Three types of migraine
Acephalgic migraine
"Acephalgic" means "without head pain". Thus an
acephalgic migraine is a complex of neurologic symptoms without a headache. About 5% of
migraine headaches fall into this category. These episodes may easily be confused with
strokes or transient ischemic attacks (TIAs). As with classic or
common migraines, symptoms may include partial loss of vision, loss of strength, loss of sensation, difficulty with speech and memory or any other neurologic function. The cause of the symptoms is thought to be spasm of arteries in the brain, thus interrupting blood flow to segments of the
brain. These symptoms may be eliminated by the same treatments used for other types of migraines.
Basilar migraines
Basilar migraines are very similar to
acephalgic migraines, but are associated with headaches. They may initially manifest by total blindness, confusion, inability to speak, double vision or vertigo. The confusional states may last from several hours to several days although most symptoms are over in half an hour.
Cluster headaches
Cluster headaches are a variant of
migraines that have a seasonal or periodic nature to their occurrence. Unlike other types of migraines, men are more commonly afflicted than women (8:1 ratio). Cluster headaches comprise about 5% of all migraine type headaches. An individual may be free of any headache symptoms for months or years, and then have a period of time (usually several weeks) when they are afflicted by up to several headaches per day. The headaches are often very intense, associated with eye pain and involuntary tearing. The pain is confined to only one half of the head, usually behind the eye and in the temple. Rather than being throbbing and building over time, they are usually explosive in onset, deep and continuous.
Cluster headaches last one to two hours and may occur several times a day, every day for several weeks. Frequently, they may occur at the same time every day. The treatment of cluster headaches varies from that of other migraines. The usual medication to prevent migraines, beta blockers, do not help. Lithium, a medication usually used for manic-depressive syndromes, seems to be most effective. Sansert is also used for cluster headaches. Alcohol precipitates the majority of initiation of cluster headaches, but not the recurrences.
