Migraine Types: Symptoms, Risk, Factors, and Treatments

There isn't just one type of migraine. In fact, migraine types can vary significantly in the symptoms they cause, how they start, how long they last, and even the parts of the body they affect.

By definition, a migraine is a type of headache that causes recurrent attacks of moderate to severe throbbing and pulsating pain on one side of the head. The pain is caused by the activation of nerves within the walls of blood vessels inside the meninges (the protective membranes surrounding the brain and spinal cord).

There are many distinct migraine types, including:

  • Migraine without aura
  • Migraine with aura
  • Chronic migraine
  • Abdominal migraine
  • Acephalgicmigraine
  • Migraine with brainstem aura 
  • Hemiplegic migraine
  • Retinal migraine
  • Status migrainosus
  • Menstrual migraine
  • Ophthalmoplegic migraine
  • Medication-induced migraine
  • Vestibular migraine
  • Cyclic vomiting syndrome

The article describes 14 different types of migraines, including how they differ, who they affect, and how to tell them apart.

Migraine Without Aura

Migraine without aura is often called "common migraine" or "episodic migraine." It is the most common type. Typical symptoms are a pulsating headache of moderate-to-severe intensity on one side of the head, aggravation by routine physical activity, nausea, and sensitivity to light (photophobia) and sound (phonophobia).

According to the International Classification of Headache Disorders, an individual must have at least five attacks per year to be diagnosed with migraine without aura.

Migraine With Aura

The term "aura" refers to various symptoms that start approximately 30 minutes or so before the headache begins. The symptoms of aura are usually visual and may include such disturbances as seeing flashing lights or wavy lines, or losing part or all of your vision for a short period of time. Aura can sometimes include loss of the ability to speak, sensory disturbances (e.g., tingling or numbness), and motor problems (e.g., weakness in the extremities). 

Migraine with aura is less common than migraine without. It is also possible to experience aura without having a headache or any other symptoms afterward; this situation becomes more common as people get older. 

What Is "Alice in Wonderland" Syndrome?

This is a rare form of migraine aura that causes distortions in perception. Someone with this condition might feel as if their body is getting smaller, then larger, or might find that time seems to speed up or slow down. Children experience this syndrome more than adults, but it can occur in people of any age.

When is migraine an emergency
Illustration by James Bee, Verywell

Chronic Migraine

When migraines occur 15 or more days per month over a period of three months or more, the condition is called chronic or transformed migraine.

Over time people with episodic migraines may develop more and more headaches for various reasons, including changes in hormones, increased stress, illness, or an increase in the use of pain medications. Having more headaches decreases the threshold for new headaches, and the condition can become chronic and less responsive to medication. 

Abdominal Migraine

Abdominal migraine is a form of migraine seen mainly in children (most commonly those ages 5 to 9), but it can occur in adults as well.

Symptoms include abdominal pain, nausea, and vomiting. This is one type of migraine that usually doesn't involve a headache, although children who have abdominal migraines often have migraines involving head pain when they're older.

Acephalgic or Silent Migraine

Simply put, an acephalgic or "silent" migraine is a migraine with many classic migraine symptoms, minus the characteristic headache. It's possible for some or all of your migraine attacks to manifest this way.

The most common symptoms of silent migraines are vision problems and alterations in color perception. Silent migraines are more common in people over 50 and are sometimes misdiagnosed as a stroke.

Migraine With Brainstem Aura

Formerly called basilar-type migraine, migraine with brainstem aura has symptoms that can be confused with those of a stroke, such as slurred speech, vertigo, unsteadiness, and numbness. As with migraine with aura, these symptoms come on gradually before the head pain of a migraine.

This type of migraine isn't common and seems to occur most frequently in adolescent girls.

Hemiplegic Migraine

Hemiplegic migraine is a rare form of a migraine that causes weakness on one side of the body, possibly accompanied by confusion or speech slurring. Like the symptoms of migraine with brainstem aura, hemiplegic migraine symptoms can be mistaken for stroke symptoms.

