06/05/2023
Feeling dizzy? Seeing twinkling lights? Having a terrible headache? You may be experiencing migraine, but what kind?
By Hida Nierenburg, MD, Neurology and Headache Medicine, Nuvance Health
If you have experienced migraine, you know it is more than a bad headache. While severe head pain is a hallmark of migraine, the neurological disorder can also cause a variety of symptoms depending on the type.
Understanding the type of migraine can help you manage triggers and find the right treatment in order to decrease how often they happen.
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What is migraine?
A common misconception about migraine is that it is just a more severe headache. However, migraine is a neurological disorder caused by changes in brain activity, arteries, chemicals and nerve cells.
Migraine can be debilitating because it prevents someone from participating in their usual activities. In fact, it is considered one of the main causes of disability worldwide. Migraine typically affects people in their productive years and can be a chronic illness similar to other conditions such as diabetes.
Migraine occurs in four phases that have unique symptoms and warning signs. Yet, not everyone with migraine will experience all four phases. Learn about the four phases of migraine: Prodrome, aura, headache and postdrome.
What is episodic migraine?
Episodic migraine is diagnosed when someone has 14 or fewer migraine attacks per month. Classic migraine symptoms are:
- Dizziness
- Fatigue
- Intense headache
- Nausea
- Sensitivity to light, sound or smells
- Visual disturbances (aura)
- Vomiting
What is chronic migraine?
Chronic migraine occurs when someone has more than 15 headache days per month for three consecutive months, with migraine attacks on eight of those days. Chronic migraine may worsen if it is not managed properly, which can make it more difficult to treat.
Someone with chronic migraine may benefit from preventive treatment in addition to avoiding triggers and rescue medication.
Related content: How to tell the difference between headaches and migraines
What is migraine with aura?
Aura is the second migraine phase, which can last five to 60 minutes. Aura can cause stroke-like symptoms including visual disturbances, temporary loss of sight, speech disturbances and numbness or tingling in the body. A migraine usually occurs after aura ends.
Related content: Women have a higher risk for stroke, here’s why
What is migraine without aura?
Some people may get migraine without aura. Signs of migraine may include pulsing or throbbing pain on one side of the head, sensitivity to light (photophobia) or sound (phonophobia), or pain that worsens during physical activity. Nausea and vomiting are also symptoms of migraine without aura.
What is a hemiplegic migraine?
Hemiplegic migraine is very rare. Someone with this type of migraine may experience classic migraine symptoms plus weakness on one side of their body (hemiplegia). This type of migraine can run in families. Genetic testing is currently only available for hemiplegic migraine.
Weakness on one side of the body is also a sign of stroke, which is a medical emergency. Call 9-1-1 if you are experiencing sudden weakness on one side of your body.
Related content: Should you go to the emergency department for a headache or migraine?
What is a retinal migraine?
A retinal migraine, also called an ocular migraine, causes visual disturbances in only one eye before the headache phase of migraine. This type of migraine is different from migraine with aura because the visual disturbances are coming from the eye. Visual disturbances from migraine with aura come from the brain. Visual problems from a retinal migraine may include:
- Decreased or lost vision (scotoma)
- Seeing twinkling lights (scintillations)
- Temporary blindness
What is a vestibular migraine?
Vestibular function has to do with the inner ear and sense of balance. Symptoms associated with vertigo occur during a vestibular migraine. In fact, vestibular migraine is the second-most common cause of vertigo in adults.
Someone experiencing a vestibular migraine may feel like they are falling, moving or spinning even though they are sitting still. They may also feel like their surroundings are moving around them, and objects may appear larger or smaller than they really are.
Interestingly, headache is not always present during a vestibular migraine. Further, many people with vestibular migraine have a history of motion sickness.
What is a menstrual migraine?
A menstrual migraine occurs around the same time of a woman’s period. Changes in estrogen levels during a menstrual cycle most likely cause this type of migraine. Someone with menstrual migraine may be able to prevent it with proper medication because they are predicable given they might occur every month during a women’s reproductive years.
How to make migraine go away
A headache specialist can accurately diagnose migraine and provide effective management options for the specific type. A headache specialist can help you:
- Understand the type of migraine
- Identify and avoid triggers
- Develop a prevention and treatment plan that may include medications or other therapies such as injections, dietary supplements called nutraceuticals, and wearable devices called electroceuticals.
The bottom line: Knowing the type of migraine can help you manage and treat it as best as possible. A headache specialist can help determine the type of migraine and develop a prevention and treatment plan that is right for you.
Learn more about headache and migraine care at the Nuvance Health Neuroscience Institute.