If you’ve ever suffered through a migraine and noticed your body feeling unusually warm, you’re not alone. Many migraine sufferers report experiencing what feels like a fever alongside their headache — and it raises an important question: can migraines cause fever, or is something else going on?
The short answer is nuanced. Migraines themselves do not directly cause a true fever, but the relationship between migraines and elevated body temperature is more complex than a simple yes or no. Understanding that relationship could be important for your health — and in some cases, it could help you recognize when a symptom that looks like a migraine is actually something far more serious.
What Is a Migraine, Exactly?
Before diving into the fever question, it helps to understand what a migraine actually is — because it is frequently misunderstood as simply a “bad headache.”
A migraine is a complex neurological condition involving abnormal brain activity that affects nerve pathways and brain chemicals. It typically produces intense, throbbing head pain — usually on one side — but it can also cause a wide range of other symptoms including nausea, vomiting, extreme sensitivity to light and sound, visual disturbances known as aura, dizziness, and cognitive difficulties often called “brain fog.”
Migraines occur in phases. The prodrome phase can begin hours or even days before the headache itself, producing subtle warning signs like mood changes, food cravings, neck stiffness, and fatigue. The aura phase involves neurological symptoms like visual disturbances or tingling sensations. The headache phase is the peak of the attack. And the postdrome phase — sometimes called the migraine “hangover” — can leave sufferers feeling drained and unwell for hours or days afterward.
According to the American Migraine Foundation, migraines affect more than 39 million men, women, and children in the United States alone, making it one of the most prevalent neurological conditions in the world. This full-body nature of migraines is key to understanding why fever-like symptoms sometimes appear alongside them.
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Can Migraines Cause a True Fever?
Medically speaking, a true fever is defined as a body temperature of 100.4°F (38°C) or higher, caused by the immune system’s response to infection, inflammation, or other systemic triggers. The Mayo Clinic defines fever as a temporary increase in body temperature that is often caused by an illness and is a sign that something out of the ordinary is going on in the body.
Migraines, on their own, do not typically cause a true fever in this clinical sense. The mechanisms behind a migraine — changes in brain chemistry, nerve pathway activation, and vascular changes in the brain — do not directly trigger the immune response that produces a measurable rise in core body temperature.
However, this does not mean that people with migraines never experience fever at the same time. There are several important reasons why fever and migraine can occur together, and understanding those reasons matters. Your brain is very complex. You an do a lot to help it like listen to the Brain Wave Song or have a proper diet. But, migraines can still happen even if your brain is completely healthy.
Why Fever and Migraine Can Occur Together
1. Fever Can Trigger a Migraine
One of the most well-documented relationships between fever and migraine works in the opposite direction from what many people assume. Fever is a well-known migraine trigger.
When the body runs a fever, it undergoes significant physiological changes — dehydration, inflammation, disrupted sleep, and alterations in blood flow. All of these are established migraine triggers. For people who are already prone to migraines, getting sick with a fever-producing illness very commonly sets off a migraine attack at the same time.
In this scenario, the fever and the migraine are occurring simultaneously but are caused by the same underlying illness — not by each other. The National Institute of Neurological Disorders and Stroke (NINDS) notes that migraine triggers vary widely between individuals and can include hormonal changes, certain foods, stress, and physical factors including illness and fever.
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2. Autonomic Nervous System Disruption
Migraines involve significant disruption to the autonomic nervous system — the system that regulates involuntary body functions including temperature regulation, heart rate, and blood pressure.
During a migraine attack, some people experience vasodilation — widening of blood vessels — which can cause flushing, increased skin temperature, and a sensation of warmth that closely mimics the feeling of a fever without producing an actual measurable rise in core temperature.
This is sometimes referred to as a subjective fever — the person genuinely feels feverish, hot, or chilled, but a thermometer does not confirm an elevated temperature. This phenomenon is reported by a notable percentage of migraine sufferers and is a direct result of autonomic dysfunction during the attack.
