Migraine Headache Types: When to Seek Emergency Care
Before Looking at Migraine Headache Types, Let’s Look at the Stats
As we have learned, up to 37 million of people in the United States, or 12 % of men, women in children, suffer from migraine. The numbers for the world aren’t far behind, with the World Health Organization reporting that 10% of the world have been diagnosed with migraines. That’s 1 in 10 people around the globe who suffer migraine. These numbers reflect the number diagnosed, and officials believe that is only half of the people who experience migraines have been diagnosed.
In fact, as many as 60% of men and 70% of women with migraine are not properly diagnosed and many more have yet to seek medical attention. That’s 2 in 10 people around the world or nearly 1 in 4 people in the US alone! If you’ve ever experienced one, you know it and perhaps you’ve been diagnosed. Migraine headaches aren’t all the same. Come along as I examine the different migraine headaches types as well as some headaches much like them.
Now that we know that you, or perhaps a loved one HAVE migraine headaches, you might be wondering if everyone experiences the same thing, or are there different types of migraine headaches? You might not be surprised to know that there are.
Migraine is a spectrum disorder, in that no two people experience the same symptoms and one person doesn’t necessarily suffer the same symptoms all the time. For example, you may experience aura with one migraine, but not the next. You may experience numbness and tingling in your right arm one time, but in the left the next time, and so on.
In this article I will discuss the types of migraine headaches and what the symptoms are of each. If you are keeping a headache journal, this article may help you and your doctor determine which type(s) of migraine you suffer from and then be able to tailor your treatment plan for each.
Now, let’s delve into the different types of migraine headaches. I have arranged them in alphabetical order. I have also included types of headaches that may or may not be types of migraine, but the implications are similar to those of migraine, as is the pain suffered by those who have them.
Abdominal Migraines is a type of migraine that affects children and can be quite distressing for them and their parents. The symptoms mimic other disorders and diagnosis consists of ruling out other causes altogether. The symptoms of an abdominal migraine are vomiting and dizziness with or without the headache pain which occurs roughly once a month. This being the case, diagnosis may take some time. It is easy to write off the symptoms of the first attack or two as the stomach flu or food poisoning, but repeated attacks will indicate something else going on.
A doctor will want you to keep track of the symptoms and may order blood tests along with imaging such as x-rays, CT scans and possibly sonogram studies and even an MRI studies to rule out other causes.
Brainstem Aura Migraines (formerly known as Basilar Migraines) also know as Bickerstaff Syndrome are one of the types of migraine headache that can be complex and frightening. They present mostly in children and adolescents, most often in teenage girls around their menstrual cycles.
The symptoms are centered around functions that are controlled by the brainstem and include pins and needles in the hands and feet, partial or total blindness in BOTH eyes that resolves after a migraine passes, slurred speech (Dysarthria), double vision in BOTH eyes, and vertigo (extreme dizziness with unsteady gait or loss of balance, as if drunk), ringing in the ears (tinnitus), and fainting. It will be accompanied by pain in the back of the head that can be on BOTH sides.
The symptoms present before the head pain and may persist throughout the head pain, resolving shortly afterward. While it does generally occur in children and adults, it is not unheard in adults, especially in young adults. Being specific about your symptoms in a journal will help distinguish this type of migraine from others which are similar.
Doctors will want to rule out damage or any organic issue within the brain, and will likely ask for imaging such a CT scans and MRIs before diagnosing Brainstem Aura Migraine
Cervicogenic Migraines, aka Cervicular Headaches, are not one of the migraine headache types, but are similar to migraines. They are caused by an organic lesion or injury to the neck or spine.
Symptoms generally relate to where the damage is located, and mimic those of migraine, but will be accompanied by considerable pain in the neck. Also, symptoms of aura do not recede with the head pain. The same is true of the neck pain, though relieving the neck pain usually relieves a headache.
If you are having symptoms of migraine with aura that is accompanied by neck pain, and if the aura does not go away with the head pain, you should see a doctor immediately! Diagnosis generally involves CT scans and/or MRI studies.
Cluster Headaches, aka Suicide Headaches, are believed by some authorities to be a migraine headache type, though not by others. They occur 6 times more often in men than women and strike 1 in 1000 people. Cluster Headaches are the most painful types of pain a person can suffer, thus their moniker as Suicide Headaches.
The pain most often occurs around an eye and is sudden, without aura and is accompanied by tears, runny nose (rhinitis) and red, swollen eyes. They last for 15 to 30 minutes and occur in clusters, therefore the name, and usually occur during the day. They will go on daily for weeks, perhaps months. They may go into remission, not happening for months or years, or perhaps never again. As with migraine, the cause is unknown. They are the least common type of headache. Diagnosis may or may not include tests to rule out other causes, as the symptoms are clear and reoccurrence is predictable.
Common Migraine (with and without aura) would be next in order of the migraine headache types and includes the classic symptoms of migraine. As I discussed in my introduction to migraine headaches, the classic migraine is one in which you experience a moderate to severe pain generally on one side of the head which is made worse when engaged in normal physical activity such as reading, walking or climbing the stairs. It may or may not be proceeded by Aura which would consist of symptoms including photophobia (sensitivity to light, phonophobia (sensitivity to sounds) and/or nausea or vomiting. In fact, 85% of people who experience migraine headaches of any kind experience the classic throbbing pain, 80% experience photophobia, 76% experience phonophobia, and 73% experience nausea and vomiting.
Your doctor may ask you to document your headaches in a headache or health journal which helps in the diagnosis of migraine. If your headaches are severe, then he/she may have CT scans or MRI studies or bloodwork done to rule out other causes.
