Know the different types of migraine and recognize their symptoms. Obtain expert advice to effectively control migraine crises.

Migraine are a type of headache that can cause intense pulsatile pain, along with other symptoms such as nausea, vomiting and sensitivity to light and sound. There are different types of migraine, each with their own characteristics and triggers. Understanding different types is crucial to control and treat this weakening disease.

1. Migraine without Aura

Migraine without Aura, also known as common migraine, is the most frequent type of migraine. This type of migraine usually begins with a sharp headache on one side of the head and can be accompanied by nausea, vomiting and sensitivity to light and sound. Unlike migraines with Aura, there are no specific warning signs or neurological alterations before pain appearance. The symptoms of a migraine without aura can last from a few hours to several days.

Main characteristics:

• Pulsatile headache on one side of the head
• Nausea and vomiting
• Sensitivity to light and sound

2. Migraine with Aura

The migraine with Aura, also known as classical migraine, is a type of migraine that includes specific warning signs or neurological alterations, called Aura, before the appearance of headache. Aura symptoms often consist of visual alterations, such as seeing flashing or zigzag lines, but may also include tingling sensations, dizziness and difficulty speaking. These symptoms of the aura usually develop gradually and last between 20 minutes and an hour before the headache begins. The headache associated with a migraine with Aura can last from a few hours to a couple of days.

Main characteristics:

• Specific warning signs or neurological alterations (Aura)
• Visual alterations, tingling sensation, dizziness, difficulty speaking
• Headache usually follows the symptoms of the aura

Migraine may vary in frequency, duration and severity, so each individual experience is unique. It is important to consult a healthcare professional to receive a precise diagnosis and develop a personalized treatment plan to manage migraines effectively.

Types of Migraines

1. migraine without aura: It is the most common type of migraine and represents about 80% of cases. It is characterized by sharp, moderate to intense headaches, which occur on one side of the head. These headaches can last from a few hours to several days. People with migraine without Aura do not experience any alarm sign before the appearance of headache.

Some key features of migraine without aura include:

• Pulsatile or throbbing pain
• Unilateral location
• Aggravation for habitual physical activity
• Presence of nausea, vomiting or both
• Sensitivity to light and sound

2. Migraine with Aura: This type of migraine is characterized by the presence of specific warning signals, known as auras, which occur before or during headache. Auras are usually visual alterations, such as seeing flash lights, Zigzag lines or blind points. Some people may also experience sensory, speech or motor alterations as part of the aura.

Key features of migraine with aura include:

• Visual alterations
• Sensory alterations
• Speech or language alterations
• Motor alterations
• It usually lasts less than an hour

3. Chronic migraine: This type of migraine is diagnosed when a person experiences headache 15 or more days a month for at least 3 months, and at least 8 of those headaches are migraines. Chronic migraine can significantly affect a person’s quality of life and may require an intervention that goes beyond standard treatments for acute headaches.

Using a table format, different types of migraines can be summarized as follows:

Knowing the different types of migraine can help to diagnose and treat these weakening headaches with precision. It is important that people suffering from migraines go to the doctor to receive adequate evaluation and treatment.

Common Migraine

The characteristic symptoms of a common migraine include moderate to intense headache that is usually located on one side of the head. The pain can be pulsatile or throbbing and last from a few hours to several days. Other associated symptoms that are usually experienced during an episode of common migraine are nausea, vomiting, light sensitivity (photophobia) and sound sensitivity (phonophobia).

Note: A common migraine does not occur with Aura, which is a temporary neurological alteration that precedes or occurs during a migraine attack. If a person experiences visual or sensory alterations before or during their migraine, it can indicate a different type of migraine, such as a migraine with Aura.

Main features of a common migraine:

• Intense and sharp headache, usually on one side of the head.
• Pain that lasts from a few hours to several days
• Nausea and/or vomiting
• Light sensitivity (photophobia)
• Sound sensitivity (phonophobia)

Prevalence:

Common migraine is the most frequent type of migraine and represents approximately 85% of all cases of migraine. It affects both men and women, although it is more frequent in women. Common migraine usually appears in adolescence or at the beginning of adulthood, but can affect people of any age.

Hemiplegic Migraine

This type of migraine can be classified into two subtypes: Family Hemiplic migraine (MHF) and sporadic hemiplic migraine (MHE). HFM is a hereditary genetic disorder caused by specific genetic mutations. It is estimated that about 50% of people with HFM have a parent with this condition. On the other hand, the SHM occurs in individuals with no family history of hemiplic migraine and is believed to be caused by complex genetic interactions and environmental factors.

Signs and Symptoms

1. Headache: People suffering from hemiplegic migraine often experience a strong sharp headache on one side of the head. The headache can last hours or days and be accompanied by nausea, vomiting and sensitivity to light and sound.
2. Hemiplegia: During a crisis of hemiplic migraine, temporary paralysis or weakness may occur on one side of the body, normally the face, arm and leg. This symptom usually disappears after the episode of migraine.
3. Sensory alterations: Some people may experience sensory alterations on the affected side of the body, such as numbness, tingling or sensation of punctures.

“Unlike typical migraines, hemiplegic migraines can have a longer duration and last several hours or even days.”

Ocular Migraine

The exact cause of eye migraines is not yet known at all, but researchers suggest that they may be related to changes in blood flow to the retina or spasms in the blood vessels of the eye. Some individuals may experience certain triggers who can precipitate an eye migraine, such as stress, hormonal changes, certain foods or bright lights.

• Visual alterations are the distinctive symptom of eye migraines, and people suffer a temporary loss of vision in an eye or both. It can manifest as a blind spot, blurred vision, flashing or patterns in Zigzag.
• Unlike typical migraines, ocular migraines are usually painless, although some people may experience a mild headache.
• Episodes of eye migraine usually last less than an hour, but their duration can vary from a few minutes to several hours.

