Migraines are the third most prevalent health problem in the world and affect approximately 12 percent of the population. More common in women than men, migraines account for 1.2 million emergency room visits every year in the U.S. alone. Over four million people suffer from chronic daily migraines, and 85 percent of these sufferers are women.

Unlike the squeezing pain of a tension headache, migraines present with intense pulsing or throbbing pain and are occasionally accompanied by warning signs known as an aura. Symptoms in other parts of the body may also be present.

Recognizing the different types of migraines can help get the right kind of treatment for one’s condition. Discussing the symptoms with a doctor can help discover the kind of migraine from which a person suffers from and what treatments are available.

1. With Aura

When a migraine is accompanied by events such as visual disturbances, auditory symptoms, strange smells, or emotional changes, it’s known as a migraine with aura. These symptoms appear before the onset of migraine pain.

Causes

• Alcohol use
• Bright lights
• Changes in pressure
• Emotional distress
• Food choices
• Intense exercise
• Loud noises
• Medications
• Skipping meals
• Smoking
• Stress
• Strong smells
• Travel

Symptoms

Prior to the migraine:

• Blind spots, squiggles, or lines in vision
• Depression or mood changes
• Feeling “off” or “funny”
• Olfactory abnormalities
• Prickling in arms, face, or legs
• Ringing in the ears
• Seeing flashing lights

During the headache:

• Dizziness or feeling faint
• Nausea
• Sensitivity to light or sound
• Throbbing head pain

Treatments

• Acupressure
• Anti-nausea medications
• Ginger powder
• Lifestyle changes, including avoiding known triggers
• Managing stress
• Massage
• Over-the-counter (OTC) pain medications
• Prescription migraine medications
• Use of lavender or peppermint essential oils
• Yoga or other gentle movements

2. Without Aura

Once called a “common migraine,” this is the type of migraine most sufferers experience. Up to 85 percent of migraines occur without an aura, meaning no physical “warning” is present before the onset of pain.

Causes

Migraines without auras are thought to be caused by the same triggers as those presenting with an aura.

Symptoms

• Intense pain on one or both sides of the head
• Pain in the temples
• Sensitivity to light and sound
• Nausea
• Vomiting
• Anxiety or depression
• Fatigue

These symptoms may last up to 72 hours.

Treatments

Treatments used to ease the symptoms of migraines with auras are also effective for those without auras.

3. Ocular

Ocular migraines occur with visual disturbances and are rare among migraine sufferers. Visual symptoms may or may not be accompanied by traditional migraine pain.

Causes

• Genetics
• Hormonal changes, especially fluctuations in estrogen
• Similar triggers as a migraine with aura

Symptoms

• Aura may be experienced
• Blind spots
• Inability to perform regular tasks, including driving
• Seeing unusual images
• Temporary blindness in one eye
• Visual symptoms in only one eye

Treatments

Although ocular migraines usually disappear on their own, doctors may prescribe one or more treatments if symptoms are severe or interfere with daily life. Common treatments include:

• Antidepressants
• Anti-seizure medications
• Beta-blockers

4. Silent

When an aura occurs without a headache, it’s called a silent migraine. Aura symptoms may last for a few minutes or persist for several hours.

Causes

Specific causes for silent migraines are unknown, but theories include:

• Genetics
• Changes in the blood vessels in the brain
• Chemical changes in the brain
• Common migraine triggers

Symptoms

• Blurred vision
• Confusion and dizziness
• Digestive symptoms
• Lines or zigzags in the field of vision
• Sensitivity to light
• Tingling
• Trouble speaking
• Vision loss
• Weakness

Treatments

Silent migraines with short durations often don’t require treatment. Persistent symptoms may be managed with:

• Dietary changes
• Lifestyle changes
• OTC pain medications

5. Hemiplegic

A small number of people suffering from migraine with aura experience hemiplegia, or paralysis, as a symptom. Hemiplegic migraines may be related to genetics, known as familial, or may come on sporadically.

Causes

• Genetics
• Abnormalities in neurotransmitter production or communication within the brain
• Bright lights
• Lack of sleep
• Stress

Symptoms

• Symptoms of migraine with aura
• Confusion or trouble speaking, similar to stroke symptoms
• Numbness
• Paralysis on one side of the body
• Tingling
• Weakness

Rare symptoms include:

• Memory loss
• Loss of consciousness
• Coma

Treatments

• Anti-seizure drugs
• Avoiding certain drugs used to treat other types of migraines
• Reducing blood pressure

6. Vestibular

Episodes of vertigo may occur in people with a history of migraines. “Vestibular” refers to the inner ear, suggesting a problem with communication between the brain and the balance system located in this area of the body. This type of migraine affects only about one percent of the population.

