Types of Migraines

Migraine without aura is a type of headache pain that can feel like a severe pulsing or throbbing sensation, typically at one side of the head. For some people, the attack may be accompanied by nausea and/or light and sound sensitivity (but not the visual phenomena experienced by someone who has migraine with aura). A migraine attack can affect people of all ages, and may last anywhere from a few hours to days. Migraine pain and related symptoms have the potential to significantly disrupt the lifestyle of an affected person, particularly if they become chronic.

Migraine with aura is a type of migraine that can feel like a severe pulsing or throbbing sensation, typically at one side of the head. Most critical to a diagnosis of migraine with aura is a period of visual phenomena, immediately preceding the onset of head pain. For some people, in addition to visual disturbances, the attack may be accompanied by symptoms such as nausea and/or light and sound sensitivity. 

The frequency and severity of migraine differs from patient to patient. Episodic migraine is characterized by those with migraine who have up to 14 headache days per month; chronic migraine is characterized by 15 or more headache days per month. Chronic migraine is a severe and debilitating condition affecting around 2% of the population. 

There is little difference in migraine prevalence between males and females before puberty, but post-puberty, migraine disproportionately affects women. In many females, migraine is associated with the changes in female hormones that accompany the menstrual cycle; in fact, up to 2/3 of women report worsening migraine during their period. Menstrual migraine can be more severe and debilitating than typical migraine, lasting longer and featuring a wider array of symptoms.

‍Migraine with brainstem aura (MBA), formerly known as basilar migraine, is a rare form of migraine that starts at the lower part of the brain, the brainstem. Originally thought to occur during a spasm of the basilar artery at the back of the brain, it is now believed to be caused by a firing of nerves in the brainstem. 

Occurring in 30-50% of patients with migraine, vestibular migraine is characterized by symptoms of dizziness and vertigo. It is a somewhat underdiagnosed disorder — many areas of the brain play a role in balance and perception, resulting in slightly varied symptoms of vestibular migraine in different individuals. 

Intractable migraine (or status migrainosus) is characterized by an episode similar to typical migraine but with even more severe symptoms, lasting over 72 hours. According to the International Classification of Headache Disorders (ICHD-3), it is considered a “complication of migraine.” 

Silent migraine, known clinically as acephalgic migraine, is experienced by only about 1-3% of people with migraine. Although it can happen at any age, it occurs most commonly later in life, particularly by people who had migraine aura with headaches during childhood. A person with this type of migraine may experience certain symptoms such as visual aura, nausea, and photophobia but, critically, no related headache. 

Ocular (retinal) migraine is a rare form of migraine characterized by temporary loss of vision or blind spots, typically followed by migraine head pain about an hour later. Retinal migraine can be confused with the aura stage of migraine when visual symptoms can present as complex patterns. However, while aura generally affects both eyes, ocular migraine symptoms occur in one eye. 

Abdominal migraine is a rare form of migraine found in children between the ages of 6-12. It is distinctly characterized by episodes of pain in the abdomen that occur along with other migraine symptoms. 

A rare but serious form of migraine, hemiplegic migraine can cause muscle weakness on one side of the body. It can occur in conjunction with migraine aura, with other common symptoms including visual, speech, and sensory disturbances. The two common types are familial hemiplegic migraine (FHM), which tends to run in families, and sporadic hemiplegic migraine, when the person with migraine has no close relative who has experienced similar attacks.