do not always cause fever. If you check your temperature during an attack and it reads 100.4°F or higher, treat that as a separate finding that needs its own explanation, not a normal part of migraine.
Why Fever and Migraine-Like Headache Can Happen at the Same Time
Understanding headache and fever causes beyond migraine helps you tell the difference between a typical attack and something that needs medical attention. Several illnesses produce headache and fever together through completely different mechanisms than migraine.
Illness That May Trigger Headache or a Migraine Attack
Common illnesses like the flu, sinus infections, and colds often trigger a headache in people prone to migraines. The fever in these cases comes from the underlying infection, not the migraine itself. Among the most common causes of headaches and fever in everyday life, viral illness ranks near the top, especially during cold and flu season.
Infections That Mimic Parts of a Migraine Attack
Conditions like meningitis, encephalitis, and severe sinus infections can cause headache, light sensitivity, and nausea, symptoms that overlap with a typical migraine attack. These infections are medical emergencies when they include a true fever, neck stiffness, or confusion.
Knowing what to do if you have a migraine with fever starts with checking for these warning signs early. A stiff neck, sudden confusion, a rash, or a fever that climbs quickly all point away from a simple migraine and toward an infection that needs urgent evaluation.
Treating Fever and Headache Safely
Treating fever and headache safely starts with figuring out whether an infection, migraine, or both are driving your symptoms, since the right treatment depends on the cause. Guessing at treatment without this step often means treating the wrong problem, so treating fever and headache safely should always begin with an accurate temperature reading and a look at accompanying symptoms.
Treat the Underlying Cause
If an infection is driving the fever, treating that infection, whether with rest, fluids, or prescribed medication, resolves the fever more effectively than only managing the headache.
Fever-Reducing Medications
Acetaminophen and ibuprofen are commonly used to lower fever and ease headache pain, though people with certain health conditions should check with a doctor before regular use.
Migraine Medications
Triptans and other migraine-specific medications target migraine mechanisms directly and do not treat fever. Taking a fever reducer alongside migraine medication is common when both problems occur together.
Hydration
Fever increases fluid loss through sweating, and dehydration itself can worsen headache pain. Drinking water regularly supports recovery from both problems at once.
Avoid Medication Overuse
Using pain relievers too often, more than two to three days a week regularly, can lead to medication overuse headache, making the original problem harder to treat over time.
FAQ
Why do I feel hot during a migraine?
Autonomic nervous system activity during a migraine causes flushing and sweating, creating a sensation of heat without an actual fever on a thermometer.
Should I worry about a migraine with fever?
Yes, if you measure a true fever of 100.4°F or higher. This combination needs medical evaluation to rule out infection rather than assuming it is migraine.
Can meningitis cause severe headache and fever?
Yes. Meningitis causes severe headache, high fever, neck stiffness, and confusion together, and requires emergency medical care immediately.
What should I do if I have a migraine and a fever?
Measure your temperature accurately, treat the fever with appropriate medication, and contact a doctor if the fever persists beyond 24 to 48 hours.
Can COVID-19 cause both headache and fever?
Yes. COVID-19 commonly causes headache alongside fever, fatigue, and respiratory symptoms, distinct from a typical migraine attack pattern.
What medications can help treat fever and headache safely?
Acetaminophen or ibuprofen treat both fever and pain safely for most adults, though dosing should follow label instructions or medical guidance.
Can dehydration cause headache and fever?
Dehydration commonly causes a headache, but does not directly cause fever. A true fever alongside dehydration usually points to an underlying infection.
Sources
- American Migraine Foundation, Understanding Migraine Symptoms
- Mayo Clinic, Migraine Symptoms and Causes
- Centers for Disease Control and Prevention, Meningitis Symptoms
- National Institute of Neurological Disorders and Stroke, Migraine Information Page
- PubMed Central, Cranial Autonomic Symptoms and Neck Pain in Differential Diagnosis of Migraine
- Cleveland Clinic, Fever Overview
- Centers for Disease Control and Prevention, COVID-19 Symptoms
- MedlinePlus, Meningitis Information
- American Headache Society, Medication Overuse Headache
- U.S. National Library of Medicine, Fever Definition and Measurement
Medical Disclaimer: This article is for general educational purposes only. It does not replace advice from a doctor. Seek medical care for a new or severe headache with fever, especially with neck stiffness or confusion.
