Sunday Thoughts on Living with Migraine: Types of Migraine

TulipThoughtsGood afternoon to my extended Migraine and Headache family. I hope the day is being as kind as possible to you and your head. 

Migraine is a complex neurological disease. As you probably already know there are several types of Migraine, and getting a full and accurate diagnosis is critical to Migraine treatment and management. In the various areas of medicine, it's common for professional organizations to work together to define classification systems for diagnosis. In "headache medicine," the gold standard for diagnosing and classifying Migraine and other headache disorders is the International Headache Society's International Classification of Headache Disorders, 3rd Edition (ICHD-3).


TypesOfMigraineI've been seeing a lot of online discussions with people talking about what type of Migraines they have. Unfortunately, all too many of these discussions include types of Migraine that aren't the "standard" diagnoses from ICHD-3. This can happen when doctors aren't experienced with treating Migraine. It can also happen when people have been reading inaccurate online content. 

In any case, I thought it would be helpful to provide you with a list of types of Migraine from ICHD-3:

1.1 Migraine without aura

1.2 Migraine with aura

1.2.1 Migraine with typical aura

1.2.1.1 Typical aura with headache

1.2.1.2 Typical aura without headache

1.2.2 Migraine with brainstem aura

1.2.3 Hemiplegic migraine

1.2.3.1 Familial hemiplegic migraine (FHM)

1.2.3.1.1 Familial hemiplegic migraine type 1

1.2.3.1.2 Familial hemiplegic migraine type 2

1.2.3.1.3 Familial hemiplegic migraine type 3

1.2.3.1.4 Familial hemiplegic migraine, other loci

1.2.3.2 Sporadic hemiplegic migraine

1.2.4 Retinal migraine

1.3 Chronic migraine

1.4 Complications of migraine

1.4.1 Status migrainosus

1.4.2 Persistent aura without infarction

1.4.3 Migrainous infarction

1.4.4 Migraine aura-triggered seizure

1.5 Probable migraine

1.5.1 Probable migraine without aura

1.5.2 Probable migraine with aura

1.6 Episodic syndromes that may be associated with migraine

1.6.1 Recurrent gastrointestinal disturbance

1.6.1.1 Cyclical vomiting syndrome

1.6.1.2 Abdominal migraine

1.6.2 Benign paroxysmal vertigo

1.6.3 Benign paroxysmal torticollis

A1.6.5 Vestiblular migraine

If your diagnosis is simply "Migraine" or "chronic Migraine" it's an incomplete diagnosis. Many of us have more than one type of Migraine. For example, my diagnoses are chronic Migraine, Migraine with aura, and Migraine without aura. What's your diagnosis? If it's an incomplete diagnosis, or if it's a type of Migraine that's not included in the list above, a conversation with your doctor is in order. 

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 because a migraine is NOT "just a headache"
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Sunday Thoughts on Living with Migraine – Types of Migraine

Sunday-BouquetGood morning to my Migraine and Headache Family. I hope you're doing as well as possible today — that the weather is pleasant where you are, and that your head is being kind to you. 💕

When discussing Migraine or other headache disorders, the International Headache Society's International Classification of Headache Disorders (ICHD) is the gold standard for classifying and diagnosing headache disorders. The ICHD is now in its third edition (ICHD-3) and can be found online. There are sound, logical reasons for using standardized diagnoses:

  • It helps keep everyone "on the same page."
  • It simplifies matters if and when patients need to seek care from someone other than their regular health care providers.
  • These criteria give researchers a standardized set of criteria so that research is more uniform and valuable.
  • It's far easier for discussion purposes if everyone is using the same term to describe the various disorders.

Unfortunately, even some doctors don't use the ICHD-3 diagnoses on a regular basis. This is most likely due to how little doctors are taught about Migraine and other headache disorders during medical school. Unless a doctor is a Migraine and headache specialist or a neurologist, they may not be aware of the ICHD-3.

There are several patients who write about Migraine and headache online and/or are patient advocates for Migraine and headache patients. When we come across a discussion where a form of Migraine is being discussed, and it's not a standard ICHD-3 diagnosis, we generally give people information about the ICHD-3 and the "official" forms of Migraine. If you're part of one of those discussions, and one of us posts information for you, please don't be offended. We're just trying to offer information and support. Continuing to learn about our Migraines is one of the most valuable tools we have for working effectively as treatment partners with our doctors, and we all want to offer you the most accurate information possible.

Live well,

PurpleRibbonTiny Teri1

 

 because a migraine is NOT "just a headache"

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Sunday Thoughts on Living with Migraine 8/7/16 - Being Cautious

Happy-SundayGood morning, Migraine family. I hope you're taking some time for yourself this weekend and that your Migraines are being kind to you.

Last week, for some reason, I found myself thinking about a young woman named Abi, so I shared her story on Facebook and Twitter. If you didn't see it, take a look at I Still Remember Abi and Her Last Migraine. Abi was a young Migraineur whose parents not only didn't understand her Migraines — they'd gone so far as to accuse her of faking them to get attention. She had a Migrainous stroke, and we hoped her parents would be more understanding. Sadly, not long after she was discharged from the hospital, she had another Migraine and another stroke. The second stroke took her life.

