Different Types of Migraines: A Guide

Migraines are common and can have a big impact on daily life. Maybe you — or someone you know — has had a migraine and you want to understand it better. Or maybe you’re curious about some of the symptoms migraines can cause. If you want to know more about the different types of migraines, this guide is for you.

What is a migraine?

A migraine is a neurological disorder that most often shows up as a severe headache, nausea, and sensitivity to light and sound. Migraines last anywhere from a few hours to a few days on average and can be very debilitating. 

A migraine most often feels like a headache. But migraines are different from other headaches in a number of ways. For one thing, they often come with other symptoms, like visual or sensory changes — which can feel scary. This is called an aura and it can happen before or during a migraine. 

Migraines also often follow a pattern that’s predictable. They often occur due to certain triggers and may have the same symptoms each time.

Migraine symptoms and causes

Because different parts of the brain can be affected, people with migraines may have very different symptoms. While throbbing headache pain on one side is the most common symptom, it isn’t part of every migraine. Other symptoms include:

• Nausea

• Vomiting

• Sensitivity to light and sound or strong smells

• Visual changes (like blurry vision, flashing lights, or zigzag lines)

• Abdominal pain

• Dizziness

• Weakness

Migraines are often caused by certain triggers that differ from person to person. Common triggers for migraines include:

• Lack of sleep

• Stress

• Fasting

• Foods (certain cheeses, meats, chocolate)

• Alcohol

• Caffeine

• Strenuous exercise

• Hormonal changes (like menstrual cycle, pregnancy)

8 types of migraines and how to treat them 

Most people think of migraines as only headaches, and they often are. But migraines can take a number of different forms. Here’s a guide to eight different types of migraines.

1. Migraine without aura

What it is

The most common type of migraine is a pounding headache. For adults, only one side of the head is affected at a time, and the pain is moderate or severe. A migraine usually lasts several hours and can stick around for a couple of days. Migraine symptoms can often be made worse by:

• Bright lights

• Loud sounds

• Strong odors

Because migraines come and go over time, most people have had several migraine headaches before they recognize what’s going on.

Best ways to treat it

Over-the-counter (OTC) treatments for a migraine without aura include:

• Acetaminophen (Tylenol)

• Ibuprofen (Advil or Motrin)

• Naproxen (Aleve)

Prescription medications that can work for stopping a migraine include:

• Triptans like sumatriptan (Imitrex), zolmitriptan (Zomig), or rizatriptan (Maxalt)

• Dihydroergotamine (Migranal)

• Diclofenac (Cambia, Zorvolex)

• Lasmiditan (Reyvow)

• Rimegepant (Nurtec)

Other treatments that can be effective include oxygen therapy and neurostimulation devices.

2. Migraine with aura

What it is

About one-third of the time, a migraine headache comes with an aura. An aura is a sensory experience that’s caused by the brain itself. There are several different types of auras:

• Visual aura: This is the most common type of aura. Most often, it looks like a ring of flickering lights that spreads slowly across your vision.

• Sensory aura: This type of aura feels like pins and needles. It often happens on one side of the face, body, or tongue, and spreads over several minutes before disappearing.

• Speech/language aura: Sometimes the aura causes aphasia, or difficulty speaking.

A typical migraine aura starts gradually, spreads, and then fades over a few minutes. It doesn’t cause any weakness or movement troubles, and it goes away completely when the migraine is over. It isn’t painful, but it can be disorienting. 

Most of the time, an aura occurs at the beginning of a migraine headache, but it can happen at any point before or during the head pain. Sometimes, people who get migraines can experience an aura without getting any headache at all.

Best ways to treat it

A migraine with aura can be treated in much the same way as a migraine without aura. But, a stroke can also cause symptoms that are very similar to an aura. So it’s important to pay careful attention to what symptoms you have, when they start, and when they go away. 

If you get symptoms that are different from what you’ve experienced with your headaches before, seek medical attention right away. 

3. Migraine with brainstem aura

Migraine with brainstem aura is also called basilar migraine and vestibular migraine.

What it is

A migraine with brainstem aura is one that causes:

• Dizziness

• Ringing in the ears

• Double vision

• Loss of balance

Like other auras, the brainstem aura develops gradually over several minutes and then fades completely.

Best ways to treat it

The treatment for migraine with brainstem aura is similar to the treatment of migraine with aura. But in this case, triptan medications are not thought to be helpful. Useful treatments for vestibular migraine may include: 

• Medication for nausea (like promethazine)

• Medication for vertigo (like meclizine)

• Topiramate

• Beta blockers (like propranolol)

• Nortriptyline

4. Retinal migraine

A retinal migraine is also called an ocular migraine.