Causes

• Certain types of food
• Dehydration
• Female gender
• Lack of sleep
• Menstruation
• Stress
• Weather changes

Symptoms

• Vertigo without pain
• Dizziness
• Feeling lightheaded
• Feeling off-balance
• Motion sickness
• Nausea
• Vomiting
• “Rocking” sensation

Symptoms last anywhere from a few seconds to a few days.

Treatments

• Adequate sleep
• Beta blockers
• Calcium channel blockers
• Extra rest during menstruation
• Hydration
• Regular exercise
• Standard migraine medications

7. Menstrual

Many women experience migraines during their menstrual cycles even if they’re not prone to these headaches at other times.

Causes

• Hormonal changes, mainly estrogen fluctuation prior to menstruation

Symptoms

• Lack of aura
• Cyclical onset
• Standard migraine symptoms
• May begin prior to menstruation as a symptom of PMS

Treatments

• Acupuncture
• Hormone balancing therapies
• Ice
• OTC pain medications
• Prescription pain relievers
• Relaxation exercises
• Triptan medications to block pain signals in the brain

8. Abdominal

Most commonly seen in children ages five to nine, abdominal migraines are associated with digestive symptoms rather than head pain. Adults may also experience this type of migraine, but occurrences are rare.

Causes

• Genetic
• Problems with communication in the gut-brain axis

Symptoms

• Abdominal pain
• Looking pale
• Loss of appetite
• Nausea
• Vomiting

Treatments

• Anti-nausea medications
• Staying hydrated
• Non-steroidal anti-inflammatory drugs (NSAIDs), such as acetaminophen or ibuprofen
• Triptans

9. Basilar

Basilar migraines begin at the brain stem. Also called basilar artery migraines, these headaches primarily affect teens and young adults.

Causes

Doctors aren’t sure what causes basilar migraines, but triggers may include:

• Vasoconstriction (tight blood vessels)
• Muscle tension around blood vessels
• Twisted blood vessels
• Conditions limiting blood flow to the brain

Symptoms

• Head pain and physical symptoms of migraine with aura
• Loss of muscle control (ataxia)
• Loss of consciousness
• Numbness in the face, hands or head

Treatments

• Anti-nausea medications
• Avoiding known triggers
• Improving sleep habits to ensure a full night’s rest
• NSAIDs
• Resting or stopping work when migraine symptoms begin

10. Status Migrainosus

Status migrainosus, or intractable migraine, is a debilitating migraine lasting more than 72 hours. Occasionally this type of migraine may indicate a more serious underlying condition and require emergency treatment.

Causes

• Excessive use of painkillers
• Inadequate treatment at the onset of pain
• Incorrect treatment due to a wrong diagnosis

Symptoms

Status migrainosus presents with the same symptoms as a normal migraine, but with two notable differences:

• Increased symptom severity and duration
• Symptoms don’t resolve with standard treatment

Treatments

Because the medications and lifestyle adjustments used to treat other migraines don’t help when the pain becomes severe and prolonged, doctors sometimes prescribe:

• Anti-inflammatory drugs, such as prednisone
• Anti-nausea medications
• IV hydration
• IV medications

11. Transformed

When sufferers of occasional migraines begin to experience pain 15 or more days per month, the migraines are said to have transformed into a chronic condition. Initial episodes usually start when sufferers are in their teens and progress to chronic status.

Causes

• Excessive use of OTC headache medications
• Female gender
• Head injury
• Long history of suffering from migraines

Symptoms

• Frequent, moderately severe migraines progressing to daily occurrences
• Persistent migraine pain
• Ongoing physical symptoms associated with migraines
• Nausea
• Vomiting
• Depression
• Anxiety

Treatments

• Anticonvulsants
• Antidepressants
• Lifestyle and dietary changes
• Working with a pain management specialist

12. Visual

Also called scintillating scotoma, a visual migraine involves a specific type of aura either preceding typical migraine pain or presenting on its own.

Causes

• Abnormalities in electrical impulses in the brain
• Blood vessel spasms
• Problems with the occipital cortex of the brain

Symptoms

• Flickering, sparkling, or shimmering in the center of the field of vision
• Jagged edges around the aura
• Aura expands during the duration of an episode
• Patterns are seen within the aura
• Persists for 20 to 30 minutes before disappearing
• Migraine pain may or may not occur

Treatments

Most visual migraines aren’t disruptive enough to require special treatment, but some sufferers may benefit from:

• Anti-inflammatory medications
• OTC pain medications
• Eating a healthy meal

If one struggles with any of these types of migraines, work with a doctor or pain management specialist to ease the symptoms and address the underlying causes with the appropriate diet and lifestyle changes.