There are several types of migraine, each with different sets of symptoms and varying levels of pain. The two main types are classified as those with aura and those without aura, formerly known as classical migraine and common migraine, respectively.
Aura is a term used to describe visual disturbances such as blurred vision, flashing lights, blind spots, and wavy lines, as well as numbness or trouble speaking. In migraine with aura, such symptoms are a telltale sign that an attack is about to occur and head pain will typically follow within 10 to 30 minutes.
In migraine without aura, however, visual disturbances are not present and head pain appears suddenly, often without warning. In terms of prevalence, 10 to 30% of people with migraine experience migraine with aura, while 70 to 90% of sufferers experience migraine without aura.
Chronic migraine is defined as having 15 or more headache days per month, over a period of 3 months. The opposite of this type of migraine is episodic migraine, defined as having fewer than 15 headache days per month. While chronic migraine affects less than 1% of the population, those who do suffer from this disorder experience significant impairment in their daily lives. This is due to the nature of the attack and the length of time it affects the sufferer, which leads to absences from school and work, as well as social and leisure activities. Approximately 3 to 4% of people with episodic migraine will progress to chronic migraine every year.
Hemiplegic migraine causes temporary weakness or paralysis on one side of the body, which may occur prior to or during a headache and can last several days. This is a rare but severe subtype of migraine with aura and is further broken down into familial hemiplegic migraine (FHM) and sporadic hemiplegic migraine (SHM). The term familial hemiplegic migraine is used when two or more members of the same family experience symptoms and this is often the result of a genetic mutation. Sporadic hemiplegic migraine, on the other hand, is when an individual experiences symptoms, but has no known familial connection to the disorder. Symptoms for both FHM and SHM include vertigo, pricking or stabbing sensations, and trouble speaking or swallowing.
Migraine with brainstem aura (MBA), formerly called basilar-type migraine, is another rare subtype of migraine with aura. Neurological symptoms include visual disturbances, difficulties speaking, hearing problems, tingling or numbness in the extremities, dizziness, vertigo, and ringing in the ears. These headaches start in the lower part of the brain, hence the name ‘brainstem aura’, and spread gradually to other parts of the head. This type of migraine generally starts in childhood or the early teenage years and is more common in women than men.
Vestibular migraine is characterized by dizziness and vertigo, which may or may not involve a headache. There are several terms for this type of migraine, ranging from migraine related dizziness to migrainous vertigo, but the important thing to note here is the association between migraine and vertigo.
Vertigo is a term used to describe the feeling of spinning or a loss of balance, which can occur as part of the aura or independently thereof. This type of migraine is most common between the ages of 25 and 45 and research suggests that up to 50% of migraine sufferers will experience vestibular migraine.