Types of Migraines
September 11, 2024
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Exploring the various types of migraines, from migraines with aura to abdominal migraines. Understand the types of migraines, their symptoms and their effects.
Types of Migraines and Symptoms
Migraines are marked by an intense pulsing or throbbing on one side of the head, usually accompanied by headaches. Some types of migraines are accompanied with auras while others aren’t. Some migraines are temporary, where attacks emerge and disappear during a phase (like pregnancy, for example), while others are long-term. Some migraines hurt behind the eye while others might render one side of the body motionless. There are many kinds of migraine, each with its own characteristics, symptoms and discomforts. Today, while there is no cure for migraines, there are many ways to achieve significant symptomatic relief.
Migraines affect women more commonly than men, significantly impacting daily life. Global studies have shown that people with migraines have reduced productivity at work and in the household. Studies have also highlighted how people with migraines find it harder to commit to personal hobbies. To make matters increasingly difficult, migraineurs are more prone to disruptions in social activities and even the ability to undertake everyday activities like driving. Consequently, sleep or mental health are also significantly affected due to the condition. Despite the incapacitating impact of migraines on large populations worldwide, they remain underdiagnosed and undertreated. Treating migraines effectively often requires a multifaceted approach, but it starts with identifying and understanding the type of migraine one might have to ensure effective treatment intervention… let’s review the different types of migraines below…
Common Migraine or Migraine without Aura
The most frequent type of migraine, accounting for an estimated 75% of cases, is migraine without aura. Symptoms include headaches, increased sensitivity to light and/or sound, nausea, vomiting and increased pain with movement. Headaches of this type last anywhere from 4 to 72 hours, usually with two or more symptoms mentioned above. Children more commonly experience pain in both sides of their head while one-sided headaches occur in one’s late adolescence and adulthood. Migraine without aura is most likely to aggravate with symptomatic medication, stressing the need for therapeutic alternatives with fewer side effects.
Migraine with Aura
Though less common, accounting for approximately 12% of migraine cases, migraine with aura can last anywhere from a few hours to a few days. Migraine with aura comes with sensory symptoms, namely visual disturbances, speech difficulties, motor irregularities and auditory disturbances. Auras might present themselves as positive or negative symptoms. Positive symptoms feel like a sense (hearing, sight, speech, etc.) is being stimulated, like the introduction of bright lights, lines or shapes in one’s field of vision, while negative symptoms feel like a sense is being subdued or dulled, like hearing loss, numbness or immobility. Migraine with aura usually starts with sensory auras and then develops into the headache phase, replicating many of the common migraine symptoms, like throbbing in one side of the head. Auras might last well into the headache phase and linger after a headache has passed too.
Retinal Migraine
Also known as ocular migraine, retinal migraines are characterised by loss of vision accompanied by a headache usually an hour post the onset of visual symptoms. Symptoms include loss of vision in one or both eyes, blind spots, flashes or sparkles of light and other positive or negative visual symptoms. Visual symptoms increase gradually 5 minutes into an attack and can last up to 60 minutes. Retinal migraine is often triggered by caffeine, alcohol, smoking, stress and heat.
Hemiplegic Migraine
Hemiplegic migraines are rare, with motor symptoms like motor weakness or poor muscle control. Those suffering from hemiplegic migraines often face other aura symptoms like visual disturbances or speech impairment. Motor and other aura symptoms are fully reversible, usually lasting about 72 hours, though in rare cases motor symptoms might last up to a few weeks. Motor symptoms associated with hemiplegic migraines are usually unilateral, developing within the first 20 to 30 minutes of a migraine attack. The headache phase of hemiplegic migraines more commonly occurs after the auras have passed but might start alongside auras in some cases.
Basilar Migraine
It was previously believed that this kind of migraine developed from disturbances in the vertebrobasilar circulation, hence christened basilar migraine, but more recently it has been attributed to irregularities in nerves in the brainstem. According to the International Headache Society, basilar migraines, now more appropriately referred to as migraine with brainstem aura, originate directly from the brainstem but do not have any motor or retinal symptoms. Symptoms include vertigo, tinnitus, difficulty speaking, ataxia or double vision. Aura symptoms in this migraine can last for a few minutes to an hour followed by a headache at the back of your head that can last from anywhere between a few hours to a few days.
Status Migrainosus
Status migrainosus is a complication that lasts for over 72 hours, with symptoms usually significantly worse than other types of migraines. Status migrainosus comes with or without aura symptoms, but must be unremitting for at least 72 hours to be diagnosed as such. This type of migraine is often caused by medication overuse, underscoring the importance of finding non-intrusive therapeutic options for symptom relief. Someone suffering from status migrainosus is usually dealing with debilitating symptoms, making natural alternatives with little to no side effects a promising avenue of medical intervention.
Vestibular Migraine
Vestibular migraines come with vertigo and dizziness. Vertigo is the feeling of movement, despite being in a motionless state. The type of vertigo associated with vestibular migraines is, as patients describe it, “to and fro”. Vertigo symptoms in vestibular migraines might last from seconds to days, along with dizziness, imbalance or disorientation. People with vestibular vertigo are more likely to be susceptible to motion sickness. This type of migraine can be distinguished from basilar migraines as only a few people with vestibular migraines achieve relief from vertigo-related symptoms in the first hour of an attack. Vestibular migraines can last anywhere from 5 minutes to 72 hours.
Abdominal Migraine
Most commonly affecting children, abdominal migraines are characterised by pain in the abdomen or belly. Symptoms include stomach pain, nausea and vomiting. An abdominal migraine can last anywhere between an hour to 72 hours. A cause for abdominal migraines is believed to be disruptions in the gut-brain axis. While abdominal migraines are usually marked by pain in the abdomen, children with abdominal migraines have also reported hypersensitivity to light or sound and acute headaches. Though rare in adults, there are cases of adults suffering from abdominal migraines as well.
Cluster Headaches
Cluster headaches are often confused as a kind of migraine. People might refer to it as cluster migraines or cluster migraine pain but really are referring to cluster headaches. Cluster headaches are rare but are one of the most severe types of headaches. They are short-lived headaches and affect only one side of the head. Other symptoms include a sudden onset of pain behind the eye, nasal congestion, watering eyes and restlessness. Though not a migraine, it is important to find effective treatments for cluster headaches as the symptoms can be debilitating. For anyone mistakenly searching for “treatment of cluster migraines”, there are a range of over-the-counter analgesics or natural alternatives with little to no side effects available today.
Treating Migraines Effectively
People often choose common over-the-counter migraine medications. Some people might use paracetamol or aspirin, like Panadol or Excedrin, to reduce migraine pain. More and more people are choosing natural remedies and alternatives to get symptomatic relief from migraines these days, so as to avoid side effects like nausea or drowsiness associated with common over-the-counter medications. Eventually, working with a physician to understand what type of migraine you suffer from and tackling it appropriately is crucial. Whether it’s lifestyle modifications or natural remedies like cannabinoid medication, there are plenty of ways to tackle the many kinds of migraines out there.