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The word “migraine” is often used as a synonym for “severe headache.” However, migraine is actually the name of a neurological (nerve-system-related) disease. There are many types of migraine, each of which can cause severe headaches, along with other undesirable symptoms. Moreover, there are many other types of headache disorders that technically aren’t types of migraines.
Though headaches are a common theme among these conditions, each one has its unique causes and symptoms. If you experience frequent head pain, it’s helpful to understand precisely what’s causing it. Different treatments may be more effective than others for certain types of migraine and other headache disorders.
Migraine is a neurological condition characterized by intense, often debilitating headaches that can be accompanied by other symptoms such as nausea, sensitivity to light and sound, and visual disturbances. Types of migraine differ from headache disorders in that they typically involve more complex neurological symptoms.
Following are some of the various types of migraine.
Migraine presents with recurrent headaches lasting four to 72 hours with characteristics such as:
Approximately 25 percent of people with migraine experience an aura before or during bouts of head pain.
Aura symptoms include:
In some people, migraine 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 headache, known as aura without migraine.
The most common type of migraine is migraine without aura. In this type, the attacks present with migraine symptoms except for the aura.
Formerly known as a basilar migraine, migraine with brainstem aura causes typical migraine symptoms including aura, with additional symptoms of:
Often, these symptoms are accompanied by hyperventilation (unintentionally rapid, deep breathing) and feelings of extreme anxiety.
Silent migraine is an aura migraine without a migraine headache. This type of migraine is uncommon. According to the American Migraine Foundation, only 4 percent of people with migraine experience an aura migraine without headache pain. Also known as acephalgic migraine, silent migraine is sometimes confused with other types of visual disturbances. Persistent aura without headache pain can also indicate a stroke. It’s important to seek medical advice if you frequently experience zigzags and other aura symptoms without migraine pain.
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 present with other visual, sensory, or language problems.
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.
About 2.5 percent of people with episodic migraine go on to develop chronic migraine. In episodic migraine, headaches occur on fewer than 15 days per month, whereas in chronic migraine, migraine symptoms occur on 15 or more days of each month for more than three months. 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 migraine risk factors.
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 is usually resolved by the teenage years, but some children who have abdominal migraine go on to develop other forms of migraine as adults.
If your child complains of intense or recurring abdominal pain, ask your health care provider to consider abdominal migraine as a source. Adults with a family history of migraine are also at risk.
Menstrual migraine is a type of migraine that only flares up during menstruation. Experts believe it is caused by hormonal changes that accompany a period. If you think you experience menstrual migraine, tracking the timing of your symptoms in a migraine journal for at least three months can help your health care provider make an accurate diagnosis. A migraine attack that regularly occurs between two days before and three days into menstruation is likely to be caused by menstrual migraine.
Vestibular migraine is in its own category in the International Classification of Headache Disorders. In addition to causing headache pain and other classic migraine symptoms, vestibular migraine often includes a combination of dizziness, balance issues, and vertigo (a spinning or swaying sensation). Other names for vestibular migraine include migrainous vertigo, migraine with prominent vertigo, and migraine-related dizziness.
Not all headache disorders are technically types of migraine, but they can still cause severe headaches and other symptoms that can interfere with your daily life and well-being. Each type of headache disorder has its own unique causes and symptoms.
Status migrainosus isn’t a type of migraine. Rather, it’s a migraine attack lasting longer than 72 hours. While status migrainosus is rare, anyone who experiences migraine is at risk for status migrainosus. Symptoms of status migrainosus are generally similar to other types of migraine, but they tend to be more severe and last longer. If the headache phase of your migraine lasts longer than 72 hours or the symptoms of migraine are more intense than usual, seek immediate medical attention.
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 migraine attacks.
Cluster headaches, so called because they occur in a series, are a rarer form of headache. 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.
In paroxysmal hemicrania, people suffer attacks of pain described as “drilling” or “clawlike.” 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.
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.
Headaches that occur only during or right after physical exercise in the absence of intracranial disorders are called primary exercise headaches. Previously known as primary exertional headache or benign exertional headache, primary exercise headache is usually felt as a pulsating pain on both sides of the head. Primary exercise headaches can last from minutes to as long as two days.
Sometimes called “sex headaches,” preorgasmic and orgasmic 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. These headaches may last for minutes or up to three days. Some people experience only one sex headache, but others have several sex headaches over months.
Also known as “ice pick headaches,” primary stabbing headaches are named for the sharp, agonizing sensation they cause. They usually last only seconds, but they may occur multiple times a day. People who experience other types of migraine are more likely to get ice pick headaches.
Hypnic headache is a rare headache disorder that’s 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. A person may experience more than one hypnic headache in a single night.
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.
Some people who experience concussions or other traumatic brain injuries (TBIs) experience a migrainelike 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.
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.
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 a person’s cheek is touched or moved, such as while shaving, putting on makeup, eating, talking, or washing the face. Trigeminal neuralgia may progress over time, developing worsening symptoms and more frequent episodes.
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 upward, may get worse if the area is touched, and can cause significant restlessness.
If you experience severe headaches, headache pain, or symptoms of migraine, make an appointment with your health care provider. They can rule out other medical conditions, including other types of headache disorders. If they suspect migraine, your health care provider might refer you to a neurologist — a doctor specializing in migraine and other neurology issues — to confirm the diagnosis, identify your migraine triggers, and discuss your treatment options. A headache specialist is the best person to help you make a migraine treatment plan so you can find the relief you need.
MyMigraineTeam is the social network for people with migraine and their loved ones. On MyMigraineTeam, more than 82,000 members come together to ask questions, give advice, and share their stories with others who understand life with migraine.
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