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March 4, 2021
5 min. read

Migraines: Types & Treatment Options

Medly

Migraine, a type of primary headache disorder that can cause severe pain and other symptoms, is extraordinarily common. In fact, it affects 39 million men, women and children in the U.S. and 1 billion worldwide. Despite the fact that it affects millions of Americans, it remains largely misunderstood.

A migraine is much more than just a bad headache; it’s actually a neurological disorder with extremely incapacitating neurological symptoms. It’s also much more debilitating than a headache, and is recognized as the 6th most disabling illness in the world. For those who suffer from migraines, their pain is compounded by the fact that migraine remains a poorly understood disease that is often undiagnosed and undertreated.

patient provider

What is a migraine?

A migraine is a type of headache that can cause severe, throbbing pain or a pulsing sensation, usually on one side of the head. Migraines are often accompanied by symptoms of nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last anywhere from hours to up to a number of days, and the pain can be so severe that it interferes with daily activities.

migraine v headache

How is a migraine different from a regular headache?

Headache is an all-encompassing term that includes a wide variety of nervous system conditions that cause painful symptoms in the head, including migraine. Migraines differ from typical headaches in that the pain is usually more intense and severe, and presents with a number of other symptoms in addition to head pain.

These additional symptoms can include nausea, seeing spots or flashing lights, sensitivity to light and sound, temporary visions loss, and vomiting. Migraines also typically affect only one side of the head, though it’s possible to have a migraine that affects both sides of the head. The pain quality of a migraine is also different from a regular headache in that it is usually described as “throbbing.”

What are the types of migraine?

There are a number of different subtypes of migraine. The different types include:

Migraine with Aura (Complicated Migraine) About a quarter of people who experience migraines experience them with what is called an “aura,” which is a series of sensory and visual changes that begin shortly before or during a migraine and can last anywhere from 10 to 30 minutes. An aura can appear as a series of black dots or zig zags in your visual field, a tingling and numbness on one side of your body, or the inability to speak clearly. In a classic migraine, there are four stages, of which aura is the second. It is an unmistakable warning sign that a migraine will soon occur.

migraine

Migraine without Aura (Common Migraine) A migraine without aura can often be difficult to diagnose because its symptoms can be so similar to other types of migraine. Classic symptoms of migraine without aura include pulsing or throbbing pain on one side of the head, sensitivity to light and sounds, pain that is made worse by physical activity, nausea, and vomiting. But the key differentiator from other types of migraine is that the common migraine comes on without the two warning phases, known as prodrome and aura, that other types of migraine have.

Migraine Without Head Pain (Silent or Acephalgic Migraine) In a migraine without head pain, you may experience dizzying aura and other visual disturbances, nausea, and other symptoms of migraine, but no head pain. In almost all other ways, this type of migraine is like a classic migraine.

Hemiplegic Migraine Hemiplegic migraines are a rare and serious type of migraine headache. This type of migraine can sometimes feel more like a stroke, as it presents with weakness on one side of the body, visual aura symptoms, and a “pins and needles” sensation, or loss of sensation, on one side of the body. It can last for as little as a few hours to several days and, similar to typical aura without headache, Hemiplegic Migraine doesn’t always include severe head pain.

Retinal Migraine When temporary vision loss accompanies a migraine, it is known as a Retinal Migraine. This blindness can last anywhere from a minute to a few months, but is usually fully reversible. These migraines occur most often to women during their childbearing years. This vision loss is actually considered to be a specific type of aura that is usually a sign of a more serious issue. If you experience Retinal Migraines, it’s a good idea to seek treatment with a specialist.

Chronic Migraine Patients who experience migraines for more than 15 days in a month are considered chronic migraine sufferers. Although these patients experience head pain multiple days a month, the severity of the symptoms and head pain on any given day may vary. Many patients with chronic migraine also use acute headache pain medications on more than 10-15 days per month, which can actually lead to even more frequent headaches.

Ice Pick Headaches Ice Pick Headaches are thus named because the pain is frequently described as an “ice pick in the head.” They often develop suddenly, delivering an intense, sharp pain. Though they typically only last for a very short time, usually 5-30 seconds, they are incredibly painful. Most patients experience this pain behind the eyes, in the temple, or in the parietal area of the head. These areas are where the trigeminal nerve lives, which is the nerve in your face that’s responsible for face sensation, biting, and chewing. If you get sharp pain in this area, it’s an indication that you’re getting ice pick headaches.

Cluster Headaches Cluster headaches are known as being among the most severe types of pain that a human can experience. Cluster headaches present as a burning pain around and above the eyes, at the temples, and towards the back of the head. Other symptoms include red and swollen eyes, or a runny nose.

Cervicogenic Headaches Some headaches are actually caused by pain in the neck; these are known as Cervicogenic Headaches. Typically, this type of headache requires physical therapy as a part of treatment, in addition to medication or other types of treatment.

How are migraines treated?

There is no cure for either migraine or headache. However, it’s possible to use a combination of lifestyle changes and medication to treat your symptoms and help prevent future episodes.

migraine treatments

Common lifestyle treatments include:

  • Regular exercise
  • Dietary Changes
  • Relaxation Techniques (Mindful breathing, meditation)
  • Stress-Management Techniques
  • Keeping a Migraine Journal

Tension headaches and mild migraines can be treated with over-the-counter medications, but more severe migraines may not respond to these.

In that case, In this case, your provider may prescribe one or more of the following medications:

  • Triptans: Elitriptan (Relpax), Frovatriptan (Frova), Rizatriptan (Maxalt, Maxalt-MLT), Sumatriptan (Imitrex, Imitrex STATdose, Onzetra Xsail, Zembrace Symtouch), Sumatriptan + Naproxen (Treximet), Zolmitriptan (Zomin, Zomin-MLT)
  • Butalbital containing products: Acetaminophen/butalbital/caffeine (Fioricet), Aspirin/butalbital/caffeine (Fiorinal)
  • Prophylactic drug treatments (Oral): Propranolol (Inderal LA), Metoprolol (Lopressor, Toprol XL), Topiramate (Topamax)
  • Prophylactic drug treatments (Injectable): Aimovig, Ajovy, Emgality, Botox

References Migraine Research Foundation American Migraine Foundation Medical News Today

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