Migraine without aura (common migraine) – this is the most prevalent type of migraine. It causes a throbbing pain on one side of the head.
Generally, the pain is moderate to severe with several exacerbating factors (e.g., physical activity). Accompanying symptoms include nausea, vomiting, photophobia (i.e., sensitivity to light), and phonophobia (i.e., sensitivity to sound).
You will not experience an aura with this type of migraine.
Migraine with aura (classic migraine) – in this type of migraine, you will most likely experience an aura 10–30 minutes before the onset of symptoms.
Common symptoms of the aura include:
- Flashing lights
- Seeing distorted-looking objects
- Wavy lines
- Tingling
Menstrual migraine – as the name suggests, this type of migraine occurs in women around their menstrual cycle. You could develop the symptoms, before, during, or after your period.
Migraine equivalent – the unique feature of this type of migraine is experiencing the aura without the symptoms of a headache. Most commonly occurring in people above the age of 50, the risk of developing migraine equivalent is higher in individuals who had the classic migraine when they were younger.
Complicated migraine – the symptoms of complicated migraine are generally severe and include:
- Speech difficulty
- Trouble understanding speech
- Temporary paralysis of the arms or legs
- Numbness and tingling across the body
Fortunately, these symptoms subdue when the migrainous attack ends.
Abdominal migraine – these migraines are common in children. Symptoms include dizziness and vomiting.
To this day, there is no consensus on the exact causes of migraines. With that said, researchers found that low levels of serotonin could be a trigger.
Other risk factors of migraines include:
- Bright lights
- Loud noises
- High-intensity physical activity
- Emotional stress
- Extreme temperatures (e.g., heat, cold)
- Changes in pressure
- Dehydration
- Sleep disorders (e.g., insomnia)
- Taking certain medications (e.g., oral contraceptives)
- Smoking
- Alcohol use
- Hormonal fluctuation during the menstrual cycle (e.g., progesterone, estrogen)
To diagnose migraine headaches, your neurologist will follow these steps:
- Take your medical history
- Perform a comprehensive physical exam
- Order some laboratory and imaging tests
Each of these steps is important to gather useful data about the triggers and nature of your headaches.
After taking a detailed medical history and performing a physical exam, your neurologist may order one or more of the following tests:
CT scan – the CT scan provides an image of your skull to detect any anatomical abnormalities (e.g., tumors, bleeding, compressions).
MRI – when it comes to visualizing brain tissue, MRI is superior to a CT scan. This could be helpful for recent brain injuries.
EEG – the EEG machine is a useful tool that records the brain’s electrical activity to diagnose sleep disorders and epilepsy.
Eye exam – the eye exam is an integral part of the neurological exam to eliminate concussions and nerve palsies.
Lab tests – laboratory tests, such as complete blood count (CBC) and urinalysis, may be useful to diagnose migraine-inducing illnesses (e.g., diabetes, thyroid disease).
While the vast majority of people experience a form of migraine during their life, there are some symptoms that indicate a more serious problem.
These include:
- Experiencing the worst headache of your life
- Inability to move or feel your arms or feet
- Speech problems
- Mental confusion
- Tremors
- Vision issues (e.g., double vision)
It is true that many of these symptoms could arise from the complicated form of migraine; however, they could also suggest a more serious condition (e.g., stroke).
Seeing a neurologist about your migraine depends on the severity and frequency of the symptoms.
For instance, if the symptoms are severely impacting your quality of life, consulting a neurologist should be a priority.
You may also want to visit your neurologist in case of:
- Seizures along with your headache
- Sudden onset of headaches
- A specific pattern of the headache (e.g., they start early in the morning)
- Vision changes
Due to the complexity of migraines, your neurologist may have to try several therapies before finding the best one that suits you.
Aside from pharmacological drugs, lifestyle modifications can be very helpful in controlling the severity and frequency of migraine episodes.
Here are some of the treatments that could be helpful:
- Lifestyle modifications (e.g., managing stress, practicing mindfulness)
- Taking over-the-counter medications (e.g., Tylenol, ibuprofen)
- Anti-emetic (drugs that stop vomiting) and anti-nausea medications
- Psychotherapy (i.e., counseling)
Note that trying alternative solutions, such as herbs, without consulting with your doctor can be quite dangerous. These herbs often interact with other medications, which significantly increases the risk of adverse effects.
Tension headaches
Tension headaches are by far the most prevalent type of headache. They typically result from muscle contractions around your skull, leading to localized pain in the back or front of your head.
According to the World Health Organization (WHO), 1 in 20 people living in the developed world is regularly affected by tension headaches.
Unlike migraines, tension headaches have several identified causes, including:
- Fatigue
- Poor sleep
- Extreme temperatures
- Caffeine withdrawal
Fortunately, most cases of tension headaches require no therapy as they tend to subside spontaneously.
Cluster headaches
Cluster headaches are characterized by their sudden onset. Patients describe the pain as sharp, burning, or piercing.
They also occur around the eye or on one side of the head.
During episodes of cluster headaches, people feel restless and agitated due to the high intensity of the pain. Oftentimes, they react to the pain by rocking, pacing, or banging their head against a wall.
Other symptoms of cluster headaches include:
- Redness of the eye
- Swelling eye
- Small pupil
- Sweaty face
- Blocked nostrils
The exact causes of cluster headaches are still unclear.
New Daily Persistent Headaches (NDPH)
New persistent daily headache (NDPH) describes recurrent headaches that occur every day for at least 3 months. It generally affects people with no past history of frequent headaches.
The specific feature of NDPH is that patients tend to remember the exact date and circumstances when their headaches started.