What is a migraine headache?

The migraine is a type of vascular headache that is usually characterized by the following:

• severe pain on one or both sides of the head
• nausea and/or vomiting
• aura or disturbed vision
• and intolerance to light

What are the most common types of migraines?

The three most common types of migraine attacks are:

• With Aura or Classic Migraine is a type of migraine that involves the appearance of neurological symptoms, called an aura (flashing lights or zigzag lines, or temporary loss of vision) 10 to 30 minutes before an attack. An attack may last one or two days. Other aura classic migraine symptoms may include:
  • difficulty with speech
  • weakness of an arm or leg
  • tingling of the face or hands
  • confusion
  
  Pain associated with aura classic migraines is often described as intense, throbbing, or pounding felt in the forehead, temple area, facial area, or around the eye(s). Pain may feel as though it starts in one area and travels to another, where pain becomes more intense.
  
  
• Without Aura or Common Migraine is a type of migraine that is generally not preceded by an aura, although there may be a variety of symptoms prior to its onset. Common migraine pain may last three or four days. Symptoms may include:
  • mental "fuzziness" mood changes, fatigue, unusual retention of fluids, diarrhea and increased urination
  • nausea and vomiting
    


• Atypical Migraine (aura with dull or no headache)

Are there other types of migraines?

There are several other types of migraines including:

• Hemiplegic Migraine - Symptoms include temporary paralysis on one side of the body (Hemiplegic), vision problems, and vertigo, which begin 10 to 90 minutes before the onset of headache pain.


• Ophthalmoplegic Migraine - Symptoms include pain around the eye, sometimes with a droopy eyelid, double vision, and other sight problems.


• Basilar Migraine - Pre-headache symptoms may include vertigo, double vision, and poor muscular coordination.


• Vertiginous Migraine essentially aura without headache also known as Benign Recurrent Vertigo of adults, essentially a was described first by Slater (1979) but his observations have been confirmed by others (e.g. Lee et al, 2002). It consists of spells of vertigo, which can include tinnitus, but without hearing loss (were hearing loss allowed, this disorder would become very difficult to distinguish from Menieres disease ). Vertigo lasts from minutes to hours. Not all authors agree that BRV is caused by migraine however, and Leliever and Barber suggested that it is caused by peripheral vestibular lesions (Leliever and Barber, 1981).


• Benign Paroxysmal Vertigo syndrome of children, as described under the heading of familial syndromes, where headache does not occur. Cutrer and Baloh (1992) also observed that dizziness and headaches are not necessarily closely associated. In fact, in their 91 patients, only 5 had a consistent recurring dizziness with headache. In 30%, dizziness was consistently independent of headache. In most, spells sometimes occurred with and sometimes independently.


• Benign Exertional Headache - This headache begins at the onset of activity, with pain rarely lasting for more than several minutes and are generally brought on by running, lifting, coughing, sneezing, or bending.


• Status Migrainosus - This is a rare and severe type of migraine that can last 72 hours or longer. Pain and nausea with this headache are often so intense that hospitalization may be necessary.


• Cyclic Vomiting Syndrome (CVS) is now being looked at and considered to be a possible form of migraine. It is an unexplained functional digestive disorder characterized by recurrent, prolonged attacks of severe nausea, vomiting and abdominal pain resulting in decreased quality of life for both children & adults. Largely overlooked until about 10 years ago, millions of people worldwide suffer from this debilitating syndrome, while the clinical doctors are increasingly educated about CVS, the number of US patients diagnosed with this syndrome is climbing at a staggering rate.


• Vestibular Migraines
  Dizziness as a symptom of migraine is a common and often ignored cause of balance disorders. Migraine is a blood vessel (vascular) disease characterized by periodic, usually one-sided, headaches. These headaches are often preceded for a variable time by associated neurological symptoms, called the aura. Dizziness and vertigo can occur in individuals with migraine as part of the migraine aura or separately. Furthermore, dizziness may not occur at the same time as the headache and can even occur as an isolated event. Particularly in younger patients, dizziness or vertigo may predate the onset of headaches entirely.
  
  A family history of migraine is very common. Indeed, a family history of migraine should alert a person that a balance disorder may be migraine related. Migraine is estimated to affect nearly 25% of women, 15% of men, and 5% to 10% of children. Vertigo is very common in persons with migraine, occurring in about 25% of them. Actually, in one series, 42% of migraine patients experienced vertigo not in association with their headaches.