According to recent studies migraine is the third most common illness around the world. Roughly 39 million people in the United States and 1 billion people worldwide have migraine. Usually they feel pulsating or throbbing like headache in one side of head associated with nausea, vomiting and photophobia/ phonophobia. But some symptoms of migraine may be unique to particular people. For example every person with migraine are not having ‘Aura’. Because there are several types of migraine. Each type of migraine has their own symptoms.
Many patients are coming to hospital or outpatient clinics with headaches. Most of them are having episodic headaches. Out of them migraine is the most common episodic headache according to recent studies. 15-20% of women and 5-10% of men are suffering from migraine worldwide. Severity of migraine headache differs from individual to individual and from one attack to another. Frequent headaches severly affect day to day life of people.
Types of Migraine Headaches
As described earlier, there are several types of migraine. Sometimes, treatment of migraine may vary with the type of migraine you have. Let’s discuss types of migraine headaches. Try to find out that which type do you have.
1. Migraine without aura
This is the most common type of migraine headache. Also called as classical migraine. Almost 70% of people having migraine without aura. People usually feel severe throbbing type headache in one side of head which is associated with nausea and vomiting. The pain may worsen with movements. So it will affect your ability to do your normal routine activities. You may be also sensitive to light and sounds (photophobia and phonophobia). This headache may last around 4 hours to 4 days if not treated well.
Most migraine attacks are usually enough to keep people away from their normal activities. Sleeping usually helps to overcome the pain. So they prefer a dark, quiet environment.
Some patients recognize changes in their routine as trigger factors for migraine. Following are some examples;
- Too little or too much of sleep
- Stress
- Hormonal factors for women – oral contraceptive pills, menstruation and menopause
- Skipping meals and drinking alcohol
- Food items
- Bright lights, weather condition
2. Migraine with aura
Nearly 25% patients with migraine experience aura. Migraine aura includes temporary neurological disturbances that usually occur before other symptoms of migraine. Most of the time it is visual disturbances.
Migraine aura usually occurs half to one hour before migraine symptoms and may last up to one hour.
Visual aura is the most common type. You may feel temporary visual disturbances. Following are some examples;
- Blind spots
- Flashing lights
- Zig zag lines
- Vision loss
- Visual hallucinations
There may be other types of disturbances as well.
- Numbness or tingling sensation over the face or hand
- Muscle weakness
- Difficult to speak
- Stuffy or runny nose
- Dizziness
- Sensitive to sounds, touch, smell or motion
Migraine with brainstem aura is a condition associated with pain at the back of head on both sides, also called as basilar migraine.
3. Migraine aura without headache
Some people may experience all of above aura symptoms without headache. It is also called as silent migraine. In young adults it is easy to diagnose this silent migraine. But in elderly people it can be a stroke or transient ischemic attack (TIA). Because stroke or transient ischemic attack also having same kind of symptoms. So it is very important to diagnose properly. If it is really silent migraine they may have experienced it in their young age.
4. Hemiplegic migraine
People may develop weakness, numbness or pins and needle sensation over one side of the body. Usually it may be face, arms or legs.
Again this also may be mistakenly diagnosed as stroke. Because both conditions may present with same symptoms. So clinical examination and CT imaging is very important.
5. Chronic migraine
Chronic migraine is long term suffering from migraine headache. The exact definition is having frequent migraine attacks over 3 month period. These patients should take migraine preventive medications.
6. Ocular or retinal migraine
Patients develop vision loss with typical migraine symptoms. This is called ocular or retinal migraine. But this is not a very common type. The vision loss may be partial or complete. Usually it lasts around 10 to 20 minutes. Patients with ocular or retinal migraine can have symptoms every months. Usually the same eye is affected all the time.
Exact cause for retinal migraine is unknown. But many clinicians believe that it may be due to reduced blood supply or spasms of retinal blood vessels.
7. Abdominal migraine
Abdominal migraine is a kind of migraine with abdominal pain, nausea and vomiting. The difference is that it does not have typical migraine headache. Instead of migraine headache pain it comes with a severe abdominal pain. Abdominal migraine is more common among children. Patients may usually feel recurrent episodes of moderate to severe stomach pain which last for between 1 to 72 hours.
Abdominal migraine is quite a common condition among children. It affects every 4 in 100 children around the world and also some adults. As children are having trouble to describe the symptoms it take years to diagnose properly.
Some factors can trigger abdominal migraine. Food habits, stress, dehydration and traveling are some examples. Treatment options are same as the typical migraine headache.
8. Vestibular migraine
Vestibular migraine is another rare type of migraine headache. Other than typical migraine symptoms you may have vestibular symptoms. Vestibular symptoms are dizziness or vertigo, unsteadiness and loss of balance and motion sensitivity.
Exact cause for vestibular migraine is unknown. But most of the time it runs in family. Like typical migraine headache, vestibular migraine is also more common among women. And symptoms may get worse after menstruation.
Treatment for vestibular migraine is similar to that of typical migraine headache.
Other types of migraine headache
Other than above mentioned types of migraine headache, there are some other types. But they are very rare.
- Ophthalmoplegic migraine can cause pain around the eye with migraine symptoms.
- Status migrainosus is a severe type of migraine which can last more than 72 hours. You must go to a hospital at this condition. Because there are many other diseases to be excluded.
Finally as a summary, there are several types of migraine headache and they have some unique symptoms. It is very important to identify the correct type of migraine before starting treatments.