One subtype of a hemiplegic migraine runs in families, but you can have the condition without a family history.

Retinal Migraine

A retinal migraine causes flashes or sparkles of light, possibly combined with partial or total temporary blindness, but only in one eye. This occurs before the headache phase of the migraine starts. The head pain generally commences within an hour of these visual symptoms and can last up to three days.

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What Is a Retinal Migraine?

To diagnose a retinal migraine, your physician must rule out other possible blindness causes.

Status Migrainosus

Status migrainosus is a painful, debilitating migraine attack lasting for more than 72 hours. If moderate to severe migraine pain lasts longer than this with less than a solid four-hour pain-free period while awake, it should be considered an emergency and warrants a trip to the emergency room.

Menstrual Migraine

Menstrual migraines are a migraine type associated with menstruation and influenced by rises and falls in the hormone estrogen. There are pure menstrual migraines that only occur during menstruation and menstrually-related migraines that happen during menstruation as well as the rest of the menstrual cycle.

Menstrually-related migraines affect between 6% and 7% of people with vaginas. Pure menstrual migraines are far less common, affecting roughly one in 100 people with vaginas.

Menstrual migraines usually occur without auras and tend to be more severe, longer lasting, and more resistant to treatment than common migraines.

Ophthalmoplegic Migraine

An ophthalmoplegic migraine—also known as recurrent painful ophthalmoplegic neuropathy (RPON)—is a rare syndrome that causes recurrent migraines accompanied by the temporary paralysis of the eye muscles (ophthalmoplegia). When an ophthalmoplegic migraine strikes, a person will suddenly be unable to move their eyes from side to side.

While the paralysis may be short-lived, some people may take weeks or months to recover. The cause of ophthalmoplegic migraine is poorly understood but is believed to be related to dysfunction of the third cranial nerve that services the eye. Along with eye muscle paralysis, there may be facial pain, mydriasis (dilated pupils), and ptosis (drooping upper eyelids).

Ophthalmoplegic migraines mostly affect children, but the condition can persist well into adulthood. Repeated episodes can cause permanent cranial nerve damage.

Medication-Induced Migraine

Migraines can sometimes occur as an adverse reaction to pain medications used to treat headaches. Migraine-induced migraines most commonly affect people with pre-existing migraines who overuse certain classes of pain medications, including:

The risk increases exponentially when these drugs are combined.

Adults aged 30 to 50 are most commonly affected, particularly those who have more than 10 migraine headaches per month. These are the people most likely to abuse pain medicines.

Vestibular Migraine

Vestibular migraines are migraines that are accompanied by vertigo (disorienting spinning sensations). This type of migraine involves a nerve that regulates the vestibular system, the part of the inner ear that helps us orientate our bodies in space.

In addition to vertigo, the dysfunction of the vestibular nerve can cause a severe loss of balance, nausea, sensitivity to motion, muffled hearing, and tinnitus (ringing in the ears).

Vestibular migraines affect roughly 10% of people with migraines. Symptoms tend to develop between the ages of 20 and 40 but can occur during childhood. Menstrual migraines are frequently accompanied by vertigo.

Cyclic Vomiting Syndrome

Cyclic vomiting syndrome (CVS) is a poorly understood functional disorder that causes sudden, repeated attacks of severe nausea and vomiting. The episodes are usually unprovoked and can last anywhere from a few hours to several days. Children are more affected than adults.

In recent years, CVS has been regarded by some experts as a form of migraine. While children with CVS will usually only experience vomiting, the condition will often transition to migraines as the person reaches adulthood.

Because of the involvement of the gastrointestinal symptoms, some people regard CVS as being synonymous with abdominal migraines.

Summary

Migraines can be debilitating and isolating, and determining the type you have can help ensure you get the best treatment. This is true whether you have relatively common variants (like menstrual or vestibular migraines) or rare and potentially serious ones (like status migrainosus or retinal, hemiplegic, or ophthalmoplegic migraines).

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Teri Robert
 Teri Robert is a writer, patient educator, and patient advocate focused on migraine and headaches.