The reason I'm talking about this again today is that we should all view Abi's story as a cautionary story for all of us. Migrainous strokes aren't common, but they do happen. It's common for us to think, "It won't happen to me," but we can't know that. It can happen to us, so part of caring for ourselves is being cautious. Migraine and stroke can present with many similar symptoms. I asked Migraine and Headache Specialist Dr. David Watson how we can tell the difference between a Migraine and a stroke if we're having symptoms that make us uncertain. He told me that doctors can have problems telling the difference sometimes and have to order imaging studies to be certain. He was also quite clear that we need to seek medical care immediately if we're in that situation.

We all have to exercise our own judgement about when to seek medical care, of course, but sometimes, it seems that we dismiss warning signs too easily. We don't feel like having to go out to the doctor, we don't want to bother anyone, and so on. It's so easy to promise ourselves that we'll do something tomorrow if continues. When tomorrow comes, we put it off another day. Sound familiar? Putting things off can present us with two problems:

  1. Waiting too long to get help.
  2. Running into a weekend or holiday when our doctors are out of their offices.

When we need help, the emergency room should be saved as a last resort unless our doctors tell us to go there. ER's are busy and noisy. The doctor there don't know us or our medical history, and many of them know little about treating Migraine. So, it's really best if we call our own doctors for help.

Times when we should call our doctors include:

  • If we experience new or frightening symptoms.
  • If we're having our "worst Migraine ever."
  • If our Migraine is accompanied by:
    • unresolved loss of vision
    • loss of consciousness
    • uncontrollable vomiting
  • If the pain of a Migraine attack lasts more than 72 hours with less than a solid four-hour pain-free period, while awake.
  • If we have a head injury.

Something else we can do is have a conversation with our doctors about when we should call them or seek emergency care.

The bottom line here is not to take unnecessary chances. There have been times when, in the middle of a Migraine, anxiety caused by the Migraine led me to panic and feel there was something seriously wrong. At those times, my husband has helped me enormously by asking me if I was having unusual symptoms, if the Migraine was worse than usual. He'd sit with me and help me take deep breaths to calm down. Once I worked through the panic, I realized it wasn't an unusual Migraine after all. That said, if there had been any question left, I'd have called my doctor. I've talked with my doctor about when to call for help, and developed a check list from that discussion. With that list, I now feel that I can determine if I need to seek immediate care, even if anxiety and panic are rearing their ugly heads.

Please, remember Abi, and don't take unnecessary chances.

Live well,

PurpleRibbonTiny Teri1

 

 because a migraine is NOT "just a headache"

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Migraine Gem - Complex or Complicated Migraines

MigraineGemsPurpleThere are several forms of Migraine, and an accurate diagnosis is important. Some medications shouldn't be taken with certain forms of Migraine. How can a person know which medications are right for them and how to take care of themselves if they don't know what type of Migraines they have?

Many people are told they have "complex" or "complicated" Migraines. Sometimes, the doctor uses those words as descriptive terms, not a diagnosis. Other times, however, doctors use them as diagnoses, and that's a problem.

To find out why that's a problem and more about the different forms of Migraine, take a look at Complex or Complicated Migraine - What Are They?

Live well,

PurpleRibbonTiny Teri1
 

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© Teri Robert, 2013
Last updated October 14, 2013.

 



Migraine Gem - Sinus Headache?

MigraineGemsPurpleMany people think they have sinus headaches, and unfortunately, some doctors even misdiagnose people with sinus headaches.

The reality is that sinus headache is rare without a sinus infection. Research has shown that the vast majority of what people think are sinus headaches are actually Migraine attacks.

You can find more information on this in Sinuses Giving You a Headache? It's Probably a Migraine.

Live well,

PurpleRibbonTiny Teri1
 

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© Teri Robert, 2013
Last updated September 28, 2013.



Migraine Gem - Harry Potter and Migraines?

MigraineGems190In 2007, based on the evidence in the first five Hary Potter books, Dr. Fred Sheftell and Dr. Timothy Steiner diagnosed Harry Potter with possible Migraine.

In 2010, Dr. Sylvia Mohen and Dr. Matthew Robbins reviewd that diagnosis and the additional evidence from the last two books in the series. Mohen and Robbins arrived at a different diagnosis - nummular headaches.

You can read more about how they arrived at their diagnosis and about nummular headaches in Harry Potter - Migraines or Nummular Headaches?

Live well,

PurpleRibbonTiny Teri1
 

Make a difference... Donate to the 36 Million Migraine Campaign!

 

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© Teri Robert, 2013
Last updated September 23, 2013.



Migraine Gem - Delayed Diagnosis

MigraineGems190If you have Migraines, how many times did you see your doctor before being diagnosed? How many tests were run? How many doctors did you see before receiving an accurage diagnosis?

It takes some people years and seeing multiple doctors to get an accurate diagnosis.

Check out the interesting results of a study about why proper disagnosis is so often delayed in Why Is Migraine Diagnosis Delayed?

Live well,

PurpleRibbonTiny Teri1
 

Make a difference... Donate to the 36 Million Migraine Campaign!

 

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Page copy protected against web site content infringement by Copyscape

© Teri Robert, 2013
Last updated September 16, 2013.