What are the Different Types of Migraines?

In Online Doctor, Telemedicine by Dr. Clinton Osborn

Migraines are potent headaches that can cause nausea, vomiting, and photophobia. Migraines can last for hours or days, and sometimes they can go even longer. These horrible symptoms have plagued over 36 million Americans, and women are three times more likely than men to experience migraines. Most people experience migraines between the ages of 10 and 40 and many people claim that their migraines decrease or disappear after age 50.

There are different types of migraines and each of them has different requirements. If you are a migraine sufferer, then it’s best to find out which kind of migraine you have so you know the best treatment to combat it.

Migraine Without Aura

The classic symptoms of a migraine without aura are throbbing and pulsating pain, phonophobia, photophobia, nausea, vomiting, and pain worsened with activity. Usually, people with migraines without aura do not have any particular symptoms before the migraine so sufferers don’t know when a migraine is going to occur.

Migraine With Aura

About 25% of people with migraines will experience aura. Aura is a series of visual and sensory changes such as tingling and numbness in one part of the body or seeing black dots and zigzag lines everywhere. The aura usually occurs before or during a migraine and can last 10 to 30 minutes. People who experience these symptoms will know when a migraine is about to occur. A popular treatment is called transcranial magnetic stimulation (TMI). With this treatment, you place the device on the back of your head and it sends magnetic energy to reduce migraine attacks.

Acephalgic Migraine

Acephalgic migraine is also called “migraines without head pain”. This is a type of silent migraine that leads to symptoms of visual disturbance, dizziness, nausea, and vomiting without headache. Usually, this type of migraine is triggered by some type of food, medication, motion, movements, or colors. It’s best to observe what triggers it and avoid the issue.

Hemiplegic Migraine

A migraine that feels like a stroke is a hemiplegic migraine. Usually, these individuals will develop weakness or tingling on one side of the body, along with visual aura symptoms like loss of sensation or pins and needle feelings. This symptom can last for hours or several days.

Retinal Migraine

If a headache has caused you to lose vision in one eye, then it’s definitely a retinal migraine. This is very common in women during their childbearing ages. The blindness can last for minutes or for several months, but it’s reversible. If you experience these symptoms, it’s essential to see a specialist right away. It’s vital for the specialist to rule out other underlying causes like a tumor, papilledema, or clot.

Chronic Migraine

If you get multiple headaches for more than a month, it’s most likely a chronic migraine. Sometimes people can mistake this for a tension headache or sinus headache, which is less severe and has different symptoms. For example, a tension headache will feel like a band wrapped around your head and a sinus headache will be accompanied with sinus congestion. The treatment of chronic migraines involves sumatriptan or ergotamine.

Menstrual Migraine

Menstrual migraines are severe headaches that occur before or during your menstrual cycle. These migraines are often caused by huge hormonal fluctuation and iron deficiency as well as blood loss during the menstrual process. The best way to reduce these migraines is to take oral contraceptive pills to regulate the hormone fluctuations, painkillers, or foods rich in iron to replenish what you have lost.

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Migraine With Brainstem Aura

This is also called a bacillary migraine that starts at the inferior part of the brain, which is the brainstem. This type of migraine can lead to double vision, dizziness, and lack of coordination. The auras can last from 10 to 45 minutes before the headaches occur. The pain usually starts unilaterally and then gradually gets stronger or progressed to bilateral migraine. It usually takes 4 to 72 hours to recover and it may severely drain your energy. There are various triggers to migraines with brainstem aura, but the most common ones are stress, alcohol, insomnia, hunger, hormone fluctuation, medication, caffeine, bright lights, physical activity, weather changes, food, or other stimulations.

Abdominal Migraine

Abdominal migraines are a type of migraine that is common in the pediatric population. They usually occur in children ages 5 to 9 years old but it can also occur in a small percentage of adults. The common symptoms of abdominal migraines are nausea, vomiting, headaches, and abdominal pain. Some children will outgrow the symptoms while others will have it all the way up to adulthood.

The pain is generally located around the belly button of the abdomen. It’s described as a sore and dull type of pain. The attacks can last between 2 to 72 hours before the individual will be symptom-free. The diagnosis of abdominal migraines involves interviewing the patient’s medical history, family history, and performing a physical examination. It’s important to rule out other underlying diseases such as kidney disease, peptic ulcer, gallbladder, bowel obstruction, Crohn’s disease, IBS, and GERD before making a definite diagnosis. The treatments for abdominal migraines are hydration therapy, sumatriptan, and NSAID. If the patient constantly has an abdominal migraine, then preventative therapy such as Topiramate might be required.

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Causes of Migraines

In order to find the perfect treatment for migraines, it’s essential to know what factors trigger it. Here are the most common things that stimulate migraine attacks:


When you are stressed, your brain releases catecholamine hormones that can change your blood pressure. The elevation of blood pressure can cause severe migraine symptoms.


Some food or drinks such as alcohol, cheese, pork, or anything filled with MSG can stimulate migraine symptoms.

Change in Weather

Strong winds and storms or high altitude locations can change the barometric pressure. All of this can trigger migraine symptoms.


Drinking more than 400 mg of caffeine per day or experiencing a withdrawal of caffeine can cause severe headaches. This means high levels of caffeine can increase blood pressure, resulting in migraines and headaches. Another thing is if you expose your body to caffeine on a daily basis, the blood vessels will get used to it and developed a tolerance. When you avoid caffeine for a day, your blood vessels will have trouble adjusting, which can lead to severe headaches.

