Neurology

[ANNKOR70]

What are the different types of migraine?

headache back of head with it traveling down the left side of neck. What type of problem could this be?

[Dr Santos]

Hi,
How are you? Marilee has discussed migraine very well. Tension-type headaches usually present with dull, non-throbbing pain, associated with tightness of scalp or neck.The degree of severity remains constant and usually attributed to emotional stress. On the other hand, this can also be caused by inflammation of the blood vessels of the head or bony changes in the structures of the neck. Anti-inflammatory drugs and muscle relaxants may help provide relief. But if it persists, have this checked by your neurologist for proper evaluation. Take care and do keep us posted.

[marileew]

Hi ANNKOR70,

There is really only one type of migraine. Migraines are primary headaches, that means that they are not caused by any other (non-migraine) disease, illness or injury. Migraines are a disease on their own and migraine headaches are one symptom of the disease.

There are 4 phases of a migraine headache:
- The Prodrome. This phase may or may not happen. It's the start of the migraine and the symptoms are non-specific. Symptoms can vary from person to person and might include: fatigue, food cravings, mood changes or neck pain. Many other symptoms could be part of the Prodrome of a migraine.
- The Aura. Only 20% of people will get an aura. Aura are often visual, and people may see sparking lights or get blind spots. Auras can also include numbness, tingling, paralysis or vertigo.
- The Headache. Although most people get a headache, not everyone does. It is still a migraine even without the headache. Other symptoms include: sensitivity to light or sound, nausea or vomiting, running nose, stuffy nose, feeling too hot or feeling too cold.
- The Postdrome. A lot of people refer to this as a "migraine hangover" because it can feel very much like a hangover. It can last for 24 hours after a headache. Like with all the other phases, not everyone experiences this.

Everyone who has migraines will experience at least one of these phases or a combination of the phases. Some people only get stroke-like symptoms but no headache. Some people get a visual aura but not headache. Children often will only vomit but will not get a headache. Some people only get a headache and they feel find before and after. Some people experience all 4 phases. The symptoms can very from person to person, but it's the same disease.

In the same way that migraine symptoms can very from person to person, so can the headache symptoms. Most people experience the headache on only one side of their head, usually close to their eye. But there are lots of people who experience a migraine headache on both sides of their head or on the top of their head or in the back of their head. Regardless of where the pain is, it is still the same disease.  

If your doctor has told you that you have migraines, you likely have migraines. There is no need to be concerned though, it is a genetic disease that some people are just born with. Migraines are not life-threatening. There is no cure but there are many successful treatments. Everyone with migraines should have an acute treatment plan, and it is often a good idea to have a preventative treatment plan as well. You and your doctor can create a treatment plan that works well for you.

If you haven't been to a doctor, then you should go to a doctor for a proper diagnosis of your headache. It may not be a migraine at all. There are two types of headaches: primary headaches and secondary headaches.

The symptoms you described sound much more like a Tension Headache. This is a primary headache just like a migraine is a primary headache, but a tension headache is not a migraine! If you have tension headaches, a doctor can give you tips on how to prevent them. Reducing stress is one way to prevent them. Exercise and better posture is another way to prevent tension headaches. A doctor could also suggest over-the-counter or prescription medications that will stop a tension headache once it has started. Only a doctor can tell you if your headache is a tension headache or a migraine.

Secondary headaches are a symptom of disease, illness or injury. Grinding your teeth at night can cause a secondary headache called a TMJ headache, and a dentist can give you suggestions on how to prevent a TMJ headache or they can preform surgery in hopes that the headaches will stop. Injury to the back or neck can also cause headaches, and if you have had an injury it is important to go to the doctor to get an X-Ray, CT scan or MRI so that you will know what to do to prevent further injury and so the doctor will know if surgery is necessary.

If you think you have migraines though, and you haven't seen a neurologist yet, then the best thing to do is book an appointment with a neurologist. A neurologist will be able to rule out other causes and will be able to give you a proper treatment plan to prevent or stop your headaches.

Hope that information helps!

- marilee