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5 Types Of Migraines: Causes and Treatments

Dr. Sreelekha Daruvuri

4 Min Read

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Migraines are more than just headaches that last for a few hours to days. There can be a cluster of symptoms associated with migraine headaches and the effects can interfere with daily activities. Migraines are more prevalent in women with a strong genetic component. In about 1/3 of individuals, it is preceded by an aura which includes a group of sensory, motor, and speech symptoms that may act as a signal before the migraine starts. It includes visual disturbances like flashing lights, blind spots, motor disturbances like vertigo, and sensory disturbances like numbness. Some patients can experience just aural symptoms without a headache. There are 5 types of migraines headaches, each with its own set of distinguishable symptoms. This blog will explore the 5 types of migraine headaches.

Diagnosing Migraines

The diagnosis of a migraine is made based on a patient’s history. One must have had at least 5 headache attacks that lasted 4–72 hours (untreated or unsuccessfully treated) and the headache must have had at least 2 of the following characteristics:
– Unilateral location
– Pulsating quality
– Moderate or severe pain intensity
– Aggravation by or causing avoidance of routine physical activity (eg, walking or climbing stairs)

In addition, during the headache the patient must have had at least 1 of the following:
– Nausea and/or vomiting
– Photophobia and phonophobia (sensitivity to light and sound)

5 Types of Migraines

Migraine with Aura

One out of three patients with migraines experiences an aura. The most common aural symptoms are visual in the form of blind spots or floaters. The aura is due to an electrical or chemical signal that moves across the brain and depending on the area the signal spreads to, symptoms occur. These signals do not cause any harm but cause discomfort.

Migraine without Aura

There are no symptoms of aura in this migraine type. The headache can be unilateral, pounding/throbbing, moderate to severe can last upto half a day. There can be other symptoms like nausea, vomiting, and diarrhea.

Silent migraine

This is not the typical migraine with a headache. There are only symptoms of aura which are not followed by a headache. The symptoms can last up to an hour. Aura symptoms may include blurry vision, light sensitivity, vision loss, tingling sensation, weakness, confusion, dizziness, confusion, difficulty speaking. Unlike other types of Migraine, treatment is given in the form of anti-nausea meds. Preventive meds are given for someone who is experiencing frequent attacks.

Chronic Migraine

If one experiences a headache for more than 15 days a month with more than 8 episodes of headache with Migraine features, happening for more than 3 months, it is categorized as chronic migraines. Chronic migraine headaches can/can not be associated with aura. In some patients, this is due to overuse of pain meds that in turn lead to migraine episodes.

Treatment includes starting with a low dose of painkillers and gradually increasing to tolerated levels. Preventive medications are also given in the form of calcium channel blockers. Lifestyle changes like losing weight, stress management, avoiding skipping meals is also a part of the treatment plan.

Status Migrainosus

This is a severe type of migraine that lasts for more than 72 hrs even with the treatment. Symptoms can be much more than usual including nausea and vomiting that might need a hospital visit. Hormonal imbalances, stress, and medication withdrawal can cause this.

Causes of Migraines

Migraines occur due to abnormal brain activity that affects signaling, and chemicals released. There can also be stimulation of the Trigeminal pathway which releases pain causing chemical substances. The triggering factors are similar in all types of migraine headaches, like alcohol, weather changes, dehydration, hunger, stress, and/or too much or too little sleep.

Migraine Treatment

– Medications given to abort an acute attack or prevent the progression: Triptans, Ergot alkaloids, Opioids, NSAIDS and anti-nausea drugs.
– Medications given to prevent the attacks are based on the history: Antidepressants, SSRIs, Beta-blockers, Calcium channel blockers.
– Non-pharmacological treatment: cognitive-behavioral therapy, relaxation, biofeedback as well as acupressure, and massage.

Prevention of Migraines

– Keep a note of the trigger factors: It can be a food or stimulus like bright light that may have triggered the attack
– Maintain body weight
– Get adequate sleep: 7 hrs of uninterrupted sleep is required
– Reduce stress levels: talking to a friend/family/ mental health professional can benefit. Practice Yoga/meditation to reduce stress levels.
– Do not take pain meds without consulting a doctor. Do not ignore the headaches if they are frequent.
– Eat regular meals and do not skip meals which may trigger a migraine attack

When to see a doctor for Migraines

If the headache is
– Too severe or unbearable
– Associated with confusion and disorientation
– Associated with loss of consciousness
– With seizures or fits
– With weakness in one side of the body

These could indicate something more serious than just migraine. Getting evaluated with a head CT scan or MRI on the advice of the health professional can help in diagnosing any condition early and prevent complications.

While all types of migraines are usually diagnosed by a physician, and at times can be self-diagnosable, it’s important to understand that headaches can be caused by other abnormalities. If you’ve been suffering from severe and constant headaches, don’t self-diagnose, and consult with a general physician instead. Receiving a proper diagnosis i.e which of the above types of migraines, is important because it rules out any other causes and therefore a treatment plan can be set in place.