Types, Treatments, and Preventions Of Migraine

  • Migraine with aura
  • Migraine without aura

People that experience migraine headache may have one or both types.

Migraine without aura

Migraine signs and symptoms

Migraine without aura is the commonest migraine type. It occurs in over 70% of people with migraine.

Characteristics of Migraine without aura

These characteristics were put together by the International Headache Society.

It said that people who experience migraine without aura have had a minimum of five attacks. These characteristics include:

  • Headache attacks which last for 4-72 hours if left untreated or if there is a treatment failure.
  • A migraine headache that has a minimum of two of the following:
    • It is unilateral (occurs only on one side of the head)
    • A pulsating or throbbing pain
    • The pain is moderate to severe
    • Pain worsens when you walk or move your body
  • A migraine headache that also has at least one of the following:
    • It makes you photophobic (sensitive to light)
    • You become phonophobic (sensitive to sound)
    • It makes you feel nauseated with or without vomiting or diarrhea
  • A headache that isn’t a symptom of another disease condition.

Migraine with aura

symptoms of migraine with aura

Migraine with aura is also called classic, complicated or hemiplegic migraine. This type of migraine occurs in over 20 percent of people who experience migraines.

You are said to have migraine with aura when you experience a minimum of two headache attacks and have the following characteristics:

  • An aura that goes away completely, and has at least one of these symptoms:
    • visual disturbances (the most common aura symptom)
    • numbness, tingling sensation, or dizziness
    • speech or language problems
    • body weakness, which may last up to 72 hours
    • brainstem symptoms, which includes:
      • dysarthria (unclear speech)
      • vertigo`
      • ringing in the ears
      • hearing loss or problems
      • double vision
      • an inability to control body movements
      • reduced consciousness
      • retinal migraines: migraines that affect one of the eyes and is characterized by light flashes, blind spots, or temporary blindness
  • An aura that consists of at least two of the following symptoms:
    • at least one symptom of the aura spread gradually over a period of five or more minutes
    • each of the symptoms you experience lasts between five minutes and one hour
    • you will experience at least one of the aura symptoms on one side of the head, such as vision, speech, or language problems
    • aura comes with a headache or aura occurs one hour before you experience a headache
  • A headache that is not a symptom of another health problem and transient ischemic attack has been ruled out as a cause.

Generally, aura occurs before the headache starts, and can continue once the headache begins. Moreso, an aura and headache pain may occur at the same time.

Chronic migraines

Chronic migraine combines the characteristics of migraine and tension headaches, hence the name mixed headache. It may also be caused by excessive use of migraine medications.

People with chronic migraines experience severe tension or migraine headache for more than 15 days a month for at least 3 months.

People with chronic migraines have the following characteristics:

  • Severe headaches
  • Disabilities at home and away
  • Depression
  • A different type of chronic pain, like arthritis
  • Comorbidities such as high blood pressure
  • Previous head or neck injuries

An acute migraine

Migraines is said to be acute when you experience fewer headaches in a month compared to chronic migraines.

People that have acute migraine have unpredictable headache attacks that last up to 2 weeks a month. It is also called episodic migraine.

Acute migraine attacks can be successfully treated with acute medications such as acetaminophen, NSAIDS, triptans.

Vestibular migraine

Vestibular migraine is a type of migraine that causes recurrent dizziness or vertigo in people with history of migraine symptoms.

People with vestibular migraine may or may not have a headache but may feel a sensation of spinning dizziness which may not be noticeable or may be severe to the extent that they find it difficult to maintain their balance.

Vestibular symptoms may occur in about 40 percent of people with migraines.

Major vestibular symptoms include dizziness, vertigo and difficulty to maintain a balance.

Others symptoms may include neck pain, visual disturbances, tinnitus.

Vestibular migraines may occur in all age groups including children.

Vestibular migraines may be triggered by stress, anxiety, food or drinks such as caffeine, alcohol or dairy products, lack or too much of sleep, and hormonal changes like menstruation.

Vestibular migraines may be treated using medications such as triptans, beta blockers, and calcium channel blockers.

This type of migraine may be reduce through lifestyle modifications such as regular exercises, eating healthy, reducing stress, avoiding food or drinks that may trigger vestibular migraines.

Ocular migraine or Eye migraine

As defined by the International Headache Society, an ocular migraine is a type of migraine attack of fully reversible and temporary loss of vision or blindness in only one eye.

Ocular migraine may occur with or after a migraine headache.

Although other migraines also have visual disturbances that occur in both eyes, ocular migraine occur in only one eye.