Complex or Complicated Migraine is simply a migraine headache with the symptoms of a stroke such as numbness and/or weakness on one side of the body, difficulty speaking and the inability to move your arm, leg or both on one side of the body. These symptoms may appear in the aura stage and generally disappear within an hour after the pain has ended, though that may also take several days.
Complicated or Complex Migraine can occur with or without an actual infarction (loss of blood flow) to the brain. Symptoms will usually last longer with an infarction of the brain.
It is VERY IMPORTANT to seek medical help if you experience this migraine headache type! In the case of an infarction, it is imperative that you get treatment to prevent permanent damage. In fact, treatment for this type of migraine could prevent a lack of blood flow (infarction) to the brain.
Diagnosis would include CT scans and/or MRI studies of the brain done immediately after entering the emergency room. Treatment could include IV fluids or IV drugs to stop the migraine and to ensure that you remain hydrated, as dehydration can happen easily in migraines of any kind.
A Hemiplegic Migraine is a type of migraine headache similar to a Complicated or Complex Migraine as the symptoms are easily confused. A Hemiplegic Migraine is one that happens with paralysis to one side of the body along with visual disturbances.
Symptoms would include pins and needles and/or to the affected side, speech difficulties, visual symptoms and confusion. Unlike a Complicated Migraine, the symptoms described may occur before or after the headache pain. These symptoms can last up to an hour or may last for days, but usually, are resolved after 24 hours.
It is important that you get medical help right away in this type of migraine, so that a Complicated or Complex Migraine can be ruled out. You will notice that the only real difference in this type of migraine and Complex or Complicated Migraine is that in the Hemiplegic Migraine, you have visual symptoms not generally associated with the other. Diagnosis may include CT scans or MRI studies.
An Opthomologic (Retinal) Migraine is simply a kind of migraine headache with visual disturbances or the loss of vision in one or both eyes that resolves with the headache pain.
An Opthamomoplegic Migraine is rare and occurs in children or young adults. Symptoms of this kind of migraine include an intense pain behind both eyes, double vision and the paralysis of the eye muscles resulting in droopy eyelids. It is accompanied by vomiting and sometimes seizures. Medial attention should be sought in migraine of this nature because of the likelihood of seizures.
Menstrual Migraines are exactly what they sound like. They are any kind of migraine (with or without aura), that occur in the days before, during, or in the days following a woman’s menstrual cycle. They can begin in the teens and last through menopause. Keeping a good journal that includes your migraines as all as the beginning and end of you’re menstrual cycle will help in diagnosing this type of migraine.
Silent Migraines is a migraine headache type which occur when you have all the symptoms of you’re usual migraines without the debilitating pain of the migraine attack itself, including the fatigue and irritability and moodiness of the postdrome.
Sinus Headache is very similar to migraines in that the pain is severe and it occurs in one general place on you’re head. They are caused, however by colds, flu, and sinusitis, an infection of the sinus cavities, which are the spaces filled with air around and behind the eyes and nose. You may have pain on one side or both sides of your face depending on which side(s) are affected. The pain is usually helped by taking decongestants and/or antibiotics.
Sinus Headaches intensify when you move your head suddenly or strained. Another way to differentiate migraine from Sinus Headache is that Sinus Headache is accompanied by fever, runny nose, congestion and/or clogged ears. While having sinus issues can trigger your usual migraines, Sinus Headache itself is not a kind of migraine.
Status Migrainous is a condition in which a migraine headache has caused a patient to be hospitalized because of a migraine headache. Most cases or Status Migrainous occur because the migraine attack (or the pain of the migraine) has lasted for more 72 hours or more.
This happens because the pain is not relieved by the usual methods used in the emergency room treatment of a migraine. Commonly, the person suffering the migraine has also become dehydrated. Generally, further treatment includes measures that must be closely monitored or which result in the patient’s vitals to be continuously monitored. Not one of the migraine headache types, it is one of the complications of migraine.
Vestibular Migraine is, simply put, a migraine with dizziness that includes an extreme sensitivity to motion and movement (vertigo). Vestibular Migraines often do not always include the severe pain associated with many other types of migraine. The pain is either diminished or nonexistent Please note that does not exclude migraine attacks that are severe.
You may notice that I have not talked about Chronic Migraine. That is because Chronic Migraine is not a singular event. Chronic Migraine is when you experience 15 or more days in a month, for at least three months, where you have suffered 15 or more days when you experienced any of the four stages of migraine, or have suffered 8 or more migraine attacks, referring to the pain portion of a migraine
For those who have not read my introduction, Chronic Migraine interferes not only with your ability to work but also in your ability to care for yourself (bathe, cook, clean, get dressed). It is the point where you’re migraine is not just debilitating, but is disabling.
As you can see, there are many different types of migraine headaches as well as headaches sometimes confused as migraine. No matter what type of migraine you believe you may have, it is important that you seek the counsel of a doctor. Some migraines, as we have learned, are serious or can result in long-term problems.
When you see a doctor, it is important that you know what symptoms you have experienced. It is not always necessary to have kept a migraine journal, but symptoms are important. Knowing these symptoms helps you and your doctor to differentiate between a really bad headache and migraine headache types. Keeping a journal of your headaches and your migraines will help you and your doctor to determine what treatment is appropriate for you.
I hope that this article has been helpful to you. Now you understand what migraine headache types there are. Knowing the types of migraine headaches will aid you in finding the right treatment for yours and will help you know when to head to the emergency room.
Please come back often as I add more information on journaling, triggers, treatments and what you can do to ease your migraine suffering.
I welcome any thoughts, questions, comments or feedback. To continue the conversation, comment below.