The Ultimate Guide to Understanding Migraine Types

The Ultimate Guide to Understanding Migraine Types

Migraines are not just headaches but complex neurological conditions affecting millions globally. Understanding the various types of migraines is crucial in seeking effective treatment and managing symptoms effectively. This knowledge is essential, especially when considering the need for urgent medical attention, such as visiting an emergency room near you or an emergency room in Houston in severe cases.

Understanding Migraines

A migraine is more than a mere headache. It’s a severe, throbbing pain usually on one side of the head, often comes along with nausea, vomiting, as well as high sensitivity to light and sound. Unlike a regular headache, migraines can last hours to days, significantly impacting daily life.

Common Triggers and Causes of Migraines

Various factors, including stress, certain foods, weather changes, and hormonal fluctuations can trigger migraines. Genetic predisposition also makes some individuals more susceptible than others.

Types of Migraines

Migraine with Aura (Classic Migraine)

  • Description and symptoms: Migraine with aura, previously known as classic migraine, involves neurological symptoms called an aura that precede the headache. The aura symptoms can include visual disturbances like flashing lights, zigzag lines, blurring, and tingling sensations or speech disturbances. The headache phase brings moderate to severe throbbing pain which is typically felt on one side of the head. Nausea, vomiting, and sensitivity to light and sound often occur.
  • Typical aura experiences: The visual aura associated with classic migraines commonly appears as shimmering lights or flashing zigzag lines. It slowly expands outward into a crescent shape and usually lasts less than an hour. Some people experience tingling sensations, speech problems, or confusion during the aura phase. The headache begins after the aura symptoms resolve.

Migraine without Aura (Common Migraine)

  • Characteristics and how it differs from classic migraine: Migraine without aura was previously known as common migraine. Unlike classic migraines, no aura symptoms precede the headache, which begins suddenly. The pain is often described as pulsating and is typically severe enough to disrupt daily activities. Migraines without aura also cause sensitivity to light, noise, and smells. Nausea, vomiting, and increased urine production can occur.
  • Treatment is the same as for classic migraines, focusing on triggers avoidance, pain management, and preventive medications in severe cases. However, those with aura tend to have more frequent attacks.

Chronic Migraine

  • Definition and diagnosis criteria: Chronic migraine is defined as experiencing migraine headaches on 15 or more days per month for at least 3 months. At least 8 of those monthly headache days must involve classic migraine symptoms. Chronic migraines may evolve from episodic migraines that increase in frequency.
  • Treatment challenges: Treatment of chronic migraines aims to reduce the number of headache days and restore responsiveness to acute and preventive migraine medications. Identifying and avoiding triggers is especially important. Medication overuse headaches from painkillers can develop, which requires stopping painkillers and preventing rebound headaches.

Menstrual Migraine

  • Link with hormonal changes: Menstrual migraines are more frequent or severe migraines that occur in the few days before, during, or after menstruation. They are linked to hormonal changes during the menstrual cycle, especially declines in estrogen right before periods begin.
  • Specific symptoms and management: Menstrual migraines typically last longer with more intense pain and nausea. Preventive approaches include taking magnesium, riboflavin or NSAIDs starting a few days before a period. Hormonal birth control to stabilize estrogen levels may help. Triptans and analgesics can treat acute attacks.

Hemiplegic Migraine

  • Symptoms mimicking a stroke: Hemiplegic migraines are rare and involve temporary paralysis or weakness on one side of the body that resembles a stroke. They are accompanied by visual aura and numbness. Speech may be slurred and vision impaired on the affected side.
  • Diagnostic criteria and care: Hemiplegic migraines are diagnosed via symptoms, exams to rule out other causes like stroke, and family history. Rest in a quiet, dark room speeds recovery. Hydration, over-the-counter analgesics, triptans, and antinausea medication can relieve symptoms.

Vestibular Migraine

  • Connection with balance and dizziness: Vestibular migraines cause vertigo along with head pain and other migraine symptoms. They are tied to dysfunction in the inner ear’s balance system. Dizziness begins early in an attack and can linger for days after head pain resolves.
  • Management strategies: Vestibular rehabilitation therapy helps retrain the brain’s balance responses. Preventive medications include beta blockers, tricyclic antidepressants, and anti-seizure drugs. For acute attacks, anti-nausea drugs ease vertigo while triptans relieve head pain.

