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Migraines

Also called: Migraine Headaches

- Summary
- About migraines
- Types and differences
- Risk factors and causes
- Signs and symptoms
- Diagnosis methods
- Treatment and prevention
- Ongoing research
- Questions for your doctor

Reviewed By:
Vikas Garg, M.D., MSA

Types and differences of migraines

The two major classifications for migraines are:

  • Migraine without aura. Also known as common migraine, this type of migraine is characterized by a severe throbbing headache felt usually on only one side of the head. Additional symptoms may include nausea, vomiting, allodynia and sensitivity to light, sound and odors. It is the most common form of migraine.  

  • Migraine with aura. Also known as classic migraine, this type of migraine is similar to the common migraine except it is preceded by warning symptoms (aura) before the headache occurs. The aura usually presents as a visual disturbance that begins 20 to 60 minutes before the onset of the migraine, but can start up to 48 hours before.

Additional classifications include:

  • Complicated migraine. In some cases, warning symptoms (aura) are prolonged, or continue into or through the headache period.  This type of migraine is known as a complicated migraine. Forms of complicated migraine include:

    • Ophthalmoplegic migraine. During this migraine, patients develop a partial or complete paralysis of the nerves needed for eye movement. The pain typically surrounds the eye. Triggered by weakness of the muscles encasing the eyes, the pain can last anywhere from a few days to a few months. This is a rare form of migraine that most often occurs in children and young adults.  

      Eye Anatomy

    • Retinal migraine. Also known as an ocular or ophthalmic migraine, this type of migraine is characterized by multiple episodes of blind spots or blindness related to a headache. It differs from other forms of headache because the retina (light-sensitive tissue in the back of the eye) is responsible for the visual disturbances, not the brain.

    • Hemiplegic migraine. This form of migraine is characterized by numbness or tingling and temporary paralysis on one side of the body. Because of its similarity in symptoms to a stroke, individuals should seek immediate medical attention if they experience these symptoms.

      Although they occur rarely, hemiplegic migraines are considered one of the most severe forms of migraine. In some cases, it may take several weeks for a patient to recover completely. In addition, patients may suffer permanent weakness after multiple episodes.

      A rare type of hemiplegic migraine can be inherited. Known as familial hemiplegic migraine, this condition has been connected to mutations in genes on several chromosomes. Familial hemiplegic migraine is autosomal dominant, meaning it can be passed on to a child if only one parent has the abnormal gene.

    • Basilar migraine. Also known as Bickerstaff’s syndrome, this type of migraine is characterized by neurological symptoms related to the brainstem. It occurs as the result of a migraine affecting circulation in back of the neck or brain. Patients may experience headaches located at the back of the head, accompanied by numbness on both sides of the body and severe vomiting. Additional symptoms may also occur, including dizziness, double vision, loss of balance, confusion, slurred speech, disorientation, fainting and loss of consciousness. This condition occurs most often in children and young women.

  • Migraine equivalents. Also known as migraine variants, acephalgic migraine or simply migraine aura without headache, this rare type of migraine presents in a form other than head pain. A patient with a previous history of migraines may be diagnosed with this condition when the headaches have been replaced by an equivalent set of symptoms. A migraine equivalent may present in the form of visual abnormalities (e.g., blind spots), neurologic deficits or psychic disturbances without headache.

    A common form of migraine equivalent is the abdominal migraine. Also known as periodic syndrome, this form of migraine most often occurs in children. Patients usually have a family history of migraines, and they often develop typical migraines later on in adulthood. The condition is characterized by recurrent bouts of abdominal pain without headache. These episodes can last for a number of hours. The condition is often accompanied by nausea, vomiting, flushing and pallor (paleness). 

Additional terms used to describe migraines include:

  • Coexisting migraine and tension headache. Also known as transformed migraine, chronic migraine and chronic daily headache, this condition is characterized by the combination of a chronic tension–type headache and recurrent migraine headaches. In most cases, patients with this condition have a personal history of migraine headaches that can be traced back to adolescence or young adulthood.

  • Cyclic migraine syndrome. Patients with this syndrome usually have 10 or more migraines a month, which are accompanied by typical migraine symptoms. These headaches are not classified as cluster headaches because they are long-lasting and do not have symptoms typically associated with cluster headaches.

  • Menstrual migraine. This term may be used to describe migraines that occur during ovulation or before, during or immediately after a woman’s menstrual period.

  • Nocturnal migraine. This term may be used to describe migraines that occur during the middle of the night or in the early morning. Patients experiencing nocturnal migraines are often awakened by them. They may be caused by changes in the brain’s neurotransmitters that occur during sleep.

  • Status migraines. This term may be used to describe a migraine that continues for more than 72 hours.

  • Migraine with acute-onset aura. This term may be used to describe aura that fully develops in less than five minutes.

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Review Date: 01-19-2007
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