Types of Migraines

Migraines are often defined as vascular headaches, meaning severe headaches caused by problems with blood vessels in the head. While intense and very painful headaches are indeed a common feature in migraines, migraines actually include a vast array of symptoms, discussed in a different article in this site. While all migraines share the same basic symptoms, doctors usually differentiate between two main types.

Classic Migraine

Classic Migraine is characterized by the presence of an "Aura". "Aura" is the name given to a set of neurological symptoms that appears approximately half an hour before the actual migraine pains begin. It is estimated that only twenty percent of migranuers actually suffer from classic migraine, i.e. experience an aura prior to the actual attack.

The Aura can appear in different forms. Many patients have reported the following symptoms for the aura stage –

Visual cues such as flashing lights, blind spots, zigzag lines and even temporary loss of vision.
Temporary speech impairment.
Auditory or other sensory hallucinations including tingling sensations, pins and needles or even numbness.
Other neurological signs that repeat themselves consistently prior to migraine pain. v

In his book about migraines, Oliver Sacks dedicates a whole chapter to this fascinating phenomenon, where he discusses the possible manifestation of these auras. He mentions not only simple visual cues as part of the aura, but also a variety of trance like states and disturbance in the sense of time and space. Sacks provides detailed descriptions of the nature of the visual hallucinations experienced during the aura phase, including drawings of typical visions by as told by migraine patients. It has been claimed that some complex works of art, including Alice in Wonderland, were possibly inspired by the trance-like quality of the aura stage.

Apparently, common visual hallucinations during the aura phase of a migraine include seeing flashing lights, often described as stars, flames or simple geometric shapes, shooting through the person's field of vision. These can come in large groups, up to hundreds at a time and are usually white (though not always). There are other possible visual cues, and in fact, the possible visual expressions are so varied that some researchers focus on these alone. Again, other sensory effects are possible, with or without visual effects.

Why do some migraine patients go through an aura is not fully understood. One theory holds that the aura is part of a process called "Spreading Depression" where you get a kind of a wave spreading across the cortex, debilitating various areas as it progresses and ending with the outburst of an intense headache.

Common Migraine

Common migraine is very much the same as Classic Migraine, but it is not preceded by an "Aura". As it name indicates, it is the more common type of migraine. Most patients do not experience a pre-migraine "aura" and are therefore defined as "Common Migraine" sufferers. Some sources also indicate that patients with common migraine tend to suffer more from stomach pain and diarrhea during a migraine attack.

That said, it is also possible that some people do go through a phase of aura where their aura symptoms are not as dramatic or pronounced. Milder auditory or olfactory hallucinations may be ignored by some patients, along with changes their emotional and cognitive state.

Other Types of Migraines

As a Migraineur, you probably suffer from either Common Migraine or Classic Migraine. There are additional classifications that pertain to rarer forms of migraines. During my research on migraines, I have come upon quite a few sub-types of migraines. Basilar Migraine, Hemiplegic Migraine, Silent Migraine, Cyclic Migraine Syndrome, Ophthalmoplegic Migraine, Retinal Migraine, Abdominal Migraine, Ocular Migraine (also known as acephalgic migraine), status migraine, Nocturnal Migraine and Cyclic Migraine Syndrome. Some of these I have covered in this website. Others you may wish to search for some more -

I used to think that I suffered from a common migraine. However, since originally writing these articles, I began to pay closer to my sensations prior to migraine attacks. I now believe I do experience an aura prior to migraines. My aura is mainly olfactory. I become acutely aware of smells, and I smell things that are not really there. I do go through a definite speech impediment phase, which usually continues throughout my migraine attack. There have been more than one occasion where I did undergo distinct emotional effects prior to the migraine, specifically anxiety attacks. It is possible to have both classic migraines and common migraines, intermittently. At this point, I am not sure if this is indeed the case with me.