Different Types of Migraine

Migraine is a chronic neurological disorder that effects different people in different ways. In the this post we will look at several common types of migraine disorder. 

Classic migraine

Classic migraine is a clinical syndrome that is characterized by headache that is preceded by aura. It is also known as migraine with aura. The symptoms seen in aura include visual disturbances, nausea, difficulty speaking or alteration in sensation that can occur for up to an hour prior to the onset of headache. Prodromal symptoms are those that are seen a few days to a few hours before the onset of the headache. Symptoms can include changes in mood, tiredness, constipation or diarrhea and cravings for food. Once the prodromal phase and the aura have passed, the headache sets in which affects one half of the head. Patients may have blurring of vision, may see flashing lights or may even be sensitive to the lights. The pain can last for a few hours up to 2 to 3 days. Once the pain subsides, the post-migraine phase sets in. This is the recovery phase and patients can either be tired or relieved.

Silent migraine

This is an attack of migraine without the headache. Patients will still experience the prodromal symptoms and aura. It can be fairly difficult to diagnose.

Basilar migraine

Basilar migraine is also known as Bickerstaff syndrome. It is commonly seen in adolescent and young women. It is believed to occur due to a reduction in the amount of blood flow to the lower part of the back of the brain.

Patients who suffer from this form of migraine primarily experience dizziness, light-headedness and vertigo. These symptoms are typical of what is known as ‘vertebrobasilar insufficiency’. Along with this, they will experience headaches which are typical of migraine. Nausea and vomiting, double vision and altered levels of consciousness can also be seen. Some patients have also reported difficulty speaking (dysarthria) and episodes of collapse with loss of consciousness.

Retinal migraine

This condition is also called as ocular migraine or ophthalmic migraine. It is seen in younger adults and is characterized by the disturbance of or loss of vision in one eye. It is believed to occur due to the constriction of the blood vessels that supply the retina.

Typically, the onset of disturbance in the vision is visualized by the patient as a mosaic pattern which gradually enlarges to involve the entire field of vision. The episodes last from anywhere between a few seconds to up to an hour. Patients may or may not have headache associated with this. This combination of sudden loss of vision with or without associated headache is fairly diagnostic of retinal migraine. However, other causes need to be identified and hence forth further investigations will be required to confirm the diagnosis.

Hemiplegic migraine

This is a well-recognized form of migraine that typically presents as a headache associated with weakness of one part or one side of the body (called hemiparesis or hemiplegia). There may or may not be associated difficulty speaking during these episodes. Following the onset of symptoms, the weakness may resolve but the headache may persist for a period of time. Sometimes the weakness completely resolves before the headache even starts.

Broadly classified, there are two different types of hemiplegic migraine. Familial hemiplegic migraine is one that is carried through generations through a specific gene mutation. The second type is sporadic hemiplegic migraine which is similar to familial migraine but does not have the strong family history attached to it.  

Abdominal migraine

This is a form of migraine that is seen in children between the ages of 5 to 9 years, though it may be seen in adults as well. Typically, patients experience pain in their abdomen along with nausea and vomiting. The abdominal pain is central in location or around the navel, though sometimes it can be in the abdomen in general. It is described as a dull ache. The pain can last for up to 72 hours and can be rather distressing. There may or may not be associated aura.

Complicated migraine

This consists of a combination of different migraine conditions such as chronic migraine, migraine induced seizures and status migrainosus (continual migraine that does not go away). These conditions are fairly rare but still seen in patients suffering from migraine. Patients who have persistent aura will experience the typical aura for up to a few hours or even days (normally lasts up to 60 min). Patients who suffer from seizures due to migraine will experience them within an hour following the occurrence of migraine aura.

Nocturnal migraine

While not considered typical of migraine, nocturnal migraine is still considered as a clinical condition that causes headache in the middle of the night or first thing in the morning. It is believed to occur due to the release of certain neurotransmitters when the individual is asleep. These neurotransmitters are the ones that trigger the migraine.

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