What are the different migraine types?

A migraine is a common condition that typically involves throbbing or pulsating headaches affecting one side of the head. Migraines also frequently involve light or sound sensitivity, as well as nausea and vomiting. The pain from a migraine attack can be so debilitating that it interferes with your regular activities, including school and work. Migraines can persist for hours or even days. That being said, migraines aren’t the same for everyone, and there are different types of migraines.

A warning sign known as an aura may occur before or during a migraine episode. Auras are primarily visual, with symptoms like light flashes or blind spots. They can also cause speech difficulties and tingling on one side of the face or in an arm or leg.

Auras may also occur without an accompanying headache. These are referred to simply as "migraine aura without headache." Older terms for this condition include "acephalgic migraine" or "silent migraine."

When the aura is primarily visual, the condition can be referred to as a "visual migraine," regardless of whether a headache is involved. Visual auras can involve several optical distortions, such as zigzag lines that float across your field of vision, shimmering spots or stars, or even changes in vision or temporary vision loss. The visual disturbances usually last for up to 30 minutes before going away.

Several older names referring to migraines have since fallen out of favor. For example, ​​"ocular migraine" was previously used to describe a migraine with aura. The term ocular migraine has also been used interchangeably with what healthcare providers prefer to call retinal migraine, a migraine characterized by repeated attacks of visual aura or vision loss lasting less than one hour, usually in one eye.

Vision changes in one eye may also be a sign of a more severe condition, including a stroke, acute glaucoma, or a detached retina, which is why it's important to discuss your symptoms with your healthcare provider.

Other types of migraines may not involve any headaches, making them an atypical migraine. For example, abdominal migraine is a condition often discussed within the medical community. Abdominal migraine typically affects children and often involves abdominal pain, nausea and vomiting episodes. There is evidence that children with a personal or family history of migraine headaches have an increased risk of developing abdominal migraines. Researchers are still trying to understand the potential connections between abdominal migraine and migraines with headache.

Similar to abdominal migraine, vestibular migraines may or may not involve headaches. Instead, vestibular migraines involve symptoms such as vertigo, imbalance, nausea and vomiting that lasts anywhere from several minutes to several days.

Migraines are common but can be challenging to pinpoint, especially considering the many types of migraine syndromes. Much work remains to uncover and understand the different types of migraines and find the best treatments for every patient. This is why it's essential to talk to your healthcare provider about any migraine symptoms you may experience. Your provider can also recommend the best over-the-counter migraine medication or prescription treatments for you.

Published January 2023.