What types of migraines are there?
Migraines without aura
Recurrent headache disorder that manifests as attacks lasting 4-72 hours. Typical features of headache are unilateral localization, pulsating quality, moderate or strong intensity, aggravated by routine physical activity and association with nausea and / or sensitivity to light and noise.
Migraines with aura
Recurrent, minute-long attacks of unilateral, fully reversible visual, sensory, or other central nervous system symptoms that usually develop gradually and are usually followed by a headache
Aura symptoms include:
Visually: This is a common type of aura. It can be experienced as flashes of light. It often manifests itself as an amplification spectrum: a zigzag figure near the fixation point, sometimes colored or dark / gray spots in the field of vision.
Sensor technology: In the form of needles and needles that slowly move away from their origin and affect part of one side of the body, face and / or tongue. Deafness can occur as a result, but it is possible that numbness is the only symptom as well.
Language and / or language: It is difficult to speak coherently, find the right word, and understand what is being said.
Engine: Difficulty lifting your arm or moving your leg, or hanging your face down.
Brain stem: Slurred speech, feeling that the environment is spinning, buzzing or ringing in the ears, double vision, imbalance when walking.
What is Chronic Migraine?
Headache that occurs 15 or more days / month for more than 3 months and has the characteristics of a migraine headache for at least 8 days / month.
What are the complications of migraines?
Status migraine: Migraine attack that lasts more than 72 hours.
Persistent aura without infarction: Aura symptoms that last a week or more without brain scans showing a stroke.
Migraine infarction: One or more migraine aura symptoms associated with decreased blood supply to an area of the brain, detected by brain scans, beginning during the course of a typical migraine with aura attack.
Migraine aura-triggered seizure: A seizure triggered by a migraine attack with an aura.
What episodic conditions can be associated with migraines?
Cyclic Vomiting Syndrome: Recurrent episodic fits of severe nausea and vomiting that are typically stereotypical in the person and occur at predictable times. Attacks can be associated with pale appearance and lethargy. All signs disappear completely between attacks.
Abdominal migraines: A disorder that persists for 2-72 hours, mainly in children, as recurrent attacks of moderate to severe midline abdominal pain associated with nausea and vomiting, and is normal between episodes. There is no headache during these episodes. Adults can also have abdominal migraines with dyspepsia and abdominal pain.
Benign paroxysmal dizziness: In otherwise healthy children, a condition characterized by repeated brief attacks of dizziness that occur without warning and resolve spontaneously.
Trigeminal autonomic headache (TAC)
What is a cluster headache?
Extreme, one-sided pain in the eyes, over the eyes, temples, or a mixture of these, lasting 15 minutes to 3 hours and occurring once every other day to eight times a day. On the same side of the headache, eye reddening, tearing, blocked or watery nose, forehead and face sweat, reduced pupil size, sagging eyelid and / or eyelid swelling, and restlessness or excitement are common.
It may be:
Episodic: Cluster headache attacks occur in periods of 7 days to a year, separated by pain-free phases of at least 3 months.
Chronic: Cluster headache attacks that occur for a year or more without remission or with remission times of less than 3 months.
What is paroxysmal hemicrania?
Unilateral headache that lasts 2-30 minutes and occurs several times a day. They can be associated with redness of the eyes, tearing, nasal congestion, or a watery nose. They respond remarkably to indomethacin tablets.
It may be:
Episodic: attacks of paroxysmal hemicrania that occur for periods of 7 days to a year, separated by pain-free periods of at least 3 months.
Chronic: attacks of paroxysmal hemicrania that occur for more than a year without remission or with periods of remission of less than 3 months.
What is hemicrania continua?
Persistent, strictly one-sided headache lasting more than 3 months, which can be accompanied by reddening of the eyes, tears, blocked nose or watery nose. They respond remarkably to indomethacin tablets.
It may be:
Remitting subtype: Hemicrania continua, characterized by pain that is not continuous but is interrupted by periods of remission lasting at least 24 hours.
Incessant subtype: Hemicrania continua, characterized by persistent pain for at least one year, with no remission periods of at least 24 hours.
What are short-term unilateral neuralgiform headaches?
Attacks of moderate or severe, purely unilateral headache that last for seconds to minutes, occur at least once a day, and are usually associated with pronounced lacrimation and reddening of the ipsilateral eye.
It may be:
- Brief unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT): if this is accompanied by reddening of the eye and tearing of one side of the pain.
- Brief unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA): the redness and tearing may not be noticeable symptoms and only one of them may be present.
Episodic: attacks of short-lasting unilateral neuralgiform headache attacks that occur for periods of 7 days to a year, separated by pain-free periods of 3 months or more.
Chronic: attacks of short-term unilateral neuralgiform headache attacks that occur for periods of more than a year without remission or with remission periods of less than 3 months.
IMPORTANT NOTE: All of the following primary headaches can also be a manifestation of secondary headaches
Dr. Pravin Thomas | Consultant and Clinical Director – Headache and Interventional Headache Neurology Services | Mazumdar Shaw Medical Center, Bommasandra, Bangalore
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