There are many different types of migraine, and recent advancements in research has lead to a recognition that we must accurately diagnose and treat by migraine type to effectively manage migraine. Many people who experience significant or frequent migraine attacks have more than one type of migraine, and may find that different treatments work for different types of attacks.
Migraine without aura, also called common or typical migraine, is the bad headache, nausea, sensitivity to light, smell and sound, that many are familiar with.
Migraine with aura, also called classic migraine, has all the symptoms of common migraine, with an additional phase before the headache where many strange symptoms are experienced. Aura symptoms are usually one of the senses not working quite right (for example numbness or pins and needles, seeing colours or flashing lights, strange tastes).
Migraine Aura Without Headache (MAWH) involves all of the elements of a migraine attack with aura… without the headache.
Hemiplegic migraine typically involves significant weakness and numbness is experienced on one side of the body. Paralysis to either part (such as a facial droop) or all of the side (which looks a lot like a stroke) can also happen.
Migraine with brainstem aura (also brainstem migraine, previously called basilar type migraine) can involve visual disturbances, speech disturbances, hearing problems, weakness, vertigo, decreased consciousness, and in the most severe attacks, coma.
Retinal migraine causes temporary blindness or visual disturbances in one eye.
Vestibular migraine affects vision and balance. It is common for Vestibular migraine patients to not have a headache during their migraine attacks.
Abdominal migraine, common in children, involves abdominal pain, vomiting, diarrhoea and other gastrointestinal upsets, and not necessarily headache.
A migraine attack can last for days, weeks and even months. A migraine attack that will not end is sometimes called ‘status migrainosus’ or ‘intractable migraine’. Persistent migraine that does not respond to treatment or lifestyle modifications is sometimes called refractory migraine. Chronic migraine refers to someone that has at least 15 days of headache, 8 of which are migraine days, every month for at least three months.
If you are not sure what type of migraine you have, ask your neurologist or GP. Some treatment options are not recommended for some types of migraine, and some have higher risks than others.