Almost 38 million Americans get migraine attacks. They usually feel pulsing or throbbing on one side of the head. They can also cause nausea, vomiting, and sensitivity to light and sound. And they can be much more severe than other headaches.
But migraine attacks aren’t all alike. Yours might be very different from someone else’s.
With or Without Aura?
The two major categories are migraine with aura (once called "classical migraines”) and migraine without aura (formerly known as "common migraines”).
"Aura" usually includes visual symptoms like lines, shapes, or flashes. You may even lose some of your vision for 10 to 30 minutes. You could also feel tingling in your arms and legs. Auras can even affect smell, taste, touch, or speech.
Aura happens to about 1 in 4 people who get migraine headaches. It usually starts before the head pain begins and lasts up to an hour.
There are also several migraine subtypes.
With Brainstem Aura
This used to be called basilar type migraine. It includes visual, sensory, or speech or language symptoms and at least two of the following: slurred speech, vertigo (a sensation of spinning or dizziness), tinnitus (ringing in the ears), double vision, unsteadiness, and severe sensitivity to sound.
Episodic
This is the general pattern for most people with migraine. It means you get migraine attacks from time to time – up to about 7 days out of the month. In general, if you have a headache or migraine attack on more than 7 days out of the month, you may have a more serious form of migraine-like high-frequency episodic migraine or chronic migraine (see below).
High-frequency episodic
This pattern of migraine means you have 8 to 14 headache days per month with at least some migraine symptoms. It also makes you more likely than others to develop
chronic migraine.
Chronic
This is a headache that happens 15 or more days a month for more than 3 months. It includes migraine symptoms on at least 8 of those days each month.
Hemiplegic
This word means "paralysis on one side of the body." The aura that comes along with these headaches causes temporary (less than 72 hours) weakness on one side of the body. The aura symptoms usually go away within 24 hours.
The symptoms are very similar to a stroke but cause no lasting nerve damage.
Still, don't diagnose yourself! If you have symptoms of hemiplegic migraine, get medical help right away to rule out a stroke.
Migraine Without Headache (Silent Migraine)
Yes, you can have a migraine without head pain. It's often called a "silent" migraine.
Aura is usually the main warning sign of this type of migraine. But you may also have nausea and other migraine symptoms. It usually lasts only about 20-30 minutes.
Abdominal Migraine
An abdominal migraine affects your belly instead of your head. The symptoms include:
Stomach pain
Nausea
Appetite loss
Vomiting
Adults can get abdominal migraines. But they usually affect children who also have regular migraines, or who have relatives with migraines.
Doctors don't know what causes them. But they share some of the same triggers as regular migraines. And migraine medications can work to treat them.
Menstrual These usually happen 2 days before the start of a woman’s period and last through 3 days after. Women who get these may also have other kinds of migraine headaches at other times of the month, but the migraine around menstruation is usually without aura.
Ocular (or Retinal) This form of migraine is very rare. It involves seeing colors, flashing lights, or other visual changes, including the loss of some or all vision in one eye. The visual loss should last less than an hour and be followed by a typical migraine headache. However, other serious conditions can cause sudden loss of vision in one eye, so go to a doctor right away if you have vision changes.
Vestibular With this type of migraine, you also get vertigo. The spinning sensation usually lasts a few minutes to hours.
Status Migrainosus Ongoing pain -- lasting longer than 3 days -- is a trait of status migrainosus. It can be caused by some medications or medication withdrawal.
The pain and nausea from this type of migraine can be so intense that you need hospital care. Get help right away if so.
Ophthalmoplegic Migraine
If you have pain and weakness around your eye, you need medical help right away. Rare symptoms like these may be due to ophthalmoplegic migraine -- what's now known as neuralgia -- or a more serious condition. Ophthalmoplegic migraines often last a week and may cause a droopy eyelid, double vision, and other eye changes.
When to Call the Doctor
Call your doctor right away if you have:
A change in migraine features, how often a migraine happens, or how severe it is
A headache that lasts days, getting worse as it goes
A headache brought on by coughing, sneezing, bearing down, or straining while on the toilet
Call 911 or go to the emergency room if you have:
The worst headache you’ve ever had, especially if it started very quickly
Headache after a head injury
Head injury with loss of consciousness
Fever or stiff neck with a headache
Confusion or lack of consciousness
Paralysis or weakness
Seizure
Change in vision
Vision loss
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