Many people assume there’s just one single type of migraine, but in fact, there are many different types of migraine and migraine variants. The 2 most common ones are classic migraine and common migraine. These are also referred to as migraine with aura (classic) and migraine without aura (common).
Classic Migraine – Classical migraine has been described as a familial disorder characterized by recurrent; attacks of head pain, often on one side (often two sides in children), that varies in intensity, frequency, and duration and accompanied by aura. The aura associated with classic migraines are visual hallucinations such as jagged lines or being partially blinded in one or both eyes, disruptions in sight, smell or touch, or even speech. The aura actually serves as an early warning sign.
Common Migraine – Most people with migraine have common migraine or migraine without aura. This type of migraine causes a throbbing pain on one side of the head. The pain is moderate to severe and gets worse with normal physical activity. You may also have nausea and vomiting and may feel worse around light and sound. The headache lasts 4 to 72 hours if it’s not treated. A common migraine doesn’t begin with an aura.
Hormones & Migraine
Headaches in women, particularly migraines, have been related to changes in the levels of female hormones estrogen and progesterone before, during, and after a woman’s menstrual cycle. Estrogen, progesterone, and even testosterone levels can fluctuate significantly a few days before and after menstruation, leading to migraines. Women approaching menopause can also experience hormonally-related migraine.
Menstrual Migraines – Fueled by the drop in estrogen levels just prior to menstruation, true “Menstrual Migraines” occur at the time of menstruation. “Menstrually Related Migraines” occur throughout the menstrual cycle. They are often more severe, last significantly longer, and are more resistant to treatment than the usual non-menstrual migraine attacks. Menstrual migraines are now considered a separate disorder from other types of migraine.
RARER FORMS OF MIGRAINE
Retinal or Ocular Migraine vs. Visual Migraine– Not all migraine sufferers experience the head pain commonly associated with migraine attacks. Some people experience a type of silent migraine with visual disturbance but no head pain. “Ocular migraine” also known as “retinal migraine” is often confused with “visual migraine” which is a symptom of visual changes or vision loss resulting from the aura phase of the common migraine. Ocular or retinal migraines happen in the eye, so only affect the vision in that eye, while visual migraines occur in the brain, so affect the vision in both eyes together.
For people who experience ocular migraines, the visual changes are a little different and can be very frightening as they most often include temporary vision loss that can last up to an hour. Both ocular migraines and visual migraines can occur with or without a headache.
Hemiplegic Migraine – Hemiplegic migraine is a rare subtype of migraine with aura characterized by the presence of motor weakness (hemiplegia). Typically, migraine aura has visual symptoms as aura, but occasionally impairment of speech may also be seen. Symptoms of a hemiplegic migraine attack are similar to a stroke that typically includes sudden severe headache on one side of the head, weakness on one side of the body, ataxia (poor muscle control), and aphasia (speech impairment) which can last for hours, days or weeks, Hemiplegic migraine may run in the family (familial hemiplegic migraine) or occur sporadically in an individual (sporadic hemiplegic migraine). (1)
Nocturnal Migraine – Although nocturnal migraine is not a true migraine variant, it is unique in that it occurs during the middle of the night or the early morning hours. It is thought to be related to the circadian activation of certain neurotransmitters during sleep, which are known to trigger a migraine attack.
Basilar Artery Migraine (Migraine with brainstem aura or MBA) – This is a type of migraine that begins in the brainstem and includes aura, or preceding symptoms like vertigo, speaking and hearing difficulty, and loss of muscle control. A throbbing at the back of the head which can lead to dizziness and difficulty speaking occurs in this migraine form. (2)
Abdominal Migraine – This is a type of silent migraine with abdominal pain and typically no head pain. The pain usually causes nausea and vomiting and is most often seen in young children, but is starting to be recognized in adults as well. Abdominal migraines are diagnosed in children who meet these criteria:
- At least five attacks of abdominal pain that each last 1 to 72 hours
- Dull pain around the belly button, moderate to severe in intensity
- At least two of these symptoms: appetite loss, nausea, vomiting, pale skin
Abdominal migraines usually follow a pattern, same type of appearance, same time of day, and the same duration with the symptoms going away completely between migraine attacks.
USING A MIGRAINE DIARY or MIGRAINE TRACKER
A migraine diary is a tool for managing your migraines by tracking your symptoms and recording important facts about your migraines – before, during, and after they occur. Use this MIGRAINE DIARY or look up an application on your smartphone, to help you identify potential triggers and monitor the effectiveness of treatments and alternative therapies. The data you generate can also help your doctor correctly diagnose migraine or other disorders. Continue to record in the diary each migraine experienced.
To the Best of Health,
Curt Hendrix, MS, CCN, CNS
References:
(1) https://pubmed.ncbi.nlm.nih.gov/18405771/
(2) https://pubmed.ncbi.nlm.nih.gov/29939655/
