There are many types of migraine. The two most common types of migraine are defined by the presence or lack of an aura – an abnormal feeling, visual or auditory disturbance, or smell. Other specific types of migraine may be classified by unique symptoms or triggers.
Different treatments may be more effective for different types of migraine.
Migraine with aura
Approximately 20 percent of people with migraine experience an aura before head pain begins. Aura involves changes in perception such as visual disturbances (flashing lights, zig-zag lines, or blind spots), hearing music or noise with no source, or tingling and numbness in one arm or leg or on one side. In some people, aura manifests as a strange smell, a sudden change in personality, or a cognitive disruption such as difficulty speaking. Aura usually lasts between five minutes and one hour.
It is rare but possible to experience an aura that is not followed by a migraine attack, known as aura without migraine.
Migraine without aura
The most common type of migraine is migraine without aura. In this type, all of the most common migraine symptoms are usually present except for the aura.
Migraine with brainstem aura
Formerly known as a basilar migraine, migraine with brainstem aura causes typical migraine symptoms including aura, with the additional symptoms of vertigo, slurred speech, tinnitus (ringing in the ears), impaired hearing, and uncoordinated movements. People having a migraine with brainstem aura tend to hyperventilate and become extremely anxious.
In about 10 percent of people, migraine progresses to chronic migraine. Chronic migraine is defined as migraine symptoms on 15 or more days of each month. Some people with migraine have daily symptoms. Migraine is more likely to progress to chronic migraine in people who overuse migraine medications and have other risk factors.
Cluster headaches, so called because they occur in a series, are a more rare form of migraine. Series of cluster headaches may last for weeks or months, followed by a headache-free remission period that may last for months or years. Cluster headaches can also cause eye redness and tearing, sweating, and nasal congestion.
Chronic and persistent pain that is usually on one side of the head and face is the most prominent symptom of hemicrania continua. Hemicrania continua also causes drooping eyelids, eye redness and tearing, sweating, and nasal congestion. Headaches in hemicrania continua can last as long as six months followed by a period of remission.
In addition to typical migraine symptoms, people with hemiplegic migraine experience pronounced weakness on one side of their body. During a hemiplegic migraine, people may also lose coordination and some degree of consciousness.
Hypnic headaches are a rare type of migraine most likely to affect people over 50. Since hypnic headaches start at night and often wake people, they are sometimes called “alarm clock headaches.” Hypnic headaches may last as long as six hours. More than one hypnic headache may occur in a night.
Ice pick headaches
Also known as primary stabbing headache, ice pick headaches are named for the sharp, agonizing sensation they cause. Ice pick headaches, usually last only seconds, but may occur multiple times a day. People who experience other types of migraine are more likely to get ice pick headaches.
In abdominal migraine, intense pain is felt in the abdomen instead of the head. Abdominal migraine is most common in children, especially between the ages of 5 and 9. Abdominal migraine usually resolved by the teenage years, but some children who had abdominal migraine go on to develop other forms of migraine as adults.
New daily persistent headache
In some people, a headache starts one day and does not go away. New daily persistent headache (NDPH) may or may not have other symptoms similar to migraine. In about 30 percent of people, NDPH is preceded by a viral illness such as cold or flu. In about 10 percent of people, NDPH seems to be immediately preceded by a stressful life event. NDPH can last for years, suddenly go away, or persist indefinitely.
Pain in occipital neuralgia is described as piercing, throbbing, or like an electric shock. Pain is generally felt in the back of the head, upper neck, and behind the ears, sometimes behind the eyes, most often on one side. The pain may start in the neck and spread upwards. People with occipital neuralgia often have photosensitivity.
Sex headaches may be felt as a dull ache that builds slowly as arousal increases, or occur suddenly as a throbbing pain during or just before orgasm. Sex headaches, also known as orgasmic or pre-orgasmic headaches, may last for minutes or days. Some people only experience one sex headache, but others have several sex headaches over months.
In paroxysmal hemicrania, people suffer attacks of pain described as drilling or claw-like. Attacks may last several minutes and occur several times a day. It is possible to have daily attacks of paroxysmal hemicrania or long periods of remission. Paroxysmal hemicrania can also cause drooping eyelids, eye redness and tearing, and nasal congestion.
Some people who experience concussions or other traumatic brain injuries (TBI) experience a migraine-like headache about seven days after the injury or after regaining consciousness. Post-traumatic headaches can be mild or severe, and symptoms may be infrequent or continual.
Primary exertional headache
Headaches that occur only during or right after physical exercise are called primary exertional headache. Primary exertional headache is usually felt as a pulsating pain on both sides of the head. Primary exertional headaches can last from minutes to as long as two days.
Also referred to as an ocular migraine, retinal migraine can cause temporary partial or total blindness in one eye. Vision usually returns in 20 to 30 minutes, but blindness may persist as long as an hour. Visual symptoms may begin with dimming vision, flashing lights, or a pattern of blank spots before vision is temporarily lost. Retinal migraine commonly occurs in the same eye each time.
Sinus headaches cause pressure and pain in the face, especially around the eyes, cheeks, and the forehead. Sinus headaches are often accompanied by sinus congestion and an ache in the upper teeth. Pain in sinus headaches is usually worse when bending forward or lying down.
Tension headaches are the most common type of headache. Tension headaches occur when muscles in the head and neck tighten and become tense, usually in response to stress. Tension headaches may occur along with migraines.
Also known as tic douloureux, trigeminal neuralgia is a disorder of the trigeminal nerve. The trigeminal nerve provides sensation for most of the head, face, and teeth. Trigeminal neuralgia causes extreme pain that may be felt as burning, aching, stabbing, or electrical shocks. Attacks of trigeminal neuralgia can last for seconds or minutes and may occur one after another in episodes that last as long as two hours. Attacks may be triggered when the cheek is touched or moved, such as in shaving, putting on makeup, eating, talking, or washing the face. Trigeminal neuralgia may progress over time, developing worsening symptoms and more frequent episodes.
Is it possible to have more than one type of migraine?
Yes. It is not uncommon to experience more than one type of migraine.