What are the Main Types of Migraines?

Migraine attacks might be labelled under a common name, but there are several different types with a variety of aggravating symptoms that can be used as clues in finding a treatment protocol.

Once the type of migraine is identified — including the specific symptoms that accompany that type — there are ways to avoid the triggers that bring on the migraine attack as well as lessen its duration and frequency. 

These are the primary types of migraines and the symptoms common to their attack:

Migraine Without Aura

This type of headache is usually on one side of the head with a throbbing or pulsating pain. The most identifiable characteristics of this type of migraine include:

  • It may occur anything from once a year to several times per week
  • Between 70-90% of people with migraine experience this type
  • It may last between 4 and 72 hours if left  untreated or unsuccessfully treated
  • The sufferer will likely feel sick and may vomit or have diarrhoea
  • The sufferer may also become sensitive to light (photophobia) and/or sound (phonophobia)

Migraine without aura often affects normal daily life and will worsen with everyday exercise.

Migraine With Aura

People who suffer this migraine type will have many or all the symptoms of a migraine without aura and additional neurological symptoms which develop over a 5- to 20-minute period and last less than an hour. The most identifiable characteristics of this type of migraine include:

  • Frequency can vary anywhere from once a year to several times per year
  • 10-30% of people with migraine experience this type
  • Blind spots in the field of eyesight and/or temporary blindness
  • Coloured spots and/or sparkles or stars
  • Flashing lights before the eyes
  • Tunnel vision and/or zig-zag lines

Some neurological symptoms usually happen before a headache — which could be mild, or no headache may follow. Speech and hearing can be affected and some patients have reported memory changes, feelings of fear and confusion and, more rarely, partial paralysis or fainting.

Chronic Migraine

A chronic migraine is diagnosed as experiencing more than fifteen headache days per month over a three month period of which more than eight are migrainous, in the absence of medication. The most identifiable characteristics of this type of migraine include:

  • Between 2.5 and 4.6% of people with episodic migraine experience progression to chronic migraine
  • Some patients have defined triggers such as caffeine, bright lights, hormone, food or sleep deprivation
  • Up to 73% of chronic migraine patients overuse headache medications
  • Patients with chronic migraine are nearly four times more likely to end up visiting the accident and emergency department in any three month period

Chronic migraine is a distinct type of migraine that is sometimes progressive. It’s important to recognize how often everyday life is disrupted by migraine and keep a record of how many days per month you have a headache.

Menstrual Migraine

Menstrual migraine is associated with falling levels of oestrogen and is most likely to occur in the two days leading up to a period and the first three days of a period. The most identifiable characteristics of this type of migraine include:

  • This type of migraine is thought to affect fewer than 10% of women
  • Causes might be the withdrawal of oestrogen as part of the normal menstrual cycle and/or the normal release of prostaglandin during the first 48 hours of menstruation.
  • Taking an anti-inflammatory painkiller such as mefenamic acid could help

There are no tests available to confirm the diagnosis, so the only accurate way to diagnose menstrual migraine is to keep a diary for at least three months recording both your migraine attacks and the days you menstruate.

Vestibular Migraine

Vestibular migraine is a type of migraine where patients experience a combination of vertigo, dizziness or balance problems with other migraine symptoms. The most identifiable characteristics of this type of migraine include:

  • The symptoms of vestibular migraine are vertigo or dizziness alongside other migraine symptoms such as headache, nausea, sensitivity to light and sound and aura
  • This type appears in at least five episodes with a present or past history of migraine
  • Vestibular symptoms (vertigo or dizziness) lasting between five minutes and 72 hours
  • The concurrence of migraine headache or other migraine-associated symptoms in at least half of the episodes.

Treatment of vestibular migraine is similar to that of other types of migraine, with special focus on standard migraine preventive medications,

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