Ocular migraine is characterized by the following symptoms:

  • Flashes of light or shimmering lights
  • Seeing Zigzaggling lines
  • Temporary loss of vision or blindness in one eye
  • A headache that occurs on one side and last for 4 to 72 hours
  • Nausea and vomiting may occur

Ocular migraine can be triggered by bright lights, loud sounds, caffeine, and foods containing MSG, tyramine, and nitrates, red wine.

Others may include stress, anxiety, and strong odors. These triggers vary from person to person.

The cause of ocular migraine is not quite certain, but experts believed that ocular migraine may be connected to spasms of blood vessels in the retina and nerve cells changes that spread all over the retina.

Ocular migraine symptoms most often occur within an hour of a headache and usually go away in 30 minutes.

It is advisable that when you experience a headache try and rest your eyes or take a pain reliever recommended to you by your doctor.

Other medications that are used for ocular migraine include antiepileptics, tricyclic antidepressants and beta blockers.

Complex migraine

A complex migraine is a type of migraine with aura. Its symptoms are similar to those of stroke.

These symptoms include fatigue or body weakness, stress, mood disorders, loss of vision and difficulty in speech.

David Dodick, M.D., neurologist, Mayo Clinic in Arizona, further explains the symptoms, triggers and treatment for complex migraines.

Watch this video below to know more…

Menstrual migraine

Menstrual-related migraines can occur with or without aura. It affects up to 60 percent of women who have any type of migraine.

Menstrual migraine usually occurs 2 days before a menstrual period and 3 days after the period starts.

The pain associated with menstrual migraine occurs in the presence of the hormone estrogen.

Estrogen is the female sex hormone responsible for regulating menstrual cycle.

Whenever the estrogen and progesterone levels change it makes women become more vulnerable to headaches.

Some factors can trigger menstrual migraine such as oral contraceptives, and birth control pills.

Oral contraceptives and birth control pills usually influence estrogen and progesterone levels.

The symptoms of menstrual migraine are similar to migraines without aura which include photophobia, phonophobia, nausea and vomiting.

Common medications that have proven to be effective in menstrual migraine include nonsteroidal anti-inflammatory drugs (NSAIDs), dihydroergotamine (DHE), triptans, and aspirin, acetaminophen, and caffeine combination (AAC).

Acephalgic migraine or migraine without headache

An Acephalgic migraine is an uncommon type of migraine. It occurs when a person experiences an aura without a headache.

Acephalgic migraine is also referred to as migraine without headache, aura without headache, silent migraine, and visual migraine without headache.

The name acephalgic, silent, or visual are not diagnostic terms but are terms used to describe a migraine without headache.

Acephalgic migraine is common to all age groups. It occurs more in females than males and the incident increases during perimenopause.

Acephalgic migraine is characterized by all the symptoms of migraine but without a headache pain.

These symptoms include flashes of light, seeing shimmering colors, visual disturbances, seeing zigzag lines and many more.

It is important to note that acephalgic migraine symptoms are similar to stroke or transient ischemic attack symptoms, therefore it is expedient that differential diagnosis is conducted to rule out stroke and transient ischemic attack.

Common Acephalgic migraine triggers  include caffeine, alcohol, chocolate, food or drinks with tyramine such as red wine, bright lights, sensitivity to sound, extreme weather conditions, hormonal changes e.g menstruation, pregnancy, birth control pills, and lack of sleep or amnesia, missed meals.

Some of the major ways to prevent the occurrence of acephalgic migraine include eating healthy meals, having adequate rest and sleep, regular exercises, and reduce stress.

Hormonal migraines

Hormonal migraines mostly occur in women due to changes in hormone levels.

This type of migraine is linked to the female hormone estrogen.

The levels of hormone changes during menstruation, when a woman is pregnant, and before and during menopause.

Also hormonal levels are affected when a woman is taking birth control pills and oral contraceptive pills.

The occurrence of Headaches is connected to the female hormone estrogen.

Estrogen is a female sex hormone that controls the chemical serotonin in the brain. Serotonin is a neurotransmitter that regulates pain and mood.

A drop in the levels of estrogen can trigger a headache.

Hormonal migraine is characterized by the following symptoms: acne, loss of appetite, weakness, lack of coordination, constipation, decreased urination.

Hormonal migraine can be treated with or without medications.

Home or non-pharmacological remedies include drinking plenty of fluids, placing a cold ice bag on the head, lying down in a dark and quite room, performing deep breath relaxation exercises, Doing a gentle massage where you feel the pain.

Medication or pharmacological approach include the use of NSAIDS and triptans, beta blockers, antidepressants, calcium channel blockers and anticonvulsants.

Cluster migraine

A cluster migraine is a rare type of migraine. It occurs in about 1 to 2 people in every 1000.