IMPORTANT: If you experience any sudden or severe visual alteration, it is crucial to seek immediate medical attention to rule out other possible serious causes.

Vestibular Migraine

One of the main symptoms of vestibular migraine is vertigo, a feeling of turning or turning that can last from a few seconds to several hours. This dizziness can be weakening and cause coordination difficulties and daily activities. Another frequent symptom is the imbalance, in which people can feel unstable about their feet, have erect walking problems or experience the feeling that they throw them to the side.

• Headaches: vestibular migraines are often associated with sharp headaches that can be from slight to severe intensity. These headaches can be accompanied by sensitivity to light and sound, nausea and vomiting.
• Auditory symptoms: Some people with vestibular migraines may experience auditory alterations, such as tinnitus (bursts in their ears) or sensitivity to certain sounds.
• Visual alterations: During vestibular migraines, visual symptoms, such as blurred vision, double vision or visual hallucinations can also occur.
• Unleashed factors: vestibular migraines can be triggered by various factors, such as stress, hormonal changes, certain foods or drinks, lack of sleep or changes in weather conditions.

Vestibular migraines can significantly affect a person’s quality of life, since symptoms can be chronic and unpredictable. It is important that people who experience these symptoms request a medical evaluation and adequate diagnosis to develop an effective treatment plan.

Menstrual Migraine

The exact cause of menstrual migraines is not fully known, but it is believed that it is related to the fluctuation of estrogen and progesterone levels in the body. It is known that estrogens influence the perception of pain and dilation of blood vessels. Changes in estrogen levels during the menstrual cycle can trigger migraines in susceptible people.

Important information:

• Menstrual migraines are usually more serious, durable and resistant to treatment than no n-menstrual migraines.
• They can be accompanied by additional symptoms such as nausea, vomiting and sensitivity to light and sound.
• The menstrual migraines of a woman can decrease or disappear after menopause, when hormonal fluctuations cease.

Control of menstrual migraines includes preventive and acute treatments. Preventive measures may include the use of hormonal medications, such as oral contraceptives, to regulate hormonal levels and reduce the frequency and severity of migraines. Acute treatment options include free or recipe sale analgesics, as well as nausea medications. Lifestyle modifications, such as regular exercise, stress reduction and maintenance of a constant sleep schedule, can also help prevent menstrual migraines.

Chronic Migraine

Chronic migraine can have a significant impact on the quality of life of a person, which often leads to lack of work or school and affects their ability to perform daily activities. It is estimated that approximately 2-3% of the population suffers from chronic migraines.

Key characteristics of chronic migraine:

• Headache that occurs 15 or more days a month for at least 3 months.
• Of those 15 days or more, at least 8 are associated with migraines
• Migraine attacks usually last 4 hours or more if left untreated.

Chronic migraine is often a complex condition that requires careful management and treatment. Although its cause is not yet known exactly, it is believed to involve a combination of genetic, environmental and neurological factors.

Retinal Migraine

During a retinal migraine attack, people may experience various visual disturbances. For example, flickering lights, zigzag patterns, or blind spots may be seen. Some people may even lose vision completely in one eye. These visual symptoms can be frightening and debilitating, significantly affecting daily activities and quality of life.

Retinal migraines usually affect only one eye, and vision loss or disturbances may develop gradually over several minutes. Visual symptoms usually disappear on their own within an hour.

• Retinal migraines usually affect people with a history of migraines with aura.
• This type of migraine usually affects women more.
• Stress, certain foods, hormonal changes, and physical exertion can trigger retinal migraine attacks.

It is important to note that retinal migraines should not be confused with other eye conditions that can cause similar symptoms, such as retinal detachment. Proper diagnosis and evaluation by a healthcare professional is essential to rule out any underlying eye problems or conditions that may require immediate medical attention.

Silent Migraine

Although silent migraines are so called because they lack the typical stabbing or throbbing pain in the head, they are accompanied by other symptoms that can significantly affect a person’s quality of life. These symptoms may include visual disturbances, such as temporary blindness, blurred vision, or seeing flashing lights and zigzag patterns (known as an aura). Additionally, people may experience sensory disturbances, such as tingling or numbness of the face or extremities, difficulty speaking or finding words, confusion, dizziness, and mood changes.

Note: Silent migraines are similar to other types of migraines in terms of triggers and possible underlying causes. These triggers can include stress, hormonal changes, certain foods, bright lights, strong smells, and changes in sleep patterns. It is important to note that although silent migraines do not cause headaches, they can have a significant impact on daily functioning and should not be disregarded.

Diagnosis and Treatment

Diagnosis of silent migraines can be difficult due to the absence of headache pain. Medical professionals often rely on a person’s description of their symptoms and a complete medical history. The diagnosis can be confirmed by ruling out other possible causes using various tests, such as visual field tests, brain imaging, or blood tests.

Treatment for silent migraines usually involves a combination of lifestyle modifications and medication. Lifestyle changes may include identifying and avoiding triggers, managing stress levels, maintaining a regular sleep schedule, and eating a balanced diet. Medications commonly prescribed for silent migraines include preventive drugs such as beta blockers or antidepressants, as well as medications to control individual symptoms during an episode, such as anti-nausea drugs or pain relievers.

1. Preventive medications to reduce the frequency and intensity of silent migraines.
2. Acute medications to relieve specific symptoms experienced during an episode.
3. Lifestyle modifications to control triggers and improve overall well-being.

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Author of the article

Dr.Greenblatt M.

Medical oncologist at the Robert Larner College of Medicine, MD, at the University of Vermont