What Type of Migraine Do I Have?
If you experience migraines, you know how difficult and even debilitating this condition can be. While there are many unknowns in the medical community when it comes to the causes of migraine, medical research has led to some helpful labels we can use to classify different types of migraines.
So, what are the different types of migraines? We'll explain some common varieties, including migraine with aura, migraine without aura, vestibular migraine, chronic migraine and ocular migraine.
Migraine With or Without Aura
First, we can classify migraines into two major categories — with and without aura. You may have also heard these categories referred to as classic, or complicated, migraines and common migraines. To understand the difference between migraine with aura and migraine without, we have to understand what aura is.
What Is a Migraine Aura?
Aura is a set of symptoms that about 25-30% of migraine patients experience. These symptoms tend to immediately precede other migraine symptoms, including head pain, and typically last less than an hour. Aura symptoms can include disturbances related to:
Vision: The most common aura symptoms are vision-related. A person may start to notice their vision is affected by the appearance of bright or dark spots, flashes, stars or zigzags. They may even lose partial vision temporarily.
Physical sensation: Aura can also involve tingling or numbness sensations. This can occur on the face, on hands and fingers or on one side of the body. A sensory aura typically starts as a tingling feeling in one arm that travels up and can spread to one side of the face.
Speech: Another symptom some people experience in the aura stage is interference with their ability to speak. They may have trouble saying the right words or begin to slur their words.
Aura symptoms can be different for different people, so the above symptoms merely represent some of the most common features of this migraine stage. Some people may experience less common sensory disturbances — for example, muscle weakness, ringing in the ears or changes in their sense of smell or taste.
While aura is typically seen as a precursor to the attack phase of a migraine, some people can experience migraine aura without ever getting a headache. This is most common for people age 50 and older and is nicknamed a "silent migraine."
What Does It Mean to Have a Migraine Without Aura?
Not all migraines include an aura phase — in fact, most do not. Some people experience migraine with aura sometimes but also experience migraine without aura. With a migraine without aura, or common migraine, a person does not necessarily get a warning that their head pain and other migraine symptoms are coming on.
While the aura stage isn't present, people can still experience some aura-like symptoms during their migraine attack. For example, with an ocular migraine, you can experience vision disturbances.
Your sense of balance comes from your vestibular system. This sensory system tells your brain where you are positioned in relation to your environment and how you're moving so you can orient and steady yourself. You probably don't think much about this sensory system unless you experience a problem with it. One way your vestibular system can be compromised is through a vestibular migraine.
People can experience problems with their vestibular system separate from a migraine. But if you notice you have a vertigo attack at the same time as migraine symptoms like head pain, nausea or sensitivity to light and sound, you're likely dealing with a vestibular migraine.
Vertigo is a swaying or spinning sensation that will make you feel off-balance or dizzy. Vestibular migraine treatment at home may combine migraine pain treatment with measures to combat this dizziness since these are two different problems, even if they are related.
Chronic or Episodic Migraines
We can also classify migraines according to their frequency. There are two main diagnoses to be aware of — chronic and episodic migraine.
How Do You Know if You Have Chronic Migraines?
Between 3-5% of Americans have chronic migraine, though some estimates put that percentage a bit lower. Chronic migraine is a diagnosis for a person who experiences migraine symptoms at least 15 days per month. In other words, someone with chronic migraine has as many migraine days or more than days they go without migraine symptoms. These are the most severe instances of migraines and often involve migraines that last longer in addition to their increased frequency.
While all migraine cases can interfere with a person's professional and personal life, chronic migraine can be especially debilitating because of their frequency. Chronic migraine treatment options are more likely to focus on prevention compared to treatment plans for less frequent migraines.
What Are Episodic Migraines?
Most people with migraine suffer from what's known as episodic migraine. A person who has fewer than 10 migraine days per month has low-frequency episodic migraine, and a person who has 10-14 migraine days per month has high-frequency episodic migraine. Cases of episodic migraine can evolve into chronic migraine — especially with medication overuse. However, in the majority of cases, migraines remain in this episodic category.
Another type of migraine you may have heard of or experienced yourself is an ocular migraine. These migraines may also be referred to as visual, monocular, retinal or ophthalmic migraines since they affect your sense of sight.
This type may seem similar to migraine with aura, which tend to have vision-related symptoms, as well. The main distinction is that ocular migraines affect only one eye — not both. If you notice flashing lights, dark spots or other abnormalities in your vision in both eyes, then it's likely a migraine with aura. If one eye is unaffected, however, it's likely an ocular migraine. Additionally, ocular migraine symptoms mainly consist of vision loss rather than flashing lights or other vision disruptions.
One study found that half of ocular migraine patients experienced complete vision loss in one eye. One in five experienced blurred vision instead. Less common symptoms included incomplete loss of vision, dimming and blind spots. The study also found that more than three-quarters of participants had a headache on the same side as the eye that experienced vision disturbance. Blindness from ocular migraines typically lasts less than an hour. It can occur either before or during a migraine headache.
Try CEFALY Today
No matter what type of migraines you experience, the desire for relief is universal. If you suffer from episodic migraines, with or without aura, and medications and home remedies have fallen short, there's an alternative solution you can try or incorporate into your migraine treatment plan — CEFALY.
The new CEFALY DUAL Enhanced from CEFALY Technology is designed and clinically proven to help prevent and treat migraine pain by targeting the trigeminal nerve. By sending tiny electrical impulses to this nerve through a comfortable electrode placed on the forehead, the CEFALY device can lower the intensity of a migraine headache and prevent future symptoms. This device is cleared by the FDA and is convenient to use in your own home or on the go. Learn more about CEFALY and get yours today!
Reviewed by: Deena E. Kuruvilla, MD, a board-certified neurologist and the director of the Westport Headache Institute, where she employs a holistic biopsychosocial approach to diagnosis and treatment. She held clinical appointments at the Yale University School of Medicine prior to starting her own practice and has authored many articles, book chapters, and research publications.
Last updated on September 30, 2021 at 2:22 PM ET