How are Migraines Treated

Migraines are treated with two types of modalities: preventative therapy and prophylaxis.

Preventative Therapy

Preventative therapy emphasizes on medication that will stop the migraine symptoms. Usually, your doctor will prescribe something simple like a higher dosage of painkillers such as NSAID or Ibuprofen. If that does not work, your doctor will prescribe sumatriptan or ergonovine. Keep in mind that sumatriptan is highly preferred and is more successful than ergonovine.

The mechanism of action of both sumatriptan and ergonovine focuses on constricting the blood vessel that runs towards the brain. This is important because the main issue with migraine symptoms is that the blood vessels are dilated, so too much blood runs toward the brain. When there’s a lot of blood flow to the brain, it can lead to a buildup of pressure, therefore, triggering the migraine symptoms. Fortunately, drugs like sumatriptan and ergonovine can constrict the blood vessels to prevent too much blood flow to the brain.


Prophylaxis focuses on migraine prevention. Since the common triggers of migraines are overactivity of the brain and high blood pressure, the main emphasis of prophylaxis is to reduce your brain activity and to reduce the blood pressure. If you have 4 or more migraine attacks per month, then you will definitely need prophylaxis medication. Your doctor can prescribe you prophylaxis such as a beta-blocker, topiramate, or valproate.

How to Prevent Migraine

Aside from medication, it’s also important to consider additional strategies to prevent migraine attacks.

Avoid Triggers

The most obvious strategy is to avoid triggers such as food, lights, stress, medication, or anything that will stimulate the migraine symptoms.


The best way to reduce migraine attacks is through relaxation. Meditation involves calming your brain and your whole body system. With daily meditations, people often claim a reduction in migraine attacks as well as feeling better and at peace with themselves.


Some migraine sufferers claimed that yoga has significantly improved their symptoms. It’s the combination of movements and relaxation that help lower the stress and reduce the overstimulation of brain activity.


Keep in mind that insomnia and lack of sleep can stimulate a migraine attack. Fortunately, with the proper amount of sleep, it can help reduce migraine symptoms. On average, people should be getting around 7 to 10 hours of sleep, so if you can obtain that amount on a daily basis, it can definitely help with reducing migraines.

Kids with Migraines and What to Avoid

One of the most common mistakes that parents make is giving their kids aspirin during a migraine attack. Aspirin can lead to Reyes syndrome in the pediatric population. Reyes syndrome is a rare and serious condition where the liver and brain swells up. It commonly occurs in children recovering from viral infections or the flu, mainly because the parents give them aspirin. Early symptoms of Reyes Syndrome include rapid breathing, diarrhea, vomiting, and fatigue. In severe cases, kids can develop seizures. If this happens, stop the aspirin immediately and bring your child to the hospital.

For kids with migraines, it’s best to stick with simple pain medication such as NSAID or Ibuprofen. If the migraines are constant, then bring them to the doctor’s office for prescription medication such as sumatriptan can help them. Keep in mind that when kids have a migraine, it’s usually due to other causes such as sugary foods, soda, or lack of sleep. Definitely explore their lifestyle to look for potential triggers. At the end of the day, the proper medication and lifestyle modification can reduce migraine attacks in your kids.

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Should I See a Doctor for a Migraine?

If you continuously get migraine attacks, then it’s a good idea to see your doctor. Your doctor will conduct a physical exam and ask pertinent questions about your symptoms. This is very important because if the symptoms are alarming, your doctor may have to do an MRI to make sure that it isn’t a tumor or infection causing a migraine. Often times, if a tumor is big enough, it can compress on the blood vessels of the brain leading to migraine symptoms. Another thing is that bacterial infections in the body can travel up to the brain resulting in an abscess. This can also cause severe headaches and migraine symptoms. It’s important to rule these factors out because if a tumor or infection is left untreated, it can be life-threatening. After all these issues are ruled out, the doctor can prescribe both therapeutic and prophylactic medication to stop and reduce the migraine attacks.

In any case, the physicians at GuruMD are available to diagnose and treat your migraines. In situations where an MRI or further testing is required, GuruMD can order and provide discounts for both lab work and/or the necessary imaging services. Patients can truly get complete care by visiting GuruMD to see a physician online. The online doctors can review your ailment via a phone call or video encounter to address whether your migraine is dangerous or not. Whether the migraine is benign or not, the doctor can order the appropriate tests and prescribe you with the proper medication. That way, you won’t suffer the high cost or long wait at the ER.


Migraines are a common issue that often plagues patients. There is a variety of migraines and causes of them, which makes it very difficult to treat. It’s important to rule out dangerous underlying issues such as tumors, stroke, infections, edema, and other issues before classifying a type of migraine. After making the proper migraine classification, it’s imperative to find triggers to the migraine. For example, if spicy food causes migraine symptoms, then it’s best to avoid anything spicy. If the migraine is very severe to the point that avoiding triggers don’t work, then definitely consider medications such as painkillers, sumatriptan, topiramate, or other medications that your doctor can prescribe. At the end of the day, you want to live life to the fullest, but you won’t be able to do that with constant migraine attacks, so why not get the help that you deserve?

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