3. Hypothalamic Involvement
The hypothalamus — the region of the brain responsible for regulating body temperature — is believed to play a significant role in migraine attacks. Research published in the journal Cephalalgia suggests the hypothalamus may be activated during the prodrome phase of a migraine, before the headache even begins.
Since the hypothalamus controls thermoregulation, its disruption during a migraine can cause genuine fluctuations in body temperature — including low-grade temperature elevations that, while not a true fever by clinical definition, are measurable and real.
Some researchers believe this hypothalamic involvement explains why a subset of migraine sufferers consistently record slightly elevated temperatures during their attacks.
4. Inflammation
Migraines involve neurogenic inflammation — an inflammatory process in the nervous system that contributes to the pain and other symptoms of an attack. While this inflammation is localized to the nervous system and does not produce the systemic inflammatory response that causes a true fever, it does involve the release of inflammatory compounds including CGRP (calcitonin gene-related peptide) and prostaglandins.
According to research from the National Institutes of Health (NIH), CGRP plays a central role in migraine pathophysiology and is associated with the vasodilation and neuroinflammation that characterize a migraine attack. In some individuals, this neuroinflammatory process may contribute to mild systemic effects including temperature sensitivity and general feelings of being unwell that resemble flu-like symptoms.
Migraine Symptoms That Mimic Fever
Understanding which migraine symptoms can feel like fever helps explain why so many people ask this question in the first place. The following migraine-associated symptoms are commonly mistaken for signs of fever:
- Chills and sweating — Temperature dysregulation during a migraine can cause cycles of feeling hot and then cold, often accompanied by sweating, that closely resemble the chills and sweats of a true fever.
- Body aches — Many migraine sufferers report generalized body aches and muscle tenderness during an attack, particularly in the neck and shoulders. Combined with head pain, this can feel remarkably similar to the body aches of a flu-like illness with fever.
- Fatigue and malaise — The profound exhaustion of a migraine attack — particularly during the postdrome phase — closely resembles the malaise of a febrile illness. Sufferers often describe feeling as though they have been physically ill.
- Nausea and vomiting — These symptoms appear in both migraines and fever-producing illnesses, further blurring the line between the two experiences for people trying to identify what they are experiencing.
- Cognitive impairment — The confusion and difficulty thinking clearly that accompanies many migraine attacks also appears in high fevers, contributing to the overlap in perceived symptoms.
The Cleveland Clinic provides a comprehensive overview of migraine symptoms and notes that the condition can affect virtually every system in the body during a severe attack, which is why many sufferers describe migraines as a full-body experience rather than simply a headache.
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When to Be Concerned: Fever With Headache as a Warning Sign
This is the most critical section of this article, and it deserves careful attention. Sometimes a migraine is a sign of something more serious.
While migraines and fever frequently co-occur for the benign reasons described above, fever combined with severe headache can also be a symptom of serious and life-threatening conditions that require immediate medical attention.
The following conditions can present with both fever and severe headache and should never be dismissed as “just a migraine”:
Meningitis
Bacterial meningitis is an infection of the membranes surrounding the brain and spinal cord. It is a medical emergency. Its classic symptom triad is severe headache, high fever, and neck stiffness — sometimes accompanied by sensitivity to light, nausea, vomiting, and in serious cases, a distinctive rash.
The Centers for Disease Control and Prevention (CDC) emphasizes that bacterial meningitis can progress to life-threatening complications within hours. Anyone experiencing severe headache with fever and neck stiffness — particularly if those symptoms came on suddenly — should seek emergency medical care immediately.
Encephalitis
Encephalitis is inflammation of the brain itself, usually caused by a viral infection. Symptoms include fever, severe headache, confusion, seizures, and altered consciousness. Like meningitis, it is a medical emergency.
