Headache is only one of the symptoms of a migraine attack. There are almost always other symptoms which may be different in different migraine sufferers. There are two main types of migraine: migraine with aura (classic migraine) and migraine without aura (common migraine). Migraine types Migraine with Aura (classic migraine) Only about 20% of migraine sufferers have this type of migraine, in which neurologic symptoms (called the aura) preceed or accompany the headache. Some people have the auras alone without the headache. The most common auras are visual and may consist of shimmering worm-like apparitions, disturbances that look like heat waves rising off an asphalt road, zig-zaggy lines, white, dark, or colored spots, blind spots in the vision (often the left or right half of the visual field, or hemianopia), seeing stars, etc. Any neurologic symptom may be part of an aura, including weakness or paralysis, tingling numb sensations (paraesthesias), double vision (diplopia), vertigo or dizzyness (sensation of spinning), inability to think or speak, a feeling of euphoria, imbalance, etc. Because patients who are having strokes or TIAs (transient ischemic attacks) often have similar symptoms, physicians and patients can find the symptoms of this type of migraine alarming and patients going to emergency rooms for migraine with aura will often get many investigative procedures. In most patients, these auras are followed within 30 minute or so by a typical migraine headache which is described below under common migraine. Migraine without Aura (common migraine) Most migraine patients have this type. They may get some blurring of vision and dizzyness with their headaches, but don't have the more specific neurologic symptoms preceding the headache. The headache in both types of migraine can be very severe. Some women have said the pain is worse than childbirth. The severity is best measured by what the patient is forced to do. In severe attacks, the patient must go to bed, and wishes no stimulation. Noise, lights,and smells are very bothersome and the patient is irritable. In less severe migraine attacks, the patient has varying degrees of loss of function, from not being able to concentrate well to not being able to continue their activities at all. The pain is usually throbbing and often on one side of the head. Common locations are behind the eye, in the back of the head, and the temple. Nausea is almost always present and vomiting in severe attacks. The scalp often is sore and it hurts to brush the hair. The headache can last from hours to days. If the patient can sleep, the headache may be gone when they wake. Migraine attacks may occur once a year or less often. In some unfortunate persons they can occur every day. The average is probably about once a month. Basilar Migraine Basilar migraine is a form of migraine with aura in which the patient suffers brain-stem symptoms such as vertigo, diplopia (double vision), slurred speech, weakness, imbalance, even blindness. It is more common in young people but is not very common. Retinal Migraine A type of migraine in which the vision in one eye is almost completely abolished. Rarely, permanent blindness results. Abdominal Migraine Occurs in children with belly pain instead of headache, superimposed on nausea and vomiting. Often confuses their doctors, who understandibly suspect an abdominal process causing these symptoms, not migraine. Menstrual Migraines A common variant where the migraine attacks occur primarily just prior to or during the menstrual period. Family history Migraine is hereditary. Most patients with migraine will have someone else in their family who suffers. Because it is more common in females, the mother and sisters are most likely to also have migraine. Migraine triggers Migraines often have characteristic triggers. Connect to the trigger page to see what they are.