What it is

A retinal migraine is a migraine with a visual aura that you only see in one eye. Sometimes, the visual aura in a retinal migraine can be a loss of vision or “blind spots”. These spots can be large enough to make it hard to see anything from the affected eye. Like other migraine auras, the aura that comes with a retinal migraine spreads and fades over a few minutes. 

Blindness in one eye is a frightening experience, and it can be a sign of stroke or other neurological condition. If you think you might have this type of migraine, you should be seen by a healthcare provider to figure out what’s causing your symptoms.

Best ways to treat it

The same medications used for other types of migraines can be effective in treating retinal migraines as well.

5. Hemiplegic migraine

What it is

A hemiplegic migraine is similar to a migraine with aura, except that the aura causes certain muscles to get weak. The weakness usually happens on one side of the body, and it can range from mild to severe. 

Some people with hemiplegic migraines only notice a small difference in strength when they get a migraine. Others have symptoms so severe they can’t walk or move. 

Like other migraine auras, the weakness caused by hemiplegic migraine goes away completely when the migraine is over. But it can take up to 72 hours to do so.

Familial hemiplegic migraine

About half the time, hemiplegic migraines run in families. When this happens, the symptoms are often more severe. These days, healthcare providers can test family members of people with hemiplegic migraines to see if they carry one of the genes that causes them.

Best ways to treat it

For the headache, a useful treatment can be nonsteroidal anti-inflammatory drugs (NSAIDs), such as:

• Ibuprofen (Advil or Motrin)

• Naproxen (Aleve)

• Diclofenac (Cambia, Zorvolex)

Treating the muscle weakness is more difficult, but researchers are studying a few different possible treatments right now. 

In general, it’s not a good idea to use triptan medications if you have hemiplegic migraines, because they could increase the risk of stroke.

6. Menstrual migraine

What it is

A menstrual migraine is a migraine that comes and goes according to your menstrual cycle. Most of the time, menstrual migraines happen during the several days before — or right after — your period starts. Any of the types of migraine discussed here can be menstrual migraines, although the most common are migraines without aura. Migraines that happen with the menstrual cycle can be especially intense and difficult to treat.

Best ways to treat it

Menstrual migraines can be treated in the same ways as the other types of migraines. The good thing about menstrual migraines, however, is that the timing of them is fairly predictable. Since menstrual migraines come and go with your period, one way to treat them is to take a preventive medication, most commonly a triptan. It may be useful to take this medication a few days before you expect your period. 

Combination birth control pills taken continuously to suppress your period may also help. But women who get migraines with aura shouldn’t use them due to the increased risk of stroke. 

If you suspect you’re having hormonal migraines, your healthcare provider can help you figure out the best treatment for your symptoms.  

7. Chronic migraine and status migrainosus

What it is

Most migraines come and go within a few hours and happen a few times per month or less. If you get migraines 15 or more times per month for several months, you may have chronic migraines.

If you get a single migraine that lasts longer than 72 hours and the symptoms are debilitating, that’s called status migrainosus.

Best ways to treat it

Chronic migraines usually require a preventive medication that you take every day. Examples of preventive medications used for chronic migraine are:

• Propranolol (Inderal)

• Amitriptyline (Elavil)

• Topiramate (Topamax)

Status migrainosus is difficult to treat. A headache specialist or emergency care team usually needs to be involved in treating these symptoms.

8. Abdominal migraine

What it is

Abdominal migraines happen in children. You can think of them as a migraine of the stomach. Abdominal migraine involves belly pain around the belly button that comes in episodes without any obvious cause. During an episode, the child has symptom, such as:

• Stomach pain

• Nausea and/or vomiting

• Looking pale or flushed

• Loss of appetite

Sometimes, a child with an abdominal migraine has a headache at the same time, but sometimes they don’t. Each episode can last for hours or days, and in between episodes the child goes back to normal. Children who get abdominal migraines tend to develop migraine headaches when they get older.

Cyclical vomiting syndrome

In some children, the stomach pain isn’t as big of a problem as the vomiting. The vomiting can be severe and occur several times per hour. Cyclical vomiting episodes happen on a predictable cycle without any other cause.

Best ways to treat it

Usually, abdominal migraines go away as children get older. Most of the time, no medications are needed. If abdominal migraines happen often, treatment includes following a special diet and avoiding foods or situations that trigger it.

Other common treatments for abdominal migraine include:

• OTC pain relievers (ibuprofen, acetaminophen)

• Medications for nausea (like chlorpromazine)

• Sumatriptan

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Written by:

Kerry R. McGee, MD, FAAP

Kerry McGee, MD, FAAP, has over a decade of experience caring for babies, children, and teenagers as a primary care pediatrician. She has a special interest in adolescent health, particularly in adolescent mental health.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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