Sinusitis
Severe sinus infections can produce significant head pain alongside fever. Unlike migraines, sinus headaches typically produce pain and pressure concentrated around the forehead, cheeks, and eyes, and are accompanied by nasal congestion, facial tenderness, and discolored nasal discharge. Distinguishing between a sinus headache and a migraine can be difficult, and a fever helps point toward an infectious cause.
COVID-19 and Other Viral Illnesses
Headache is one of the most commonly reported symptoms of COVID-19 and many other viral illnesses, and these infections frequently produce fever alongside it. The World Health Organization (WHO) notes that headache disorders are among the most common disorders of the nervous system and can be significantly exacerbated by systemic illness. For migraine sufferers who develop what feels like a migraine alongside a fever, considering an infectious cause is always appropriate.
How to Tell the Difference
If you experience fever alongside a headache, the following factors can help you assess what you are likely dealing with:
- Known migraine history — If you have a well-established pattern of migraines and your current attack closely resembles your typical attacks in character and progression, an infectious cause is less likely — though not impossible.
- Fever severity — True fevers in the context of serious conditions like meningitis tend to be high and rapidly progressive. A very slight temperature elevation during what feels like a migraine attack is less alarming than a temperature of 103°F or higher.
- Neck stiffness — This is the single most important distinguishing factor. Neck stiffness that makes it painful or impossible to touch your chin to your chest alongside fever and headache is a medical emergency until proven otherwise.
- Sudden onset — Migraines typically build over time through their phases. A headache that reaches maximum intensity within seconds or minutes — sometimes described as a “thunderclap headache” — is a medical emergency regardless of fever, as it can indicate a brain bleed. The American Headache Society recommends immediate emergency evaluation for any thunderclap headache.
- Response to migraine medication — If your usual migraine treatments provide relief, an infectious cause becomes less likely. Headaches caused by meningitis or encephalitis do not respond to migraine medications.
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Managing Fever-Like Symptoms During a Migraine
For migraine sufferers who experience temperature dysregulation, chills, sweating, or subjective fever sensations as part of their attacks, the following management strategies may help:
- Stay hydrated. Dehydration worsens both migraines and temperature dysregulation. The Harvard T.H. Chan School of Public Health recommends consistent fluid intake throughout the day — not just during an attack — as a foundational strategy for overall neurological health.
- Rest in a temperature-controlled environment. Extremes of heat or cold can worsen both migraine symptoms and the discomfort of temperature dysregulation. A cool, dark, quiet room remains the standard recommendation for migraine management.
- Cool compresses. Applying a cool, damp cloth to the forehead or back of the neck can help manage the sensation of heat and provide comfort during an attack.
- Track your symptoms. Keeping a migraine diary that includes temperature readings when you feel feverish can help you and your doctor identify whether you are experiencing true temperature elevations or subjective fever sensations — and can support more accurate diagnosis and treatment.
- Discuss with your doctor. If fever-like symptoms are a consistent part of your migraine attacks, discussing this with a neurologist or your primary care physician is worthwhile. It may influence your diagnosis, your treatment plan, and the monitoring approach your doctor recommends.
The Bottom Line
So — can migraines cause fever? Migraines do not typically cause a true clinical fever, but they can cause very real fever-like sensations through autonomic nervous system disruption, hypothalamic involvement, and neuroinflammation. Additionally, fever-producing illnesses are well-established migraine triggers, meaning the two conditions frequently occur together.
For most migraine sufferers, experiencing warmth, chills, or a general sense of feeling feverish during an attack is a known — if uncomfortable — part of the experience. However, fever combined with severe headache is also a potential warning sign for serious conditions including meningitis and encephalitis that require immediate medical attention.
When in doubt, always err on the side of caution. If your headache and fever feel different from your usual migraine pattern, if neck stiffness is present, or if symptoms are rapidly worsening — seek medical care without delay.
This article is intended for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional regarding any medical condition or symptoms you are experiencing.
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