Health Articles

A migraine attack can be divided into four phases:

A ‘premonitory’ phase occurs in up to half of people with migraine. You may feel irritable, depressed, tired, have food cravings, or ‘just know’ that a migraine is going to occur. You may have these feelings for hours or even days before the onset of the headache.

The aura phase (if it occurs).

The headache phase.

The resolution phase when the headache gradually fades. During this time you may feel tired, irritable, depressed, and may have difficulty concentrating.

Less common types of migraine

There are various other types of migraine which are uncommon, and some more types which are rare. These include:

Menstrual migraine. The symptoms of each attack are the same as for common migraine or migraine with aura. However, the migraine attacks are associated with periods. There are two types of patterns. Pure menstrual migraine is when migraine occurs only around periods, and not at other times. This occurs in about 1 in 7 women who have migraine. Menstrual-associated migraine is when migraines occur around periods, and also at other times of the month too. About 6 in 10 women who have migraine have this type of pattern. Treatment of each migraine attack is the same as for any other type of migraine. However, there are treatments that may prevent menstrual migraines from occurring. See separate leaflet called ‘Migraine Triggered by Periods’ for more detail.
Menstrual Migraine – Google Books Result
Abdominal migraine. This mainly occurs in children. Instead of headaches, the child has attacks of abdominal (tummy) pain which last several hours. Typically, during each attack there is no headache, or only a mild headache. There may be associated nausea (feeling sick), vomiting or aura symptoms. Commonly, children who have abdominal migraine switch to develop common migraine in their teenage years.

Ocular migraine. This is sometimes called retinal migraine, ophthalmic migraine or eye migraine. It causes temporary loss of all or part of the vision in one eye. This may be with or without a headache. Each attack usually occurs in the same eye. There are no abnormalities in the eye itself and vision returns to normal.

Hemiplegic migraine. This is rare. In addition to a severe headache, symptoms include weakness (like a temporary paralysis) of one side of the body. This may last up to several hours, or even days, before resolving. Therefore, it is sometimes confused with a stroke. You may also have other temporary symptoms of vertigo (severe dizziness), double vision, visual problems, hearing problems and difficulty speaking or swallowing.

Basilar-type migraine. This is rare. The basilar artery is in the back of your head. It used to be thought that this type of migraine originated due to a problem with the basilar artery. It is now thought that this is not the case, but the exact cause is not known. Symptoms typically include headache at the back of the head (rather than one sided as in common migraine). They also tend to include strange aura symptoms such as temporary blindness, double vision, vertigo, ringing in the ears, jerky eye movements, trouble hearing, slurred speech, dizziness. Unlike hemiplegic migraine, basilar-type migraine does not cause weakness. There is an increased risk of having a stroke with this type of migraine.

Do I need any tests?

Usually not. There is no test to confirm migraine. A doctor can be confident that you have migraine if you have the typical symptoms. However, some people with migraine have non-typical headaches. Sometimes tests are done to rule out other causes of headaches. Remember, if you have migraine, you do not have symptoms between attacks. A headache that does not go, or other symptoms that do not go, are not due to migraine.

Tension headaches are sometimes confused with migraine. These are the common headaches that most people have from time too time. Note: if you have migraine, you can also have tension headaches at different times to migraine attacks.