More than 13 percent of Americans are affected by migraines, severe pain in the head that is sometimes accompanied by vision problems, nausea, vomiting, and dizziness. Rarely, however, migraines can cause symptoms and complications in other parts of the body. These migraine variants are named according to the part of the body that is affected. Most of these migraine variants are very rare. Your doctor may be able to tell if your symptoms indicate you have one of these rare or extreme types of migraines, or another condition altogether.

Hemiplegic Migraines

Hemiplegic migraine affects 0.03 percent of Americans. People with hemiplegic migraines experience paralysis or weakness on one side of the body, disturbances in speech and vision, and other symptoms that often mimic a stroke. The paralysis is usually temporary, but it can last for several days. Two types of hemiplegic migraine exist:

  • Familial Hemiplegic Migraine (FHMR): FHM is an inherited genetic migraine disorder that causes hemiplegic migraines. (Genetic testing can determine if a person has the gene mutations that are associated with this migraine variant.) If a parent, sibling, or child has FMR, the chances you will have FHM are higher.
  • Sporadic Hemiplegic Migraine (SHM): SHM is associated with hemiplegic migraines that occur in people without the genetic disorder and without a family history of hemiplegic migraines. Both FHM and SHM are diagnosed after a person has symptoms of a hemiplegic migraine on several occasions. However, if that person does not have a relative with diagnosed hemiplegic migraines, doctors may believe the person has SHM—both present the same way; the only difference is the presence of the known genetic risk.

Ophthalmic Migraine

Ophthalmic migraines (also sometimes called ocular or retinal migraines) are rare migraine variants characterized by repeated instances of visual disturbances such as blind spots or blindness on one side of the field of vision. These disturbances typically last between a minute and an hour and usually occur before a migraine begins.

Ophthalmoplegic Migraine

Ophthalmoplegic migraine is a rare migraine variant that is most common in young adults and children. This type of migraine begins as an intense migraine pain behind the eye and includes double vision or paralysis of the eye muscles that cause a droopy eyelid. Patients may also experience vomiting and seizures during this type of migraine. Your doctor might wish to also check for an aneurysm, a bulging spot in the brain, to see if it may account for the symptoms.

Menstrual Migraine

As the name suggests, these migraines are related to a woman’s menstrual cycle and the fluctuations of hormones that precede it. More than half of women with migraines report a flare-up of symptoms prior to having a period. Migraines caused by menstruation are typically more severe and last longer than migraines at other times of the month.

Basilar Migraine

Basilar migraine, also known as Bickerstaff syndrome, typically causes dizziness and vertigo prior to a headache. However, this migraine variant may also cause ringing in the ears, slurred speech, loss of balance, syncope, and even loss of consciousness prior to a headache. This type of headache is most common in adolescent girls and young women, so researchers believe it is likely related to the hormonal changes that primarily affect females at these ages.

Abdominal Migraine

Children are typically most affected by abdominal migraines. Symptoms generally last one to 72 hours and include nausea, vomiting, and flushing. For children who have been struggling with this migraine variant for a longer period of time, symptoms may also include attention deficit problems, clumsiness, or delayed development. This variant is more common in children who have a family history of migraines. 

Chronic Migraine

Patients who experience repeated and ongoing episodes of migraine may have a variant called chronic migraine. (It’s also sometimes called transformed migraine.) People with this variant typically experience headaches on at least half of the days in a month; many will have migraines daily or almost daily. This type of migraine typically begins in the late teens or early 20s, and the frequency of migraines will increase over time. These patients tend to overmedicate with over-the-counter and prescription medicines that can actually make migraine headaches worse. Many patients with chronic migraine also suffer from depression.

Vertebrobasilar Migraine

Migraines preceded by vertigo may be a sign of vertebrobasilar or vertiginous migraine. Vertigo is a common complaint for many people with migraine, but frequent and recurring episodes of vertigo may be caused by a problem in the lower part of the brain. 

Status Migrainosus

This very serious and very rare migraine variant typically causes migraines so severe and prolonged that patients must be hospitalized. This severe migraine can last several hours or even several days. Most complications associated with this migraine variant arise because of prolonged vomiting and nausea. Over time, you will become dehydrated, and you will need intravenous treatment to stay hydrated.

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Break It Down: Migraine and Severe Migraine

Migraines are intense headaches that affect more than one in 10 people. Women are three times more likely to experience migraines than are men, and migraines have been shown to run in families.

These painful headaches can last up to 3 days if not treated, causing throbbing pain, sensitivity to light or sound, nausea and vomiting, and difficulty doing normal physical activities, such as standing or walking. Severe migraines can also cause symptoms like uncomfortable tingling or weakness in your arms and legs, or even vision changes such as seeing flashing lights or blurring. Vision changes, odd sensations of smell, or feeling unwell may precede a migraine in what is known as the aura. Auras typically begin slowly over five to 20 minutes and usually cease within 60 minutes.

While rare, other types of migraines can cause partial blindness, double vision, paralysis on one side of the body, vertigo, or symptoms that may mimic a stroke. Migraines can become so severe and disruptive that they require treatment in the emergency department. If you experience speech, vision, or balance problems you haven’t experienced before, you should be seen by a qualified medical professional. Persons over the age of 50 should seek medical attention if what appears to be a migraine starts suddenly, like a clap of thunder, because this presentation could be a sign of something more serious.

You should know that certain factors can trigger migraines. These include physical or emotional stress, bright lights and sounds, strong odors, changes in the weather, cigarette smoking, drinking alcohol, not getting enough sleep or food, and certain foods and food additives. Women experiencing hormone changes during menopause may also begin to experience migraines for the first time.

If you begin to experience a severe migraine, resting in a quiet, dark room might help. Several over-the-counter medicines, such as ibuprofen or naproxen, may help relieve the symptoms and severity of migraines.

Your doctor may prescribe special medications to treat migraines. Triptans comprise the class of drugs most commonly prescribed for severe migraines. Other types of medications, including antidepressants, cardiovascular drugs, and anti-seizure medications, have been approved to help treat and prevent migraine headaches.

Avoiding known triggers is a logical way to avoid migraines. Other ways to help prevent them include getting adequate sleep, relaxing to relieve stress, and using acupuncture or massage therapy.

Keeping a diary of your headaches, noting events that lead up to them and their severity, and bringing it to your doctor’s appointment can offer clues about how best to treat your migraines.