Types of Migraine
Migraine Ireland
Data suggests that between 12-15% of Irish people suffer from migraine – this means that roughly half a million people suffer from migraine in Ireland. It is estimated that migraine costs Irish businesses €252 million every year as a result of lost productivity with the average migraineur missing between 1.5 and 4.5 days from work annually. Despite these staggering figures migraine remains a misunderstood and under managed condition.
All age groups suffer. Children as young as twelve months have been diagnosed. Three times more women than men suffer mainly due to hormonal changes. People who are subject to migraine come in a large variety of shapes, ages, temperaments and personalities. Migraine is hereditary in approximately 60% of cases.
Migraine Ireland
Data suggests that between 12-15% of Irish people suffer from migraine – this means that roughly half a million people suffer from migraine in Ireland. It is estimated that migraine costs Irish businesses €252 million every year as a result of lost productivity with the average migraineur missing between 1.5 and 4.5 days from work annually. Despite these staggering figures migraine remains a misunderstood and under managed condition.
All age groups suffer. Children as young as twelve months have been diagnosed. Three times more women than men suffer mainly due to hormonal changes. People who are subject to migraine come in a large variety of shapes, ages, temperaments and personalities. Migraine is hereditary in approximately 60% of cases.
Migraine without Aura
The majority of migraine sufferers have Migraine without Aura. The most common symptoms of Migraine without Aura are:
Intense throbbing headache, usually on one side of the head, worsened by movement and lasting from 4-72 hours.
- Nausea, sometimes vomiting
- Sensitivity to light
- Sensitivity to noise
- Sensitivity to smells
- Stiffness of the neck and shoulders.
- Blurred vision
If you experience two or more of these symptoms, and if they prevent you from continuing with normal daily activities, then you may be suffering from migraine without aura.
Migraine with Aura
Migraine with Aura refers to a range of neurological disturbances that occur before the headache begins, usually lasting about 20-60 minutes. About 20% of people with migraine experience ‘aura’ in addition to some or all of the symptoms of ‘Migraine Without Aura’.
The disturbances are usually visual e.g.
- Blind spots
- Flashing lights
- Zig-zag patterns
Aura can also present in other ways:
- Pins and needles on one side usually starting in the fingers/ arm, sometimes spreading up into the face
- Slurring of speech
- Muscular weakness
- Loss of co-ordination
- Confusion
The other symptoms of migraine will usually follow the migraine aura. These are:
- Intense throbbing headache, usually on one side of the head, worsened by movement and lasting from 4-72 hours
- Nausea, sometimes vomiting
- Sensitivity to light
- Sensitivity to noise
- Sensitivity to smells
- Stiffness of the neck and shoulders
- Blurred vision
If you experience two or more of these symptoms in addition to the aura symptoms and if they prevent you from continuing with normal daily activities, then you may be suffering from migraine with aura.
Aura with no headache
About 1% of migraineurs experience migraine aura without ever having a headache. The most common symptoms of migraine aura are visual disturbances such as:
- Blind spots
- Flashing lights
- Zig-zag patterns
Migraine aura can also present as:
- Pins and needles on one side usually starting in the fingers/ arm, sometimes spreading up into the face
- Slurring of speech
- Muscular weakness
- Loss of co-ordination
- Confusion
Hemiplegic Migraine
Hemiplegic Migraine is a rare form of migraine where the person experiences many of the usual migraine symptoms, but may also suffer from temporary numbness, weakness or even paralysis on one side of their body!
The word Hemiplegia comes from the Greek – ‘Hemi’ meaning ‘half’ and ‘Plegia’ from either ‘plēgē’ meaning ‘stroke’ or ‘plēssein’ meaning ‘to strike’.
Unlike a stroke, the symptoms of Hemiplegic Migraine begin slowly and build up as the migraine progresses. Weakness and numbness usually go away within 24 hours, but may last a few days.
Hemiplegic migraine can be one of the more difficult types of migraine to diagnose as many of the symptoms can mimic stroke, seizures or other conditions.
MRIs, CT scans and other neurological tests, as well as a full review of your medical history are usually done to rule out other more sinister causes of the symptoms.
What are the Symptoms of Hemiplegic Migraine?
- Numbness or weakness on one side of the body (Hemiplegia)
- One side of the face can fall which looks like a stroke
- Headache
- Visual disturbance and aura (sparkles, shimmers)
- Numbness or tingling in extremities
- Slurred speech or trouble speaking
- Fever
- Confusion, brain fog and in extreme and very rare cases possible unconsciousness
- Ataxia – muscles not working properly
- Nausea and/or vomiting
- Dizziness/Vertigo
- Increased sensitivity to sound and/or light
Hemiplegic Migraine, like most other types of migraine, can be triggered by many things, including food, weather, stress, lack of sleep, skipping meals, and dehydration.
The best way to figure out your triggers and when you might be in danger of an attack is to keep a diary, or even use a migraine app like Migraine Buddy or Curelator.
They will track your attacks and will hopefully help you to live as normal a life as possible while coping with this condition.
Treatment and Medication Options
Due to the nature of Hemiplegic Migraine, finding the right treatment can be difficult. Unlike other migraine types, Triptans are contraindicated for Hemiplegic Migraine as they constrict the blood vessels. This constriction may happen during the attack itself, thereby increasing the risk of stroke, so Triptans are rarely prescribed.
Acute medications used include the normal NSAIDs such as Ibuprofen or Diclofenac (Difene), along with an antiemetic (anti-nausea) medication such as Domperidone or Metoclopromide to ease the nausea and help absorb other medication more quickly.
- Hemiplegic migraine is generally treated with preventative medications, including:
- Calcium Channel Blockers – Verapamil (Isoptin), Flunarizine (Sibelium)
- Anticonvulsive Medication – Topiramate (Topamax)
- Antidepressants – Amitriptyline
- Beta Blockers such as Propranolol (Inderal) are generally avoided as they can interrupt the dilation of the blood vessels, again heightening the chances of stroke.
Many people with Hemiplegic Migraine often find that going to a specialist physiotherapist can help them, especially with exercises for movement during or after the attack on affected limbs. Physiotherapy can also help with pain management.
Self Care and Lifestyle Adaptations
Lifestyle can be an important factor in treating or coping with Hemiplegic Migraine. Making sure that you do the following can help immensely:
- Eat well, and never allow yourself to go hungry
- Keep hydrated
- Get into a routine at home of sleeping, eating, and waking at the same time each day
- Try to keep stress at a minimum
- Do gentle, regular exercise
- Visit the Mindfulness and Relaxation Centre of Beaumont Hospital for exercises and relaxation tips
We also have a Migraine ID card which can be handy for people who lose the ability to communicate during an attack.
It lets others know that it is a migraine attack and not a stroke, so you shouldn’t end up in A&E.
It can also show the medications needed and that the attack is temporary.
It also has our Information and Support Line number on it. If you would like one, please contact us and we’ll be happy to send one out.