Forms of Migraine Headaches

Migraines are classified according to the symptoms they produce.

Migraine with aura
An aura is a single symptom or set of symptoms the patient sometimes experiences immediately before the onset of a headache. It can serve as a warning that a headache will follow. It may consist of visual symptoms, smells or unusual odors, or sensations such as tingling or numbness. The most common auras are visual. Patients often describe bright, shimmering lights around objects or at the right or left edges of their field of vision. This is known as scintillating scotoma. It may gradually enlarge to occupy the entire field of vision. Some patients feel as if they cannot see. Others see patterns of zigzag lines or images. Some patients experience strange hallucinations. Patients may describe unusual tingling or numbness (parasthesias) of the face, tongue, or extremities. This may start in one location and spread throughout the body. Other auras include motor weakness, speech or language abnormalities, dizziness, vertigo, and abdominal symptoms. The headache that follows an aura is similar to a migraine without aura, though a higher portion of patients with aura has the headache on just one side of the head.

Migraine without aura
This form of migraine is not accompanied by an aura. But, the patient may feel different the day before an attack, perhaps feeling tired or experiencing a change in his or her mood.

Opthamoplegic migraine
This less common form of migraine begins with a headache felt in the eye and is accompanied by vomiting. As the headache progresses, the eyelid droops (Ptosis) and nerves responsible for eye movement become paralyzed. Ptosis may persist for days or weeks.

Retinal migraine
This form of migraine occurs either with or without a severe headache. Patients experience visual symptoms that are in field of one eye.

Basilar artery migraine
This is another less common form of migraine that occurs primarily in young people. It involves a disturbance of the basilar artery in the brainstem. Symptoms include severe headache, vertigo, double vision, slurred speech, poor muscle coordination, and possible loss of consciousness.

This type of migraine occurs more commonly in older people. Also called lower-half headache or facial migraine, it produces deep, dull, aching, and sometimes piercing pain in the jaw or neck. Tenderness and swelling usually over the carotid artery in the neck. Episodes last a few minutes to hours and can occur several times weekly.

Headache-free migraine
This form of migraine is characterized by the presence of aura without headache. This occurs in patients with a history of migraine with aura.

Status migraine
This is rare and involves intense pain that usually lasts longer than 72 hours. The patient may require hospitalization.