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 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 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 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.
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, 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.
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.
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.
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.
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.