I actually get the nausea and vomiting about 24 hours before the peak of the pain. Generally its the nausea and vomiting that make me think I'm pregnant. One of these days that will be the case lol.
But, this weeks episode started wednesday morning - woke up feeling REALLY nauseated, vomiting and other wonderful stuff that I won't go into

since it is a family forum...
But, wednesday afternoon, I fell at work, but didn't hit my head, just wrenched my already wrecked back, a few hours later, started getting the migraine. So about 5pm started getting the pain. Then started getting fever, chills etc.
Woke up thursday feeling kinda ok, till I started moving. Then it just rapidly declined while I was driving. Drove right past work (literally) called my boss, told him I was going to the ER.
I've had MRI's, EEGs, CT scans, other wonderful things where they stick electrodes to your head to measure brain activity.. nuttin. Still unknown. This past month has been bad, but most days I can kinda keep it in check. Thursday's episode though wasn't able.
Problem with certain antidepressants is that you can't take certain migraine medicationss (paxil & imitrex for example is a bad mix) because they can cause what they call a serotonin storm. Potentially fatal.
I'll keep trying. For now though, with all the issues with my back, migraines are a piece of cake.
Todd - I wish I could lay down, but with my migraines ANY kind of pressure on my head or hair is extremely painful. Light sensitive some times, sound sensitive the other times. But never both at the same time. But pressure sensitive all the time. Kinda funny when I can't even touch my hair without it hurting at times.