It is characterized by recurrent episodes of intensely painful headaches in and around the eye on one side of the head that last for weeks or months.

The cause of cluster headache is not known but it is believed that once you are exposed to the triggers you will experience a headache.

The headache is often accompanied by nasal congestion, watery eye, and swollen eye on one side. These symptoms usually last for 15mins to 3 hours.

Some factors that may predispose you to cluster headache include tobacco smoke, alcohol and strong odor or smell.

Several treatment options are available, for acute attack; fast acting triptans, dihydroergotamine, and lidocaine spray are often prescribed.

You may be prescribed preventive medications such as prednisolone, ergotamine, gabapentin and verapamil, these medications are usually taken before a headache which helps to reduce the length of time and severity of the cluster headache.

Vascular migraine

Vascular migraine is a type of headache that is caused by the dilation of blood vessels. This dilation causes flushing that leads to a pulsating or throbbing pain, this pain may get worse with stress or physical exercise.

Vascular migraine is characterized by sensitivity to light, loss of vision, light headedness and nausea with or without vomiting.

Lifestyle modifications, stress reductions and a healthy diet are the major treatment options for vascular migraine.

They help to reduce the frequency and severity of vascular migraine. Other options are the use of analgesics such as NSAIDS.

Migraines in children

migraine in children

Migraine headache can run from parents to their children.

It occurs in children whose parents or any member of the family has migraine or has had migraine episodes when they were kids.

Children do not have their specific type of migraine, they experience similar migraine headaches that are common in adults.

Children with migraine may also experience severe symptoms such as depression and anxiety disorders.

Children are more likely to have bilateral symptoms on the head when they grow older.

Headaches that occur in the back of the head are very rare in children and their migraine usually last for 2-72 hours.

A couple of migraine variations are increasingly prevalent in children. These consist of abdominal migraines, benign paroxysmal vertigo, and cyclic vomitting.

Abdominal migraine

Abdominal migraine is a type of migraine that occurs mainly in children aged 5-9 years.

It can also be seen in adults. Abdominal migraine is characterized by stomach ache, nausea and vomiting.

Abdominal migraine might be connected to parents or relatives of children that have migraines or have had abdominal migraine when they were kids which later developed into migraine headache in their adulthood.

The abdominal pain that comes with this type of migraine is dull which maybe moderate to severe. Usually the pain is felt in the middle of the abdomen around the navel region.

Other symptoms your child may experience include headache, loss of appetite, nausea and extreme paleness. These symptoms last for 2-72 hours and in between these symptoms there should be complete symptom relief.

Most children who experience abdominal migraine grow out of it by their adolescents and in the end develop migraine headache.

Benign paroxysmal vertigo

Benign paroxysmal vertigo also known as BPV is a sudden sensation of spinning or dizziness, where you feel like your head is spinning from inside. This spinning or dizziness might be mild or intense.

BPV can occur in young children. Along with spinning sensation, your child may experience the following symptoms:

  • Nystagmus (rapid eye movements)
  • loss of balance or difficulty walking
  • Vomiting
  • Palor
  • Too much Fear
  • Sweating
  • Head tilt

The symptoms may last from few seconds to a minute and are relieved with adequate sleep.

Cyclic vomiting

Cyclic vomiting is characterized by episodes of intense vomiting. It often occurs in school-age kids.

Intense vomiting may happen four to five times within an hour for at least 60 minutes.

In addition to recurrent intense vomiting, your child may also have the following symptoms:

  • stomach ache
  • headache
  • sensitivity to light (photophobia)
  • Sensitivity to sound (phonophobia)

These symptoms may last from 1 hour to 10 days.

In between episodes of vomiting, your child may act and feel completely healthy. Symptomatic attacks can occur weeks apart.

The symptoms may develop a pattern of occurrence that becomes recognizable and predictable.

The symptoms of cyclic vomiting may be more noticeable than other migraine symptoms that children and teens experience.

Migraines and pregnancy

migraine in pregnancy

Women that are prone to migraine headache before getting pregnant may experience stronger headaches, or their migraine headache may improve during pregnancy.

Studies have revealed a slight relationship between migraines and hormones.

It is imperative that a pregnant woman suffering from headaches should be given special care or attention because the headache may be a sign of another disease condition.

Knowing the cause of headache in a pregnant woman is a major step in diagnosing and treating migraine in pregnancy, hence the cause of every headache should be well known before treatment.

Studies have revealed that pregnant women with migraine are at higher risk of experiencing the following conditions:

  • Early delivery
  • Preeclampsia
  • Give birth to a baby with low birth weight

Of all the treatments of migraine, one major way that a pregnant woman can treat migraine is by identifying her triggers using a headache diary.