Ophthalmoplegic Migraine

  • Rare form affecting the eyes: Ophthalmoplegic migraine is an extremely rare type characterized by recurring pain around the eye along with drooping eyelids, double vision, and dilation of pupils. Nerves controlling eye muscles become inflamed.
  • Symptoms and treatment options: Ophthalmoplegic migraines usually start in childhood with headaches behind the eye. The ocular nerve paralysis develops within days. Steroids may reduce nerve inflammation while standard migraine treatments are used for pain, nausea, and light sensitivity.

Retinal Migraine

  • Visual disturbances and potential risks: Retinal migraines involve repeated episodes of visual loss or disturbances in one eye, like blind spots, flashes, or blurred vision. Headaches may not occur. Loss of vision in retinal migraines is temporary but can increase stroke risk.
  • Diagnosis and treatments: Other causes of visual symptoms like ischemia or ocular conditions must be ruled out. Treatments focus on reducing migraine frequency with medications and trigger avoidance to lower retinal migraine recurrence.

Status Migrainosus

  • Understanding this severe, prolonged type: Status migrainosus refers to a debilitating migraine lasting over 72 hours with severe pain and nausea that is unresponsive to treatment. It may arise from the overuse of pain medication. Vomiting is common and leads to dehydration, requiring ER treatment.
  • Immediate care and treatment approaches: Status migrainosus is considered a medical emergency. Treatment centers on IV fluids and medications like dihydroergotamine or corticosteroids to stop the attack. Pain and nausea drugs are given for symptom relief. Preventive therapy begins afterward.

Migraine with Brainstem Aura

  • Specific symptoms and risk factors: Migraine with brainstem aura involves neurological aura symptoms indicating brainstem involvement, like double vision, poor coordination, and vertigo. These migraines are more common in those under 30 and may raise future stroke risk.
  • Treatment and prevention: General migraine medications are used for acute treatment and prevention. Since symptoms mimic stroke, MRI or CT scans help confirm migraine diagnosis and rule out other conditions. Avoiding triggers is especially vital to minimize stroke chances.

Diagnosis of Migraines

Diagnosing migraines involves a thorough medical history and sometimes imaging tests to rule out other causes. Accurate diagnosis is key to effective treatment.

Treatment and Management

Treatment can vary from over-the-counter available pain relief medicines to prescription medications. Preventive measures, lifestyle changes, and home remedies are also effective. In severe cases, visiting an emergency room near you or an emergency room in Houston may be necessary, especially for conditions like hemiplegic migraine or status migrainosus, where symptoms are severe and debilitating.


Understanding different types of migraines is fundamental in managing this complex condition. If you or someone you know is suffering from severe migraine symptoms, it’s important to seek professional help. In cases where migraines become unbearable, seeking immediate care at a facility like Memorial Heights Emergency Center can be crucial for relief and proper management.


  1. What is the difference between a migraine and a headache?
  • A migraine is a severe, often one-sided pain, with additional symptoms like nausea and sensitivity to light, whereas a headache is less severe and lacks these additional symptoms.
  1. When should I visit an emergency room for a migraine?
  • If your migraine is accompanied by symptoms like severe dizziness, loss of vision, or symptoms resembling a stroke, it’s crucial to visit an ER near you immediately.
  1. Are migraines curable?
  • While there’s no cure for migraines, they can be still managed effectively with the right treatment and lifestyle adjustments.
  1. What is the difference between migraine with aura and migraine without aura?
  • Migraine with aura, also known as classic migraine, involves neurological symptoms like visual disturbances that serve as a warning before the headache phase. Migraine without aura, previously called common migraine, occurs without these warning aura symptoms.
  1. What are some of the rarer types of migraines?
  • Some rare migraine varieties include hemiplegic migraine with temporary paralysis, ophthalmoplegic migraine affecting the eyes, and retinal migraine involving vision loss. Vestibular and menstrual migraines are also less common subtypes.

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