What you need to know right up front is that different types of migraines require different treatment. It is essential to get the right diagnosis so you can treat your type of migraine effectively.
More attention is normally drawn to the pain and the symptoms... but you must know what you are treating so you can stop it from escalating. The faster... the better!
More than half of us women and even more men (70% in fact) who get migraines do not get diagnosed properly. How is this happening? Doctors have very little time allocated to migraine in their education... that's how.
It's important to note that this neurological disease is not just a bad headache that can be resolved by taking aspirin or over the counter painkillers alone. AND just so you know… if you have migraine with aura, some medications are actually dangerous for you to take. [3]
What are the different types of migraine headaches? Here's a list of the types I've already written about:
An Important Note: With any head pain, always consult your Medical Doctor for a correct diagnosis! Never delay a visit to the hospital or your physician. Equally important is that children's migraines and headaches have very different symptoms than adults.
So please be aware of this fact and click on the links to read about the different symptoms!
Many people think that migraines are simply a severe form of headache, they're not.
They are actually a completely different type of medical
affliction.
The reality is
that a migraine is a genetic and complex neurological disease with a very broad range of
manifestations.
There are many different types of migraines that affect
individuals, each one having their own trigger, symptoms, and preferable
treatment options. Click on this post what are migraines to learn more.
The classification system has changed recently. The International Headache Society’s ICHD-3 classification system, has been simplified imo. It's been classified based on how doctors diagnose and treat migraines, not on how you describe them based on when or where you get one or how it feels.
For example... these are not official migraine types anymore, according to the IHS:
But I will still use these terms. So let's get to the official types...
The two primary classifications of types of migraines seen in medical practices are migraine without aura (MWOA) and migraine with aura (MWA) (2).
Migraine without aura (MWOA - formerly called common migraine) is the most common type of migraine experienced.
Without aura means there are no early warning symptoms prior to the attack. The experience begins with a dull ache, throbbing or pulsating pain sensation on one side of the head and then develops into a full blown attack.
The pain is typically accompanied by a combination of sensitivity to: light and sound; nausea and vomiting.
Migraine with aura (MWA - formerly called classic or complicated migraine) is the second most common type experienced by approximately ¼ of us sufferers.
The aura has the same symptoms as migraine without aura but
is always accompanied by early warning symptoms including: visual
impairment, sensory illusion (olfactory, smell, taste) or motor skills
impairment lasting hours to days (in my case) before the migraine pain
phase begins.
Migraine without aura (MWOA) gives you very little warning and occurs in 80%-85% of migraineurs.
Only hours before the attack begins, you can experience the more commonly associated symptoms listed above along with these subtle symptoms not generally well known: anxiety, depression, fatigue or unusual tiredness.
I have to remind myself that these are symptoms of an impending attack and not just me being overly emotional, which I can be from time to time.
Here are a few examples of migraines without aura:
Abdominal Migraine (MWOA)
This is no longer a type, but it's classified under 1.6 Episodic syndromes that may be associated with migraine.
Abdominal Migraines generally affect children. The symptoms include abdominal pain, nausea and vomiting and normally pass quickly.
Typically, there will be a family history of migraines and they commonly develop other types of migraines as they get older. As they pass quickly, fast acting triptans may be the best strategy.
It might be worth considering a combination of daily
preventive medication and anti-nausea medications for your child to take
to effectively deal with their attacks.
Status Migrainosus (MWOA)
This is no longer a type, it's classified under Complications of Migraine as 1.4.1 Status migrainosus.
Status Migrainosus is "a rare and severe type of migraine that can last 72-hours or longer"(1). Hospitalization is often required to assist with the intense pain and nausea that come with this attack.
Dilated blood vessels in the brain caused here, increase the risk of stroke substantially making treatment more focused on stopping or aborting the entire attack as opposed to just pain reduction strategies.
Transformed Migraine (MWOA)
In the past, this term was used for attacks that became more frequent over a period of months and years.
The overuse of certain medications causing rebound headaches or withdrawal symptoms were considered to be a factor. The newer term for this is medication overuse headache (MOH) or rebound headache.
Treatment most often consists of trialing new medications or exploring other new solutions.
From the IHS classification ICHD-3:
Migraine with aura (MWA) gives you early warning signs and occurs in 20%-30% of migraineurs.