Some of the migraine triggers that are common in pregnant women include:

  • Stress or lack of adequate rest
  • Eating Chocolate
  • Eating Cheese
  • Drinking Coffee
  • Unfavorable Weather conditions

Once triggers are identified, you can do the following simple procedures to take care of the migraine headaches.

These procedures include:

  • Gentle exercise
  • Take a little nap
  • Apply a cold towel on your forehead
  • Take a cold shower

One of the medications considered safe for use in pregnancy is acetaminophen. For more information on the safest medications to use for your migraines, kindly consult your doctor.

How do I know if I have a migraine or another type of headache?

Trying to identify migraine or other forms of headache has always been a major challenge to doctors and other health care providers.

Although most moderate to severe headaches or headaches that do not respond to OTC analgesics are considered as migraine, specific methods of identifying migraine and other forms of headache are available.

Below is a table showing the different ways migraine and Tension headache are identified:

PropertyMigraineTension headache
Other namesMigraine headache/painTension-typed headache
OccurrenceLess frequent than             tension headacheMost common
CausesChanges in brain chemicals eg serotoninStress, impaired sleep, skipping meals
PainModerate or severe, pounding or throbbingMild, moderate or severe
Affect daily routinesYesNo
LocationUnilateral or bilateral sides of the headBilateral
SymptomsPhotophobia

Phonophobia

Nausea with or without vomiting

Aura

Little sensitivity to light and sound

No nausea or vomiting

No aura

Diagnosis

diagnosis of migraines

Your Doctor may diagnose your migraines by paying attention to your symptoms, taking your medical and family history, and performing a physical examination to rule out other potential causes.

Imaging scans, such as a CT scan or MRI, can rule out other causes, including:

  • Tumors
  • Abnormal brain structures
  • Stroke

Read more>> Migraines-Causes and Symptoms

Treatment

drugs for the treatment of migraine

Migraines can’t be cured, but can be well managed. The treatment of migraine depends on the frequency of the headache, the type of medications used and for how long.

Your treatment plan depends on:

  • Your age
  • How often you experience migraines
  • The type of a migraine you have
  • The severity of the migraine
  • Whether the migraine has nausea or vomiting, as well as other symptoms
  • Other health conditions you may have and other medications you may take

Your treatment plan may include a combination of these:

Homemade migraine remedies such as:

  • Lifestyle modifications, including stress management and avoiding migraine triggers
  • OTC pain or migraine medications, such as NSAIDs or acetaminophen (Tylenol)
  • Prescription migraine medications that you take every day to help prevent migraines and reduce how often you have headaches such as triptans
  • Prescription migraine medications that you take as soon as a headache starts, to keep it from becoming severe and to ease symptoms such as triptans and NSAIDS
  • Prescription medications to help with nausea or vomiting such as entiemetics
  • Hormone therapy if migraines seem to occur in relation to your menstrual cycle
  • Counseling
  • Alternative treatment, which may include biofeedback, meditation, acupressure, or acupuncture

Preventive Measures

preventive treatments of migraine

The following are measures that will help you prevent future occurrences of migraine:

  • Identify what your migraine triggers are and avoid them.
  • Drink plenty of fluids daily. Men should drink about 13 cups of fluids and women should drink 9 cups.
  • Don’t skip meals.
  • Ensure you get quality sleep. A good night’s sleep is important for overall health.
  • Quit smoking.
  • Reduce stress
  • Learn to meditate or do yoga.
  • Regular Exercises

In Conclusion, Speak to your doctor

diagnosis of migraine

Sometimes having migraine-like symptoms does not mean you have a migraine headache, because these symptoms are also similar to those of a stroke.

Therefore it is important to speak to your doctor whenever you or your family members experience a headache that:

  • Causes slurred speech that are difficult to comprehend
  • Causes an unusual fatigue in your legs or arms
  • Happens rapidly and severely without an initially established symptom or warning
  • Occurs with a convulsion, poor vision, a high body temperature, feebleness, neck stiffness, confusion, numbness, or difficulty speaking.
  • Has an aura where the symptoms last longer than an hour
  • Is characterized by loss of consciousness

Try and see your doctor immediately you notice that your headache is affecting your daily activities and every other severe symptom that you experience.

Generally speaking, Migraine headaches can cause a debilitating, and severe pain that is very uncomfortable.

Try to have a headache diary to keep track of when your headache occurs and the symptoms associated with it, this will help you identify your triggers. Identifying your triggers will go a long way in helping you prevent migraine.

Headache diary

The good news is, there are so many treatment options that are available for you, I advise you to patiently discover the right one for yourself.

Read more>> Migraines-Causes and Symptoms

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