“Atypical migraine” isn’t a formal medical definition, but some people use it to describe migraine episodes that present with unusual symptoms or don’t follow the typical pattern.

About 1 in 10 people worldwide experience classic or typical migraine. Typical migraine episodes can include sequential phases that occur in the following order:

  1. prodrome
  2. aura
  3. pain
  4. postdrome

During these phases, various symptoms may occur, including:

  • mood changes
  • a radiating headache
  • nausea
  • sensitivity to light
  • sensitivity to sound

Atypical migraine episodes may not include all the pain phases and may present with different symptoms. Keep reading to learn more about the symptoms of atypical migraine, the diagnostic challenge it presents for doctors, and what you can do to treat and manage such episodes.

Atypical migraine vs. typical migraine

Either because of unique symptoms or the lack of typical symptoms, atypical migraine does not fit the diagnostic criteria for migraine.

Typical migraine symptoms often progress through three or four overlapping phases, and attacks can range from 4 to 72 hours.

Atypical episodes may be shorter, but duration can vary.

The third edition of the International Classification of Headache Disorders (ICHD-3) does not include a definition of “atypical migraine.” However, some people use the term to describe migraine episodes that don’t fit any of the official definitions.

The symptoms of an atypical migraine episode can be similar to a textbook description of a migraine, but there can be additional symptoms. Symptoms linked to atypical migraine episodes can include:

  • prodromal symptoms that include:
    • stiff nick
    • generalized edema
    • euphoria
    • difficulty with speech
    • difficulty concentrating
    • blurred vision
  • aura without headache
  • headaches that disrupt sleep

People sometimes describe cluster headaches as a type of atypical migraine. These headaches can cause autonomic symptoms, including nasal congestion, facial flushing, and eyelid drooping.

Some people may also consider vestibular migraine to be a type of atypical migraine. These headaches cause symptoms like vertigo, dizziness, or lightheadedness.

Atypical migraine vs. stroke symptoms

Some atypical migraine symptoms can resemble the symptoms of a stroke. This is also true of a rare migraine type called hemiplegic migraine.

Although some types of migraine increase your stroke risk, more common risk factors for stroke include high blood pressure, atherosclerosis, and diabetes. Stroke symptoms will also not resolve or improve with migraine treatments.

A stroke is a medical emergency, so an accurate diagnosis from a healthcare professional is important.

Read more: “How to Tell the Difference Between Migraine and Stroke

Anyone can experience an atypical migraine at any age. People who have recurrent atypical migraine may find that episodes come and go throughout their life. As you age, your migraine may present with different symptoms.

For example, older adults are more likely to experience bilateral headaches, meaning they affect both sides of the head. They’re also less likely to experience aura, sensitivity to light or sound, or autonomic symptoms. They may also experience less headache discomfort.

Atypical migraine may be more common in people with a family history of migraine, probable migraine, or vestibular migraine. Triggers such as diet, stress, or hormonal changes can also contribute to it.

In general, migraine is more common in females and peaks in your 30s.

The lack of typical migraine symptoms and phases can present a diagnostic challenge for doctors. There’s no such diagnosis as “atypical migraine.” What we refer to by that term may best fit under the category of “headache not elsewhere classified” or “headache unspecified” in the ICHD-3.

After reviewing your medical history, a doctor will review the possible factors contributing to your migraine episodes. This may include your eating habits and other lifestyle choices. They may also ask about your work or relationships with friends and family to help identify any stressors.

They can also help to identify any environmental triggers that have the potential to impact your next episode. To assist them with finding answers, they’ll most likely ask you to keep a detailed diary of your daily events and eating habits. This information may help unlock answers that can help them make a diagnosis.

Your doctor may also suggest that you see a dentist for jaw pain or an eye doctor for an eye exam. Sometimes, treating these problems can help prevent atypical migraine from recurring.

Treating atypical migraine usually includes:

Due to the prolonged discomfort of an atypical migraine episode, it isn’t uncommon to find it challenging to work or participate in activities you usually enjoy. You may find it comforting to nap in a quiet, dark place until the uncomfortable symptoms pass.

Work with a healthcare professional to create a strategy to help alleviate pain and limit the number of migraine episodes you have.

A doctor may suggest reevaluating your diet and eliminating or restricting your intake of certain items. This may include chocolate and soda. Both items include caffeine, which can cause headaches.

They may also suggest regulating your sleeping pattern to ensure that you’re getting enough rest. The addition of a manageable exercise program may also help you relieve stress naturally.

Although some people find success with medications that help manage their symptoms, it’s important to be aware of the side effects. Be sure to discuss these with your doctor.

When to contact a doctor about atypical migraine

Although atypical migraine episodes are common, it’s best to seek an informed opinion from a doctor. They can provide ways to minimize any discomfort and help you identify factors that make you more likely to have recurring episodes. Learning what factors affect you could help you reduce how frequently you get atypical migraine episodes.

While evaluating your health history, a doctor can also determine if your symptoms could indicate another disease or disorder. If so, they can begin a diagnostic process and treatment.

Atypical migraine refers to episodes that don’t meet the regular criteria of symptoms of phases for migraine attacks. Atypical migraine episodes may:

  • come on suddenly
  • cause aura without headache
  • cause symptoms not common to migraine

Because of the unique presentation of symptoms, diagnosis may be challenging. Still, a doctor can help guide treatment to help you manage your symptoms.

There aren’t any cure-alls for atypical migraine episodes, but relief is still possible. The right guidance or treatment program can help.