An aura can occur from one hour before the attack of the pain phase and last from fifteen to sixty minutes, but mine last for days before the pain episode strikes.
Similar to MWOA you can experience commonly associated symptoms like: anxiety, depression, and unusual fatigue.
Here are a few examples:
Acephalgic or Silent Migraine (MWA)
It
is possible to have migraine symptoms without pain. Learning this
surprised me, but I have now met several people who just get the zigzag
lines in their vision with no pain, and others who experience paralysis on one side of the body but no pain.
These are called Acephalgic or Silent Migraine and are terms used to describe types of migraines without pain as a symptom.
Other silent migraines include:
ocular, optical, and ophthalmic. Treatments for this type of migraine
vary but often: NSAIDs, triptans, and anti-nausea treatments are
recommended.
Migraine with Brainstem Aura - previously called Basilar-Type Migraine (MWA)
This is a rare form of migraine with an aura but with no weakness or motor function loss accompanying it.
It remains uncertain whether or not the basilar artery to the back of the brain is actually involved as it is also related to hormonal changes. Hence, it seems to primarily affect young adult women. (2)
The symptoms come from pressure changes around the brain stem and are more typically on both sides of the brain.
The aura symptoms that precede the headache can include: dizziness, vision and speech disturbances, loss of balance, confusion, ringing in the ears and tingling on both sides of the body.
During the attack, you might experience: temporary blindness, the inability to form words or speak properly, loss of consciousness or fainting.
These symptoms usually occur suddenly and typically last less than one hour. The pain phase that follows is then typical of a classic migraine attack. (2)
Hemiplegic Migraine (MWA)
Hemiplegic Migraine is rare and it is one of the more severe types of migraines.
You may develop some temporary motor paralysis (hemiplegia) and one-sided sensory or nerve disturbances in your body, like muscle weakness, immediately followed by the pain phase.
You might also experience some numbness or a pins-and-needles sensation. It can often resemble a stroke. The neurological symptoms disappear when the pain phase begins.
There is often family history with hemiplegic migraine and “in about 50% of these families, a chromosome defect may be found on chromosome 19 or on chromosome 1 and involves abnormal calcium channels.
A physician should be consulted for this type of headache. You should not take triptans if you have this type of headache.” (2)
"You should not take triptans if you have this type of headache." ~ headache.org
Ocular, Optical and Ophthalmic Migraine (MWA)
Ocular migraine has symptoms related to hearing problems;
Optical migraine has symptoms related to vision problems;
Ophthalmic migraine has symptoms related to extreme light sensitivity.
Other common symptoms include: localized pain around the ears or eyes, confusion, tingling of the skin, slurred speech, and for some, a headache.
Even though these are more rare types of migraines, the common triggers apply including stress and food reactions.
Recommended treatments for this type of migraine (at time of writing) include: NSAIDs, triptans, and when needed, anti-nausea treatments are advised.
However, please be aware that if paralysis in the muscles around the eyes is experienced – this is considered an emergency medication condition - the compression behind the eyes, this nerve pressure, could indicate an aneurysm.
Click here for more information on Ophthalmic migraine.
Retinal Migraine (MWA)
The symptoms of Retinal Migraines are usually a localized dull ache behind one eye and other visual disturbances like: zigzag lines, twinkling lights or an extended aura around lights, blurry vision or decreased functioning in some way.
I experience temporary tunnel vision - I can see around the edges of my eye but not in the middle. So there is a circle in the middle I cannot see.
Thank goodness this is temporary. The symptoms seem to go away or are reduced when the headache actually comes on. Or maybe that’s the ice pack doing its trick.
Retinal Migraines typically occur on one side of the head, so the pain or pressure is in one eye preceding the strong pain phase of the migraine.
So, some people have warning signals, but most do not. The usual medications are recommended for this type of migraine.
So now, to summarize, you know all about migraine with aura and migraine without aura... the other types are:
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Page Sources:
1. Migraine Headaches: https://women.webmd.com/guide/migraines-headaches-migraines.
2. Types of Migraines: https://www.headaches.org.
3. Dumas, P. (2015) 7 Types of Migraine: Which Do You Have? Available [online] at: https://migraineagain.com/10-types-of-migraine-which-do-you-have/