Types of migraines: which one do you have?

In one of my previous posts, I discussed the importance of accurate migraine diagnosis. This post outlines several types of migraines to give you an idea about the differences in symptoms. The treatments for them vary as well. In this article, I don’t list all possible types of migraine, which is why it is so important to talk to your doctor and determine which type of migraine you have. I also provide a little personal perspective on some of these types because I suffer from them and have firsthand experience as a patient.

Migraine without aura

This is the most common one of all types of migraines. Aura is like a heads-up sign before the pain comes. A migraine without aura doesn’t have that phase. See here all four phases of migraine and associated symptoms.

The most common symptoms are

• Throbbing pain, often on one side of the head and face
• The pain often worsens with movement or activity which makes it hard to do any daily tasks
• Light, sound, and smell sensitivity
• Nausea and vomiting

Migraine with aura

In addition to causing throbbing pain in your head and face like a migraine without aura, a migraine with aura can also affect your sight and speech. Some patients feel confused, disoriented, and even faint, although rare.

The sight-related aura symptoms include:

• Seeing sparking spots, zig-zag-like light patterns, flashing lights
• Blind spots
• Temporary blindness

Other aura symptoms include:

• Tingling or pins and needles-like sensation in part of your body
• Muscle weakness
• Feeling off balance

Personal experience: I have an aura before the pain comes. It makes me feel especially clumsy, slower to react, and unable to focus. I also feel pins and needles in my face and arms, see little sparkly lights in my peripheral vision and become highly sensitive to smells.

This type of migraine has the symptoms outlined above plus the aura symptoms.

Chronic migraine

Defined as 15 days of migraine per month, 8 of which come with migraine symptoms and it has been going on for more than 3 months. It has all the episodic migraine symptoms like throbbing pain, nausea, and light & sound sensitivity but it happens very frequently. 

Personal perspective: From many types of migraines, this is a tough one because it hugely impacts the quality of life. This was the reason I started writing this blog – because I am re-engineering every aspect of my life to adjust to living with chronic migraines. 

There are acute and preventative medications as well as non-drug options for the treatment of chronic migraines like wearable devices, patches, acupuncture, massage, and biofeedback. I am taking acute abortive medications but only with a frequency that is allowed for them, so I don’t experience medication overuse, also known as rebound, migraine. Rest of my migraine days, I am using alternative methods for pain management and prevention. More on that in future posts.

Ocular/retinal migraine

This migraine involves a loss of vision in one eye for a period of less than an hour and is associated with a headache. It has similar causes as other types of migraines. There are subtypes of ocular migraine. Find out more here about the difference between ocular and retinal migraine for example. It is important to see your doctor because ocular migraine can mimic other serious conditions. A comprehensive eye exam with dilation, neurologic testing, blood work, and imaging may be needed to rule out any other serious issues.

Hemiplegic migraine

This is a rare and serious type of migraine during which the patients experience weakness on one side of the body along with headache. It is a subtype of migraine with aura. Muscle weakness during hemiplegic migraine can be so severe that it causes temporary paralysis on one side of your body. These feelings happen during the aura phase along with light, smell, sound sensitivity, and visual disturbances like seeing zig-zag lights and patterns.

The hemiplegic migraine symptoms include

• Throbbing pain on one side of the head
• Nausea and vomiting
• The trouble with muscle control
• Pin-and-needle feeling moving from hand to arm
• Numbness on one side of the body (arm, leg, face)
• Weakness or paralysis on one side of the body
• Slurred speech, confusion, and language difficulties.

Many symptoms of this type of migraine mimic those common to stroke. CT and or MRIs are often done to rule out stroke or any other serious conditions.

Menstrual migraine 

Menstrual migraine starts during or before your period. It is usually caused by a rapid drop in estrogen that happens right before the period starts. It has similar symptoms to migraine with or without aura. Often these migraines get worse during midlife.

Personal perspective: My migraines got significantly worse in my mid-40s and I get especially bad migraines before my period. Often the usual treatments didn’t work while I had the migraine attack. I was in menstrual migraine agony for 7 days a month in addition to my frequent migraines with aura. But you don’t have to suffer every month for several days in a row.  Luckily there are some newer approaches that help lower the intensity of the menstrual migraine. Taking certain acute abortive medication for 5 days leading to the start of the period seems to be effective for many women that suffer from this type of migraine. Here is a great article about this so you can learn more.

Vestibular migraine

I found a great definition of this type of migraine on the MigraineTrust website. “Vestibular migraine (also referred to as migrainous vertigo, migraine-related dizziness, vestibular migraine or migraine with prominent vertigo) is a type of migraine where people experience a combination of vertigo, dizziness or balance problems with other migraine symptoms.” Here is a link to the whole article outlining vestibular migraine symptoms and treatment options.

I will write a lot more about coping strategies for various migraine types.

Migraine Blog